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2021-11-12 06:13:30 UTC

If I maintain good control over my blood sugar levels, lose weight, exercise, eat healthily.. can I ever be diabetic-free? Is it possible to reverse my diabetes status? I am a newly diagnosed diabetic

2021-11-12 02:58:45 UTC

What is the optimal range of blood sugar levels for pre meals and post meals?

2021-10-28 11:14:05 UTC

I have silent reflux which made my voice so breathy and weak and I can not speak like before Is there any hope for my voice to be like before or this problem is permanent????

I have LPR or silent reflux and I seek a good diet for some weeks But my only concern is my voice...

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2021-11-12 14:43:29 UTC

Dr. Tunn Lin Tay

Hi @Kaose07">@Kaose07 , some patients may be able to have their type 2 diabetes go into remission. It depends on how severe the diabetes is and how long the...

2021-11-12 13:15:35 UTC

Dr. Tunn Lin Tay

Hi @Kaose07">@Kaose07 , ideal blood sugar reading pre meals should be between 4-7 mmol/L. Post meal sugar levels should be <10 mmol/L. If these targets can be consistently met...

2021-11-11 02:01:26 UTC

Dr. Lim Keng Hua

If your ear pain is persistent despite ear drops and pain killers, please see a ear specialist or ENT specialist. The infective material trapped within the ear canal may need...

