VESICOVAGINAL (OBSTETRIC FISTULA) AND ITS SOCIAL IMPLICATIONS

VESICOVAGINAL fistula (VVF) is the commonest type of Obstetric fistula. It is very common around us. We just need to step down from our high horses and see the reality around us. The underprivileged people suffer a great deal due to poverty, ignorance and exploitation as well as the poor state of the health care system in Nigeria. 

VVF is a highly stigmatised condition caused by an abnormal opening between the bladder and the vagina. This leads to drainage of urine through the vagina from the bladder. It is usually caused by obstructed and unsupervised labour. It occurs mostly in people of low socioeconomic status. The condition is curable though surgical. There are some philanthropists and NGOs who help people with this condition. They pay for the surgery and rehabilitate the women.

Though the story below is fictional, it was inspired by true events. 

"So,this is how my life would continue," Seyi wondered. There seemed to be no end in sight to her problems. She wondered and wondered. She wished she could turn back the hands of time to a period when life was as simple a ABC. So much has changed since then.

Sixteen years ago, Seyi was born to her loving parents. Her father was a farmer while her mother was a housewife. She had all she wanted. Nothing much though! Food was always available. Not only in your house but also at the neighbours'. What of snacks? Hehehe! What will you do with 'Ever-militant Iya Agba'. She always had yummy snacks for all the village children. God bless her soul. Is it kulikuli, Kokoro, dodo, pongila, eekanna asa,monimoni or baba Dudu? Just mention it. Everything was available.

At age six, she was enrolled in the village mission school. Whenever she missed home, she would quickly take the path behind the school to her house where her mother would welcome her with tears in her eyes as if she didn't just leave that morning. Life was good!

Until one fateful day when she got back from school to see a crowd gathered in her compound. What could be happening? She dropped her slate and ran inside only to find her father weeping. "Baami, kilode, kilosele," she asked. Her father drew her closer and wanted to tell her something but Iya Agba quickly took her from him and backed her, rocking her to sleep. On waking up, Seyi discovered that her mother had died while trying to deliver a baby at Iya Agbebi's place.  Her mother had bled to death. She didn't really understand what was happening but she heard people saying that her mother had journeyed into the land of no return.

Two years strolled by. Her father had to remarry. Hmmmm! She was so excited. She was going to have a new mother. She looked forward to her stepmother carrying her and pampering her. Her joy new no bounds on the wedding day. After all she and Aunty Sikira were 5 and 6 already. What remained now was for life to go back to normal. Hopefully with brothers and sisters very soon and she would no longer be eleti kan. Ghengen ghengen. 

But haaaa! Aunty Sikira dealt with her. Kilode! It was as if the she was devil sent. She made life unbearable for her. Was it the beating for no just cause or chores to be done or the the lies she told against her. It was bad. Her father also became so distant. It was easier to talk to the king than it was to talk to Baami. The only time she succeeded in talking to him caused her more trouble. Ipadabo Abija Aunty Sikira was not funny at all. She tied her to a tree and beat her with seven-mouthed koboko. She then prepared a potion made with pepper and rubbed it all over her wounds. Hmmm! She thought she would die. Being a slave was better than being in this state.

This was her predicament until she met Lasun. He was an apprentice at Baba Igunnu's furniture workshop. He was very kind to her. He would give her food, help her carry load and run some errands. He seemed to understand her very well. It was a great relief to have someone care for her. She fell in love! Lasun was in love with her too. They couldn't get their hands off each other. They met daily behind the school fence and made love. They just couldn't wait to get married even though she was only 15 years old. Life was beautiful again. 

Suddenly, she was pregnant. She was not even remorseful. Ehn! Shebi that was her ticket out of her suffering. She could already see herself as the madam in Lasun's house. She sang happily as she packed her few clothes in a Bagco sac and moved in with him. What more could she hope for. Absolutely nothing! She was with the love of her life. Even though Lasun was an apprentice, he always had some change. They barely had enough but she was happy all the same.

When the pregnancy became advanced, one of her neighbours advised her to go to the hospital. She refused. Was it not Iya Agbebi that helped to deliver majority of the children in that village. Going to the hospital would just be a sheer waste of her husband's hard earned money. Iya Agbebi would do the job. Shebi the woman had told her to buy a pregnant goat and that if the goat delivered safely she would too. Was it not just the week before that the goat had triplets? Who supervised the delivery? Nobody! Haba! 