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Dr. Chun Hai Tan

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Gastric Balloon or Intragastric Balloon Treatment: How Safe and Efficient? There are several types of intra-gastric balloons in the market. Some intragastric balloon require the patient to have an endoscopic guided insertion of the gastric balloon. This procedure is usually done under sedation. A complete upper gastrointestinal endoscopy is performed to exclude cancer, presence of ulcers, stomach abnormalities that will cause any problems if an intragastric balloon is inserted. Another newer type of intragastric balloon now do not require endoscopy. It can be swallowed, and remains inside the body for a period of time before spontaneously deflate by itself. The deflated balloon is then passed through the gastrointestinal tract and passed out of the body.Intra-gastric Balloon Insertion: Is it Safe? Currently, the intra-gastric balloon is a safe and effective option between diets and exercise programs to bariatric and metabolic surgery, with about half of the patients maintaining their weight after the balloon is removed.The possibility of severe side effects like a perforation in the oesophagus, stomach or small intestine, severe bleeding are not common.Intragastric Balloon: Treatments and ProceduresBefore we discuss the treatment and procedure of intra-gastric balloon, you should first learn the proper preparation if you're going to have an intragastric balloon placed in your stomach. During your consultation, your healthcare provider will give you specific instructions on preparing for your procedure. In addition, a variety of tests and exams may need to be performed before the procedure.During the time leading up to the procedure, you may need to limit what you eat and drink and any medications you take. Additionally, you may need to begin a new exercise program.Below is the step-by-step intragastric balloon procedure:1. The consultation -- In addition to discussing your physical fitness goals, the providers will outline the procedure in detail.2. A history and physical examination, a psychological evaluation, and a nutritional evaluation -- you must undergo diagnostic tests so that they can determine whether or not you are eligible for this procedure.3. Inserting the intragastric balloon a. Depending on the type of intragastric balloon used, your bariatric surgeon may or may not perform and endoscopic procedure for you. b. For the intragastric balloons that require an endoscopy, it will be used to guide the balloon into the stomach. The procedure typically takes 30-40 minutes. This is done under sedation. The balloon typically stays within the stomach for a period of 6 to 12 months. c. The the newer type of intragastric balloon, an endoscopy may not be required. Speak to your doctor to discuss your options. 4. Removal a. Similar to insertion, balloon removal is an outpatient procedure, and ongoing support is provided for up to six months once the balloon has been removed from the stomach. b. The newer type of balloon typically will deflate on its own at around 4 months. It is then passed out from the body on it’s ownHow much weight can you lose after having Intragastric Balloon Treatment?Often, you will eat less because you will feel full faster with an intragastric balloon or others called weight loss balloon than you would normally. It may be due to the intragastric balloon slowing down the process of emptying the stomach. The stomach balloon may also affect hormone levels that regulate appetite.Changing your lifestyle habits, such as diet and exercise, can also affect how much weight you lose.During the first six months following intragastric balloon placement, weight loss may range from 7% to 15%, based on the summary of currently available treatments. Typically around 30 to 47 percent of the excess weight is lost.Intragastric Balloon Insertion: What should you Expect Before and AfterDuring the process of IGB procedure:Intragastric or gastric balloon surgery is performed as an outpatient procedure in the endoscopy unit. A medical expert will administer a sedative before the procedure.The doctor inserts a thin catheter (tube) with the balloon into your stomach during the procedure. After that, your doctor will advance an endoscope - a flexible tube equipped with a camera - down your throat and into your stomach. When your doctor fills the balloon with saline, they can see the balloon through the camera.It takes about half an hour to complete the procedure. Following the process, you are usually able to go home one or two hours later.For the newer balloon, the procedure will also be performed in the endoscopy suite. It is done in the similar fashion except that no scope is required for the insertion. Speak to your bariatric surgeon for more details.After the procedure:Drinking clear liquids can be done approximately six hours after surgery. It is usually recommended to keep the liquid diet until the second week when you can begin eating soft foods again. Then, within about three weeks of having an intragastric balloon inserted, you can start eating regular meals. Your doctor’s multidisciplinary team of dieticians will aid you in your recovery phase. An endoscope is used to remove the intragastric balloon after it has been in place for 6 months. Depending on your and your doctor's plan, you may or may not need a new balloon at that time. For the newer balloon, you will be passing the deflated balloon out. In addition to meeting with your dietician after your procedure, you'll have regular consultations with your medical team.Side Effects of Intragastric Balloon InsertionIt is not unusual to experience nausea, vomiting, and abdominal pain for a few weeks following the insertion of the device. In rare instances, a balloon rupture or balloon migration may occur. Before undergoing the procedure, you should discuss the risks and benefits thoroughly with your provider. It is very important to keep yourself well hydrated during this period of time. Dietary Guide After Intragastric Balloon InsertionThis information is a must since it will guide you through step-by-step dietary steps after gastric balloon insertion. The transition from fluid to solid phases is essential to prevent nausea, vomiting, discomfort, and other unpleasant side effects. However, it means that you should not skip any stage.Initially, a modified texture diet needs to be followed for two weeks before returning to a regular texture diet. There are four stages to the diet:FluidsThe pureeSoftRegularStage 1 - Soft fluids for a weekAs soon as you can, you can start to sip fluids. However, to achieve the most success after the IGB procedure, wait for about 30 minutes after you eat before you take a drink. Then, throughout the day, try to sip small amounts of fluids.Stage 2 - puree foods only for about 4 daysAt this stage, your food should consist of entirely smooth non-bits food. You can use a blender or liquidiser to create puree food. The reason is for your food to pass easily through your stomach.It would be better if your food is rich in protein to keep you full longer.Stage 3 - fork-mashable and soft foods for three daysSoft foods generally have a well-cooked consistency and can be easily mashed with a fork. At this point, a blender isn't necessary.Stage 4 - you can eat your regular foods (starting from day 15 onwards)After day 15, you may gradually introduce normal texture foods to your diet, and your diet will become more varied.Eating three regular meals a day and avoiding a long gap between meals is a good idea.Final WordsFor the first week following your procedure, we recommend maintaining light exercise, such as walking. Then, two weeks after surgery, you can slowly return to your regular workout routine. It shouldn't take you longer than a month to train regularly without limitations after the procedure. A balloon weight loss procedure may not result in a significant weight loss or weight regain even when performed correctly. In addition, if you don't change your lifestyle, you are more likely to gain weight. To avoid regaining weight, you should always make healthy changes to your diet and engage in regular physical activity. Speak to your bariatric surgeon who works together with a multidisciplinary team to enhance your success