If only she had known. Her labour was not smiling at all. She laboured for three days! She was hysterical. Haaa! That pain was something else. It was after the third day that the Iya Agbebi decided she should be taken to the hospital when all her incantations and herbs did not work. How she got to the hospital, she did not know. The doctor then told them that the baby had died due to prolonged obstructed labour. The child was eventually brought out dead. It was so sad. But that was just the beginning of her problem. Her urine was leaking into her vagina. She could not control the urine. The doctor said she would need surgery to correct it and that it would cost a lot of money. What would she do now?! She looked at Lasun's face and saw rejection. Her heart broke!

When they got back home, she pleaded with her husband to help her. "Where do you want me to get the money", Lasun shouted. "At this point, if go no go, come go come. Shebi we are not kuku really married. It's better you just go back to your family jeje. Me that I am managing my life. I'm just an apprentice and my head is too young for this your Bukaata. Shebi the child don die. Ehn Ehn. Dey go o. Before I come back from the shop, leave my house if you don't want wahala, Smelly woman" he said and stormed out of the house.

"He didn't mean that, Seyi wondered. She would wait for him. Lasun loved her. He was only a bit angry. She cooked his meal and waited for him. Immediately Lasun sighted her, he was furious. He ran to her, kicked her and dragged her out on to the street. He ran back inside and threw out her clothes threatening to kill her if she came back. She cried and cried till she couldn't cry anymore. Where would she go? She decided to go back to her father's house but no one wanted to see her. They all covered their noses as she moved towards them. The stench of urine was too much for them to handle. Her stepmother closed the door in her face. No one would help her. She was rejected by everyone.

That was how she became a beggar. Maybe, only maybe she could raise the #20,000 needed for her surgery. "Life is cruel,"she said as she stood up to change her 4th urine-drenched wrapper.

The  end.

–

MATERNAL DEPRIVATION: THINGS WE PROBABLY DID NOT KNOW

When I was preparing for my exams, I had no time for anything else. Twenty four hours were not enough. There was just too much to read. I would stay back at work most times and even when I was home, I would lock myself in. I should not be disturbed for anything. My children was at the mercy of their nanny. At that time, passing that exam was more important to me than any other thing. My excuse was that I did not want to put my family through that process again.

After the exam, I had a malnourished child on my hands! It was not funny. Guilt enveloped me. I had neglected my child. I had to devote my attention afterwards to feeding the child and in no time, his weight was above the expected for his age.

That was my experience. There are other parts of Maternal deprivation that we may not know. I will shed light on them shortly.

Maternal Deprivation occurs when a child is deprived of maternal care, the effect of which is marked in the child's first three (3) years of life.

There are Four related types of Maternal deprivation:

-Mother-Child separation as occurs in divorced homes or maternal deaths

-Multiple Mothering: the child has different mothers caring for him. He does not have attachment to a particular person as occurs in extended family system 

-Distortion in quality of care: as in Overprotection and Child abuse.

-Institutionalization: examples are children in remand homes, Orphanages etc

OVERPROTECTION

ThIs occurs when the child is extremely pampered and inadequately disciplined. It occurs often in children who are the only offsprings of parents or of a particular gender that parents had been hoping for. It may also occur to children whose parents are very busy because the parents try to compensate children for their absence.

EFFECTS OF MATERNAL DEPRIVATION 

- Failure to thrive as the child may not grow adequately

- Feeling of abandonment

- Delinquency e.g Stealing, fighting, lying, aggressiveness

- Lack of concentration in studies

- Lack of compassion for others

- Improper behaviours

As usual, here's a story for your enjoyment. It is based on overprotection as a type of maternal deprivation.

Victoria had been married for 10 years without a child. She had never ever been pregnant. Not even from morning till night. . She was labelled a witch. In fact someone claimed that Victoria was the second in command in her witchcraft society and had contributed all her children there. What name was she not called. Many people deserted her. It was as though being barren was a communicable disease. It was terrible.