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Orthopaedic & Sports

Dr. Ken Jin Tan

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Hyperextended Knee: Symptoms, Treatment, Recovery Time Your knee is said to have hyperextended when it bends backward, causing pain and swelling. Most of the damage can happen in two ligaments: ACL (anterior cruciate) or PCL (posterior cruciate) ligament which connects your shinbone with thigh bone. These ligaments help stabilise the knee for movements, rotation and pivoting.Is it possible for a hyperextended knee to recover on its own?It might take months before your knee regains its full mobility and is pain-free. After a hyperextended knee injury, most children and adults may resume their typical activities if the pain goes away quickly. If you have a slight sprain, you will recover more quickly than if you've had a more significant injury.Individuals may be able to resume their athletic activities. However, a serious knee injury may restrict how much farther they may exert their muscles.Healing takes longer in older people. They may also have persistent pain or tightness in their knees. Exercise can help to reduce this.If some sports or activities put your knee at risk of damage, you may need to cease or decrease your involvement. Also, until you've fully recovered, avoid or postpone explosive sports like basketball or skiing.What are the early symptoms of Hyperextended Knee?A hyperextended knee is usually simple to spot. The leg is bent upwards outside its normal posture of straightness and the knee is bent backwards. A hyperextended knee is accompanied by several distinct symptoms.The most evident sign is pain. The pain is strong, severe, and concentrated around the knee, which is where the damage occurred.Most people will hear or experience a snap in their knees when they are injured. This "clicking" sound is a strong indicator that the discomfort you're experiencing is caused by a hyperextended knee.Bruises emerge around your damaged knee shortly after the accident happens.Your mobility is hampered by a hyperextended knee. You discover that you would be unable to move your leg normally.You can also observe a build-up of fluid in your knee joint. It begins to bulge. Any movement is highly unpleasant in this condition known as "water in the knee."The discomfort may be less intense in less serious instances. However, if you experience weakness in your knee and a continual sense of folding, you might well have a hyperextended knee.Hyperextended Knee: Causes, Treatment, and Recovery TimeCauses"Why do you develop a hyperextended knee?", you may be wondering.When your knee joint ligaments are overworked, your knee hyperextends, or moves outside of its normal range of motion. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) are the most often damaged ligaments.Sports and accidents are frequently associated with the types of forces that cause hyperextended knees.While direct strikes to the knee are possible, twisting or straining injuries (hyperflexed/hyperextended) are more common, putting the joint through a larger range of motion than it was designed to handle.Kinds of TreatmentsAlmost every knee injury will necessitate many medical visits. If surgery is not required, RICE (rest, ice, compression, and elevation) along with some stretching exercises and maybe rehabilitation will be required. The option to have surgery is sometimes postponed to see if RICE and physical therapy are beneficial. Each injury is different, and treatment options are determined by the expected level of function. A damaged ACL (anterior cruciate ligament) in a sportsman or worker, for example, would normally require surgery, but in an 80-year-old who is not particularly active, the ACL might be rehabilitated nonoperatively with physical therapy.Most knee injuries that require surgery may now be repaired successfully using an arthroscope, which uses a camera to assess the damage and tiny punctures in the knee to implant equipment to heal the injury. Within days following the operation, patients commonly begin post-operative rehabilitation.Time for RecoveryThe time it takes to recuperate from a knee injury varies depending on the kind of damage and might range from days or even weeks for a sprain to months for anterior cruciate ligament repair surgery.How to prevent Hyperextended Knees?Here are some but effective preventive measures against hyperextended knee:Become more aware of your knee positions as you go about your daily tasks.When you're in a static position, make sure your knees are aligned properly. When standing, for example, avoid locking out the knee; when seated, avoid resting the ankles on a footstool since this causes the knee to sink into extension, stretching the posterior tissues.When doing dynamic duties like rising from a seated position or stair climbing, make sure your knees are properly aligned.Practice single-leg balance with the knee in good alignment to enhance proprioception.Consider preventing hyperextension of the knees while in sports, especially ones that involve pressure, such as leaping.Exercises and stretches that drive the knee into extension should be avoided. Standing hamstring and calf stretches, for example, should be done with caution.When to See a Doctor?If a knee injury does not improve with regular home treatment, such as rest, ice, compression, and elevation (RICE), medical help should be explored. Frequent pain and discomfort are two more indications that may indicate the need for medical attention.Final WordsPeople who have a hyperextended knee injury may fully heal after their accident. For the greatest chance of a complete recovery, a person should seek medical assistance as soon as possible after an accident and follow all treatment recommendations.Resting might be tough for athletes and energetic individuals, but it is essential for a full recovery from a hyperextended knee.Exercising and stretching can help to lower the chance of developing a hyperextended knee. It is critical to have strong muscles surrounding the knees. Stretching is also important before and after exercise, while the muscles are warm.

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Dr. Chun Hai Tan

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How Does Bariatric Surgery Help with Diabetes? Bariatric surgery is a treatment for obesity and diabetes that has been found to be durable, safe and successful. After the patient undergoes bariatric and metabolic surgery, they experience significant weight loss as well as improved glycemic control in most cases because of enforced caloric restriction combined with enhanced insulin sensitivity or increased secretion of this hormone by their liver cells due to requirements from less food intake than before surgery. Decrease in the appetite hormone, calorie restriction, alteration of the body set point in metabolism are just some of the many mechanisms of body changes after bariatric and metabolic surgery, that contribute to improvement in diabetes control.The Role of Bariatric Surgery on DiabetesThe use of bariatric surgery against obesity and type 2 diabetes mellitus (T2DM) is on the rise. A recent study suggests gastrointestinal manipulation can induce T2DM remission in patients with T2DM (metabolic surgery), especially given the digestive tract's importance in metabolic regulation. There are several mechanisms by which bariatric surgery for diabetics may modulate weight loss-independent effects, including changes in insulin sensitivity, intestinal glucose metabolism, and brown adipose tissue metabolism. Recovering After the Bariatric SurgeryHospital Recovery:Following bariatric surgery, patients usually spend one to two days in the hospital, or longer if complications arise. Most of bariatric surgeries are done via laparoscopic method (“Key hole” surgery), hence leading to a shorter period after their surgery.After surgery, your nurses will keep an eye on you in your hospital room. Your nurses will monitor your vital signs, such as blood pressure, pulse, temperature, and respiratory rate, as well as encourage you to perform breathing exercises, coughing, leg movements, and get out of bed. Doing these exercises can help lower your risk of complications. Please notify your nurse if you have any symptoms of nausea, anxiety, muscle spasms, altered breathing patterns, or increased pain. You will be able to walk around your room on the same day of surgery.Within a few days, most people are feeling ready to return to their normal activities after weight loss surgery. Keep in mind, though, that you've undergone a major operation and should take things slowly for a few weeks.Wound:Waterproof dressings will be applied to the small wounds on your abdomen after the operation. It is advised to keep the dressing on for a few days after the surgery (only change it if the wound oozes or the dressing has lifted and become non waterproof). When that happens, the wounds are usually healed enough to be left uncovered. Stitches are usually dissolvable. From the day following surgery, you can bath or shower as usual. Whenever you notice pain, redness, swelling, or pus you should go and see your Practice Nurse for a wound check.Exercise:In addition to getting enough sleep and drinking plenty of fluids, gentle outdoor exercise is important. Your exercise should slowly increase until you are walking for 30 minutes a day. As you walk, you should be able to feel your breathing getting short and your body becoming sweaty.Driving:As soon as you can wear a seatbelt comfortably and stop in an emergency, you can drive. For specific information regarding driving after keyhole surgery (laparoscopic surgery), check with your insurance company. After surgery on the abdomen, you should not lift heavy objects for two to three months.Home recovery:Based on your progress, your surgeon will determine when you can leave the hospital. Your surgeon and his team of dietitians will provide specific instructions about what to eat, what to do, and when to notify them. Speak to your nurse or discharge coordinator about any concerns you might have about returning home.Plan to take things easy once you get home. During the recovery period, your body will recover from major surgery and loss of weight.Bariatric Surgery: What is the Benefit to Diabetics?With type 2 diabetes or obesity, this type of diabetics surgery can be an effective way to lose weight.Obesity, in fact, has a strong link to the risk of acquiring type 2 diabetes. If a patient has diabetes, their doctor may suggest that they lose weight as part of their therapy.Bariatric surgery for diabetics is a type of weight loss surgery that experts prescribe for those people who are obese. They're also frequently suggesting it as a treatment for diabetes (type 2) in obese persons. This will reduce the risk of cardiovascular problems such as stroke or heart attack in the future. People who are worried about their health due to obesity and or diabetic patients should strongly consider bariatric and metabolic surgery to reduce their risk of future health issues. Is Bariatric Surgery the Answer to Diabetes?Doctors nowadays highly recommend bariatric surgery and patient with diabetes can significantly benefit from it. Bariatric surgery is now one of the fastest-growing surgical interventions around the world. The two most common bariatric and metabolic surgery done in Singapore are sleeve gastrectomy and Roux-en-Y gastric bypass. Discuss with your Bariatric surgeon to see which one is more suitable for you. Each and every patient is different, your bariatric surgeon will discuss which procedure is more suitable for you. Previously, this kind of surgery was reserved for severely obese people with life-threatening obesity. Doctors now consider surgery as a new option for treating type 2 diabetes in individuals struggling not only with their weight, but also their diabetes and other health problems. There is now strong evidence that surgery may cause some patients with diabetes to go into remission, and stay in remission for a prolonged number of years. They can also slow or stop the progression of type 2 diabetes and their complications.Bariatric Surgery for Type 2 Diabetes: Weighing the Impact for Obese PatientsAn important concern about using bariatric surgery to treat type 2 diabetes is the risk of morbidity and death associated with these procedures.The cardiovascular risks of continued obesity and type 2 diabetes must be considered along with the mortality rate after bariatric surgery. There is now strong scientific evidence that suggests bariatric surgery can increase lifespan, and reduce the patient cardiometabolic risk factors for future health problems.When To Consult A Doctor?There are several situations or conditions that a bariatrician can assist with: ● Weight loss is a priority for you, so you're willing to make lifestyle adjustments.● Various weight loss programs you have been trying on your own haven't succeeded.● If you have diabetes and coronary artery disease (CAD) as well as high blood pressure, then you have two or more risk factors for serious obesity-related complications.● You seem out of control when you overeat and feel distressed.● You have a BMI greater than 27.5kg/m2.Men have waist circumferences larger than 40 inches, women have waist circumferences larger than 35 inchesFinal WordsDespite the benefits of bariatric surgery for diabetics, all weight loss surgeries are major procedures carrying serious risks and potential side effects. Additionally, you must commit to making permanent changes to your diet and getting regular exercise to make sure your bariatric surgery for diabetes is successful long-term. Speak to your Bariatric surgeon who uses the multidisciplinary approach to improve your success after surgery