The doctors told her nothing was wrong with her. She should only be patient. The only saving grace she had was that her husband Kunle, was always on her side. If not for him, all these would have been unbearable.

Until a miracle happened that changed everything! She was pregnant. Wow! It was a long awaited blessing. After nine months, she was delivered of a healthy baby boy. However, she had complications after delivery. She had postpartum haemorrhage. The doctors then told her later that she could not have a child again! It hurt so badly but at least she had her baby. She named him Oluwaseyifunmi meaning "God did this for me".

Days rolled into weeks and moths into years, Seyi was now eight years old. There was nothing that money could buy that this boy did not have. He could even choose the kind of car to take him to school. He had two nannies at his beck and call. He couldn't lift his hand to lift anything. The servants were at his mercy. They had to be in his good books. If he didn't like someone, the person would be fired. 

Seyi was given the liberty of choosing what to eat. He almost always chose Chocolates, Bobo etc. he did not like eating Rice, yam, not to talk of Eba or Amala. Indomie was usually the other option. He did not like having a bath nor did he like brushing his teeth. Victoria would never tell him to do anything he did not want to do.

His grades in school were bad. Teachers were fed up with complaining. His mom had instructed them never to give him homework nor to correct him in school. No wonder he had repeated twice already. In fact he should have repeated again last session but because of the mom's huge donation to the school he was allowed to go to the next class.

As if that was not enough, there was no insult too large for his mouth. He had no respect for anyone. He was just a law unto himself. Kunle warned his wife saying, "A kin ke Omo kan ko di meji" meaning no matter how much you pamper a child, it can not increase the number of children you have.

One fateful day, Mom took him to the Zoo. The zoo guide had told them not to go into the crocodile's pond but because as usual, Seyi would never listen, he threw tantrums and jumped into the pond. He landed on an angry crocodile who opened his large mouth and bit off his leg. If not for the timely intervention of the Zoo guide, the other crocodiles would have eaten him up.

Victoria sat at her son's bedside in the hospital. Looking at his amputated leg, she wished she could turn back the hands of time and do things differently. She prayed and hoped it was not too late......

We might not have power over the causes of mother-child separation, Institutionalization or multiple mothering. But we do in the case of overprotection and child abuse. We owe it to our kids to train the right way as the Bible states in Proverb 22:6. It does not mean that we don't love them. In fact it's because we love them, that's why we should prepare them for the future. 

Hopefully next time, I will talk about Child Abuse. Thank you all for reading. Please share!!!

NIGERIAN RAPISTS: STOP DESTROYING OUR CHILDREN

Last week while discussing with my friend, Aunty Ameenah, we talked about how our girls have been exposed early to adult life and how many of them are being molested due to no fault of theirs. This reminded me of this wonderful piece written by a very passionate paediatrician, Dr Valentine. 

The write up was based on a true life experience that he had and with his permission, it's available on this blog with minimal editing. As parents, we have to be observant and sensitive to everything that concerns our children. I'm sorry if you find the story disturbing but know that the statistics of statutory rape is more disturbing than this story can ever be.

Thanks.

 "Sometimes ago, a 3 year - old girl was brought to my attention by the Nursing Sister on my ward. The mother complained of some discharge from girl's genitalia ("bum - bum") which made the Nurse to draw my attention to the swab* test result - also brought by the Mother. At first, I was not keen at seeing because I had closed for the day before this "over - caring" nurse started to trouble me. Good nurses are -"abaniwase baori"** really; so immediately, I asked the nurse to take the result of the swab to a junior doctor who would write out drugs based on the culture result available but she would not let me be, so I obliged.

Its not good to just write drugs for patient without proper examination (a reason why most doctors who had already closed for the daƴ would not want to see a new patient who is just arriving; 1 minute of your time may lead to a whole night of watchful waiting for a come - back effort if the patient suddenly slumps!), so I proceeded to check. It was a gory sight! The discharge coming from this child was offensive and unbelievable. The redness and pains on examining the child's "bum - bum" (vagina wall) was terrific! 

There were so many cuts:some fresh, some were healing. The mother bursted into tears and I struggled with mine anyway (I felt liƙe crying but I had to hold the tears before doctor pushes the patient's relative over the highest wall of emotions!)

Obviously, someone or something has been traumatizing this area! Anger and  nausea were an understatement for me. A 3 year old girl in a mess of unsolicited sexual assault! This is traumatic.

Did the girl entice her assailant? Did she wear provocative dresses too? Or had too much alcohol?

Rape is a forceful or non consensual  sexual contact or penetration of a victim's body with an object or the sexual organ. Penetration might be oral, anal or vaginally. Consent giving is an essential part of sexual relationship while lack of consent, use of threat, deception or coercion constitutes the sole hinge on which rape cases hang. 

The media recently has been reporting  sexual assaults or sexual abuse story "almost" on a daily basis. No, I am wrong. It is everyday that we read different versions: how a 70 year old man was seduced by a 12 year - old girl? Or how a 54 year old was claiming he had paid the dowry of a 14 year old girl and therefore could impregnate her? 

Even school Proprietors/Principals and even Vice Principals. We had thought the 'devil' - that habitual culprit - always "uses" the young school teachers only. Alas we were wrong, our protectors of children have become their tormentors. How does one save the child of an armed robber whose parent teaches pilfering and still  claims the sole propriety of his or her wards?

Rape is as common as Malaria nowadays. About 15 - 40% in certain studies in Nigeria.  When we are just recovering from Boƙo Haram anɗ still battling the Fulani herdsmen rapes of our women, girls and boys, here rapes intend to destroy our children!

What more can we say? This is because of unmanaged psychiatric illness or aberrant sexual behaviours. Either way, an adult who abuses a child is wicked, insane, afailure and/or a weakling!

Sexual intercourse involving 2 minors without consent, without equality or with coercion  is Child -  on - Child sexual abuse. In such instance, the older minor tricks or forces the younger minor into cooperation to carry out such acts. Often the older minor has been exposed to sexual activity by an adult or to Pornographic materials carelessly passed on by an adult. That in itself is a form of sexual abuse:when an adult keeps exposing a child to sexual events or activity. You can watch and monitor your maids or child minders again and again if you are looking for that abusive adult. Even some fathers and step fathers! Ha!

If an adult has sexual contact with a minor, it is a statutory rape. Even if the older person claims consent was given by the minor, it is not tenable and it is a criminal offence with jail terms if found guilty.

Children giggling and touching each other while playing may be having age appropriate sexual play that needs proper guidance and check. Normative Sexual play that is age appropriate, is not bad in itself because such children are still exploring their sexual self. They are easily distractable once they are called for errands or taking away from their friends. 

Normative sexual play is different from repetitive sexual behaviours like trying to kiss other children with tongue all out while playing or crudely demonstrating adult sexual movements with other children. This calls for caution and further probing. If a child likes to touch other children's genitals or liƙe to watch nude adults or peers, such a child must be evaluated for sexual abuse.

In the long run, a sexually abused child may become more anxious, may avoid the offender who often is a close contact(neighbours, teachers, minders, uncles and aunts), develops poor school performance, depression, poor appetite, poor weight gain, pains in the genitals (Mothers bath your dependant children everyday yourselves while you monitor the grown ups for subtle changes) and suicidal tendencies later on.

 Other signs of abuse and consequences are recurrent vaginal discharges in a prepubescent child or young adolescents (urinary tract infections can occur in young girls without sexual abuse especially with poor toilet training and or hygiene practices). Nevertheless, be concerned if your child keeps having stained under wears and genital pains.

Sexual abuse or rape is a cankerworm that can wreck our children's future so parents should become more concerned: if a child refuses to play with previously known and friendly adults or minders; parents  should not force their children to hug their relatives or neighbours as these children may not understand inappropriate touch or abuse; parents should not call their children someone else' s wife or husband especially when the person is older. Wait for the child to be a responsible adult and then can decide.

Parents should also monitor what their children watch. Some movies rated 14- or 16- are sexually explicit. Even some cartoons nowadays are not so harmless, they are suggestive.  Please be very observant and sensitive. Always listen to your children and pay close attention. If your child does not like someone, there must be a reason for it. Believe your children when they report to you. 

 Sexual education like "good and bad touches", "it is not okay for anyone to touch your genitals" and many more age appropriate sex education should be used. We should Stop sexualizing our children too. That make up, that dress that makes your girl child sexier is making a statement! Abeg let these children be children. When they are adults, they can start using makeup.