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Dr. Tunn Lin Tay

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Blood Glucose Monitoring: Purpose and How it Works Sometimes, a simple blood sugar test can be all you need to get on the right track with diabetes management. Your doctor may order this so they can see if your body is functioning properly and what might need adjusting for optimal health outcomes.The information from this procedure will help them diagnose any problems that could arise in an already complicated medical condition like type 1 or 2 diabetes, but also how best to approach managing symptoms at home through meal planning tips and adjustment of diabetes medications!What is Blood Glucose Monitoring?Diet, exercise, medications, or pathological conditions known to increase blood sugar levels such as diabetes can affect blood glucose levels. Monitoring blood sugar levels looks for patterns in those fluctuations. Blood glucose levels that are unusually high or low can result in acute and chronic, life-threatening conditions. A capillary blood glucose (CBG) test is conducted in the home as part of blood glucose monitoring. In contrast, venous blood glucose tests are commonly performed at clinical facilities.Whichever you prefer, the importance of blood glucose monitoring cannot be underestimated in any of the situations. You have to conduct a regular monitoring system of your blood glucose level to manage your type 1 or type 2 diabetes.What does Blood Glucose Monitoring do?Blood glucose monitoring is an essential element of diabetes management. You will have more information about how food, exercise, stress, and other factors influence your diabetes by identifying and recording changes in your blood sugar levels.What device should be used in Blood Glucose Monitoring?In order to manage diabetes effectively, it is essential to check blood sugar levels regularly. Blood samples are usually required to monitor blood sugar levels. At home, there are several devices available for monitoring blood sugar levels. Using a small tool, they prick your skin to take a blood sample. Next, glucose levels in the blood are measured using a small device called a glucometer.Pricking your finger can be painful and difficult. There are several devices not requiring a blood sample that is now in development. However, some of these blood sugar monitors without finger pricks are not FDA-approved. Blood sugar is measured using one of these methods and are not licensed yet to be used:● A forearm or finger is illuminated by infrared light● Blood is drawn up through the skin using low-level electricity● Tears or salivaThe devices which do not require fingerpricks but are well-recognised to be of considerable accuracy and used frequently are using technology that checks interstitial glucose – the sugar level within the fluid of our skin. These include continuous glucose monitoring devices or flash glucose monitoring devices like the Abbott Freestyle Libre sensors. These devices are placed under our skin for 7-14 days either over the arm or the abdomen and allows us to track glucose readings continuously the whole day.What are the risks and side effects of a blood sugar test?The risks and side effects of a blood sugar test have minimal to none. However, if you’re drawing blood from the vein, it is normal to experience soreness, bruising, and swelling on the spot of a puncture. Usually, it will clear up after a day or two.Fingerprick readings using glucometers do not have risks but again, soreness from the area of the fingerprick would be experienced.Continuous glucose monitoring or flash glucose meter readings are also very safe and will avoid pain from regular fingerpricks. However, there can be skin irritations from the site of these sensor insertions. Most patients do not have much issues with this.Final WordsYou can easily monitor your blood glucose level on your own. Blood glucose monitoring can be part of a healthy dietary or diabetes maintenance routine to log your blood glucose level.Depending on the type of diabetes you have and your treatment plans, your doctor will advice if regular glucose monitoring is required and it will help them and help you get better diabetes control when you know your glucose readings on a day-to-day basis.