Before I submit, my patient was being abused allegedly by her female teacher and one other boy. The description the poor toddler gave is too horrific and too concrete to be ignored or written here.....

Hmmmmmmm!

It is time we stopped this RAPE!

TinoMaria.

* Swab test: a microbiological test in which discharging fluiɗ or pus is taking to the lab to determine the cause of the infection and the best antibiotics;

**abaniwase baori: Yoruba name for a job intermediary who helps the jobless to find jobs;

References: Nelson Paediatrics' textbook, Global health action, Rape Wikipaedia.

Childhood Obesity....... What Is The Way Out

Hi friends. Happy new year. May this year usher in God's blessings like never before. Amen.

Yesterday, I had an encounter with a baby who was just 6 months but weighed 11kg. The child was being nursed exclusively on breast milk. He was yet to be weaned into the family diet. I wowed because it meant that his weight for age was 2x normal. The expected weight at six months is about 6kg. And a year old child is expected to weigh 10kg. So you can understand why the child's weight wowed me. As a physician, I really did not know what to do. I could only imagine all the complications of obesity that he child was at risk of. I could not even share it with the mother because I did not have a solution for her. Would I tell her that she should not feed the child if he was hungry. No! I could not do that. Would I want starve a six month old baby. What offence did he commit. And to think that he has not started eating solid foods. How would dieting work? I could only hope that the baby loses the weight as he grows older. Maybe when he starts crawling, standing and walking.

Below is the picture of world's most obese toddler who weighs 19kg at 18 months. On a lighter note, one would almost shit in one's pant to carry him. Lol.

This really got me thinking because most mothers want very big babies. They feel it s a thing to be proud of. This occurs especially in the affluent. People brag about how well fed their children are. It's not bad thing to feed our children well. Children must eat balanced diet. I then went down on memory lane. What were we eating in our days? I remember days of akara and ogi, moinmoin and eko, asaro with efo riro, amala, tuwo, egbo(corn meal), ekuru etc. We ate well then. The foods I earlier mentioned contain the right amount of carbohydrates, proteins, vitamins, fruits and vegetables. And here we are today bouncing in health. But what do we give our children nowadays? Indomie, Spagetti, Bobo, Ice cream, meat pie , Burgers. All the things that we did not eat, we want our children to eat. Because we can afford it abi. 

If we do not feed our children appropriately, our eyes shall see the things that our parents eyes did not see. Now we have juvenile DIabetes Mellitus, early onset Hypertension( seen now in young people of about 18 years), Early onset osteoarthritis etc. I am sure none of us wants this. So, let us do the right thing by feeding our children only on BALANCED DIET. 

 

Thanks very much for reading. This is just food for thought. CIAO.

Sexual Health and Family life

Hi dearest friends. Merry Christmas to you all. Wishing you a prosperous new year ahead. I hope 2013 was fulfilling for you. If it was not, may Almighty God not let the blessings of this year elude us, Amen.

Today, I am starting a series on sexual health in family life. You would be surprised at how much drama goes on behind closed doors! How does marriage, children, work, etc affect our sexual health? Do all these factors improve or reduce sexual activity between spouses? All these are what we want to discuss this season. I would love this topic to be an interactive one as much as possible, so I implore you all to make contributions as you read and share it. Thanks.

This is a common scenario:

Titus rolled over on his self designed king sized bed to look at his wife still sleeping beautifully beside him. Though it was still dark, he was wide awake. He loved this woman. She was the girl of his dreams, the love of his life and the mother of his two wonderful soldiers! She was an amazing woman, he thought. She was the one who held the reins of their home tightly together. How she managed everyone in their home was beyond his comprehension. He could barely survive on the very few occasions that he had to watch the boys only for a few hours. They always drove him nuts. However Titi always coped effortlessly with everything except for one thing that could not be overlooked. She was horrible in bed.