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Hypertension causes and treatment Do you want to live a healthy and disease-free life? Then try to maintain your blood pressure within a normal range (A healthy blood pressure is below 120/80 mmHg). Hypertension (commonly known as high blood pressure) is a disease in which the pressure of the blood against the artery walls becomes so high, that it leads to heart disease, stroke and other diseases. Blood pressure is determined both by the volume of blood your heart pumps and the resistance to blood flow in the arteries. Hypertension is commonly asymptomatic - you may feel perfectly normal. However, symptoms such giddiness and headache may appear if blood pressure is very high.There are generally 2 types of hypertensionPrimary hypertension:Usually, there is no detectable cause of hypertension. This type of hypertension is known as primary or essential hypertension and usually develops slowly over many months or years. This is the most common type of hypertension. Secondary hypertension:Some people have hypertension due to underlying causes. Such secondary causes include kidney disease, sleep apnoea, tumors of the adrenal gland, thyroid disorders, some medicines including pain relievers, oral contraceptives and recreational drugs such as amphetamines and cocaine.Are you at risk of hypertension?Anyone can develop hypertension, but some factors increase the risk of developing high blood pressure, namely:Age: As you grow older, your blood vessels lose their flexibility due to the reduction of elastic tissue in your arteries. They become harder and stiffer, which increases blood pressure. Weight: If you are overweight (BMI > 23), you are at higher risk of developing hypertension as compared to normal-weight individuals.Family history of hypertension: Having first degree family members with hypertension puts you at greater risk of developing hypertension.Sedentary lifestyle: A sedentary lifestyle is a risk factor for hypertension. It can also lead to weight gain which can also lead to hypertension.Diet: A diet high in sodium (table salt) increases blood pressure.Smoking: Tobacco and nicotine increases blood pressure.Complications of hypertension:Common complications of hypertension are kidney failure, heart attack, vision loss, metabolic syndrome, peripheral artery disease, stroke, dementia and erectile dysfunction. It is also known as a ‘silent killer’ in that it usually does not cause bodily discomfort, but gradually lead to long term and severe complications, which may result in death.Screening and diagnosis:Screening for hypertension is done through an automatic or manual sphygmomanometer (blood pressure machine). The World Health Organization recommends annual blood pressure screening for people aged 40 years and above. You can get your blood pressure checked by a doctor or trained healthcare professional at a clinic or with a home blood pressure monitor. A blood pressure monitor with upper arm cuff is preferred. It is important to check home blood pressure because 10-30% of people have white coat hypertension – these people have normal blood pressure at home, but elevated blood pressure whenever they are in a clinic or healthcare setting.The following diagram shows you how to check your blood pressure properly at home. (diagram taken from 2020 International Society of Hypertension Global Hypertension Practice Guidelines)Hypertension management:High blood pressure is treated through medications, diet, and lifestyle modification. Generally, treatment is needed when your blood pressure is consistently above 140mmHg systolic OR above 90mmHg diastolic.1. Medications:Common medicines for hypertension include angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), beta-blockers, calcium channel blockers and diuretics (drugs that help your kidney to remove extra water and sodium from the body). These are easily remembered as ABCD. Depending on the severity of hypertension, most doctors will prescribe one to two medications or a combination pill containing two medications. 2. Diet and HypertensionDietary Approaches to Stop Hypertension (DASH) diet is one dietary plan aimed at reducing blood pressure. It focuses on reducing salt intake, and taking more vegetables, fruits, lean protein and whole grain. You can reduce your salt intake by:- Cooking with less salt and sauces. Instead enhance the taste of food with herbs and spices- Avoiding preserved and salted food like salted eggs, luncheon meat and sausages- Asking for less sauce and gravy when eating out- Choosing fresh food over processed foodOther beneficial foods include those high in magnesium, calcium and potassium such as avocados, nuts, seeds and tofu.HPB (Health Promotion Board) has introduced an approach to healthy eating called My Healthy Plate. Quarter, Quarter, Half is an easy way to remember the right proportions of food in a well-balanced healthy meal:- Quarter plate of whole grains- Quarter plate of healthy source of protein- Half plate of fruits and vegetables3. Lifestyle modifications:Maintain a healthy body weight:Maintain a healthy body weight with an active lifestyle and healthy diet. Aim for a BMI (Body mass index) below 23 (for Asians). The formula for BMI is weight in kilograms divided by height in meters squared. Do regular exercise:An active lifestyle is important in maintaining healthy body weight and preventing hypertension. Aim for 150 minutes of physical activity per week. Lifestyle activities like mopping the floor and climbing stairs also count towards the 150 mins weekly goal. Generally, moderate intensity aerobic exercise such as walking, cycling, jogging and swimming are beneficial in the prevention and treatment of hypertension.Limit alcohol consumption:Too much alcohol intake can put you at risk of hypertension. It is also harmful to the liver. The recommended daily limit for alcohol consumption is 2 standard drinks for men and 1.5 for women. Stop smoking:Being a smoker increases your risk of developing stroke, heart diseases, lung diseases, and high blood pressure. Quitting smoking will reduce your blood pressure. If you already have high blood pressure, quitting smoking will lower your risk of developing complications such as stroke or heart attack.Manage stress and anxiety:Stress and anxiety may contribute to high blood pressure. Proper management of depression, anxiety, and stress help in lowering blood pressure. You can manage stress with proper counseling, adequate sleep, a healthy diet, and exercise. Some studies have shown that practices like mindfulness and meditation have beneficial effects in lowering blood pressure.Take home messages:1) High blood pressure often does not cause any symptoms or bodily discomfort.2) It is a silent killer. It can gradually lead to long term complications if it is not detected or treated.3) A normal blood pressure is about 120/80 mmHg4) Treatment is usually initiated when blood pressure is above 140mmHg systolic or above 90mmHg diastolic.5) If medications are warranted and prescribed, it is important to take them regularly every day. Hypertension is a long-term disease, so medications should not be stopped unless advised by the doctor.6) A healthy diet, lifestyle changes, exercise, smoking cessation and moderation of alcohol intake are all important aspects of blood pressure management.__This article is presented to you by GP+ Co-operative

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