 When he had designed his king sized bed shortly after their wedding five years ago, he had envisioned it being like a Maranatha stadium where unlimited activities would take place. Only God knew what happened to his wife. She had been completely transformed immediately after the arrival of their first son, Tim. She always had one excuse or the other for him anytime he wanted to show his desire for her. If it was headache yesterday, it would be stomach ache today and back pain tomorrow. She was always too tired in the evenings (which was understandable)  and she was always in a hurry in the mornings to get everyone ready for work. The excuses were limitless. He could not believe she was the same person he married. When they were newly weds, they would lock themselves in throughout the weekends and have marathon sex. She knew all the tricks to make him beg her for more.They used to baptise every room in their house with sex! But now, getting her to have sex with him once in a blue moon was a Herculean task. Even when she agreed to it, she would just lie there like a log of wood waiting for him to just "do the thing" and leave.

This morning, he was hoping that she would succumb to him. It was just a few minutes past three a.m. She did not have to get up until the next two hours. There was enough time to satiate his hunger for her and his "mr John Thomas" could testify to that. So, he snuggled close to Titi.

Titi stiffened as she felt her husband, Titus move close to her. "What in God's name is wrong with this man? Is sex food? Se o je bi ounje ni! Ehn? Haba! He is always looking for an opportunity to do something ni. Kilode. He won't even allow me sleep. At least we don do, do do since we marry, e no dey tire." Titi muttered.

Titi was a woman who found it very hard to understand her husband. Titus simply loved sex a lot. If he was happy he would want sex, if he was sad, it was sex that he wanted. When he got back from work he would want sex. Haba! It was sex, sex and sex for him. She was the one who carried pregnancy, twice now. She was the one who suffered the labour pains and the episiotomy she was given during delivery. She was the only one in that house with a good sense of responsibility. She had to get up early, cook, clean, wash and get everybody ready for work or school. What would Titus do to help her? NOTHING!!! His favourite song was AKEBAJE by Lagbaja. Akebaje was a lady who could not do anything in the house except to have sex with her husband and her husband loved her for it. What Nonsense! Should she leave all the house chores and be doing Kerewa?!  Oshisco. There was simply no way she was going to let him touch her this morning. She turned to her husband and said in a no-nonsense voice, "I am not in the mood".

 

Sexuality is a big part of being human. Love, affection and sexual intimacy all play a role in healthy relationships. They also contribute to your sense of well-being. We are sexual creatures, though it can be easy to forget that with all the stresses of our everyday lives. An important part of living a balanced and healthy life, however, is being in touch with our inner desires. Acknowledging and satisfying our sexual needs boosts endorphin levels, which lowers stress and heightens feelings of contentment, relaxation, and happiness.

One out of every three couples struggle with problems associated with low sexual desire. One study found that 20 percent of married couples have sex fewer than 10 times a year! 

Sex may not be the most important thing in marriage, but without it, a marriage relationship suffers. When it's good, it offers couples opportunities to give and receive physical pleasure, to connect emotionally and spiritually. It builds closeness, intimacy, and a sense of partnership. It would be one thing if these lustless men and women were married to each other; they could agree to go off into the sunset, basking in platonic bliss. But it rarely works that way. People with low sexual desire are generally married to partners who want more sexuality, intimacy, physical closeness, and connection.

If you're the spouse whose libido is lacking, remember that your most powerful sexual organ is your brain; in order to feel more sexual, you first have to decide that a loving, satisfying sex life and marriage are important. Then commit to finding your untapped sexuality within. Do not think about anything negative. Do not remember the wrongs your spouse did.

If you're the spouse with greater sexual energy, you'll need to approach your partner with greater understanding and compassion, which will improve communication, compromise, and acceptance. Do not listen to your friends when they encourage you to cheat or seek solace in pornography. Be patient with your spouse.

Factors responsible for low sex drive

It may be due to physical or psychological reasons;

1. Physical;

- menopausal or peri menopausal issues

- obesity

- stress due to work

- fatigue

- diabetes

- some anti hypertensive drugs

2. Psychological

- marital problems

- children's problems

- depression

- infidelity

- feeling ugly due to weight gain

- other emotional problems.

Tips to reviving your sexual life

- The Nike solution: "Just Do It". This does not mean you have to force yourself whenever your spouse asks for sex but you should know that having a positive attitude towards it helps. If you don't try, you won't do anything. Not doing anything may set the template for infidelity which we do not pray for.

- Be creative and active in bed. 

- See a marriage counsellor if you have marital problems.

I hope the above piece will help one marriage or two. I am expecting feedback from my readers please. Thank you very much.

How To Look Good Naked part 3

Hi friends. I am so glad to be back. I hope you are too. I am going to conclude this series today. I hope the previous episodes did some wonders in your life as it did for me.

Last time we talked about the two main components of achieving weight loss and we dwelt on DIET. Today we are discussing the second component which is EXERCISE.  Diet and exercise are like the two sides of the same coin. They both help to achieve the same goal and it is always better to to engage in both.

Studies now agree that exercise is essential for weight loss, and for keeping weight down once the ideal has been reached. As part of a healthy lifestyle, exercise has many benefits, and there are good reasons for maintaining an exercise regime even if you are not overweight. There are many different types of exercise for weight loss, including aerobic exercise, strength training, and ‘stamina’.

Some people may argue that only dietary modification works for them but I still implore you to try out some form of exercise no matter how small. Exercises help to tone our muscles, rids it of excess fat, it also protects the heart ( it is cardio-protective), and makes one to be fit for anything whatsoever. God forbid, if there's an emergency now, let it not be that it is because you can not run that is why something bad happened to you.

Below are some of the exercises that you can engage in. If you have any heart disease, it is important that you discuss with your doctor before starting out on the exercise.

AEROBICS - sometimes known as cardio exercise, this activity raises the heart rate, which causes the body to burn more energy. In order to work to the best of its powers, aerobic exercise must be performed at least five times a week, for around 20 minutes a time, in order to maximise the fuel-burning time. There are many different ways to achieve an aerobics workout – treadmills and stationary bikes, for example; running is perhaps the most commonly used form of aerobic training, although it does carry a higher risk of injury. Walking is also very good and it does not tire one easily as running does.

STRENGTH TRAINING – this improves and increases muscle mass and metabolism through exercise. Building muscle is a very necessary part of weight loss, as muscles burn calories faster than other types of cell in the body; they are a significant part of maintaining weight loss after a diet has ended. Strength training is often done with weights or using resistance bands (strength training is often known as resistance training). Without weights or exercise machines, the body itself can be used as the resistance device, for example in squats, steps, push-ups, and other floor exercises. 

STAMINA – Often known as interval training, it is often used in order to improve the cardiac health of a person, and to improve their strength and muscle mass. Sports that combine aerobics and strength training include activities such as Martial arts such as tae bo or kickboxing; Hiking or hill climbing; Swimming; Boxing; Basketball; Baseball etc 

Another way to combine the two types of exercise for weight loss is to use interval training, which combines aerobics and strength/weight training in the same exercise program. For example, 8 seconds of high-intensity training on a bike, followed by 20 seconds of moderate intensity, for example sit ups or bicep curls. The body expends a lot of energy in the high-intensity sessions, and then ‘recovers’ during the lower intensity activity; this is considered useful in preventing injury, and the body also burns calories faster during interval sessions, so that 20 minutes of interval work can burn as much fat as 40 minutes of single intensity exercise. There is some evidence to suggest that using both types of exercise for weight loss actually helps people to eat less; aerobic and strength training together cause people to consume less food – aerobics users only may stop eating fat, but they often replace this with other foods, and strength training only doesn’t affect the diet at all – so a combination of these well-known types of exercise for weight loss also results in the best changes in diet, too. 

MYSELF AS CASE STUDY

When I tried out some of the workouts like push-ups , squats and floor exercises, I found out that my weight increased. I was then told that it was because i was building muscle. This was saddening as I just wanted the weight to drop. I then went online to see what else I could do that would just make me go down. And so I stumbled on walking. Yes, WALKING. As simple as it sounds it works wonders. I found out that to maintain our normal body weight we ought to take at least 10000 steps a day. For someone like me with a sedentary lifestyle, I hardly did that. This geared me to at least try it out. I did.  I walked briskly, taking 10000 steps a day in one hour. And I have a success story to share! You may give it a trial too. It's so wonderful. It even gives you a chance to connect with your inner self, plan, and be refreshed. Do you also know that for 30 minutes after walking, you still continue burning energy. That is the wonder of walking.

How To Look Good Naked

Hi friends! I promised to walk you through November with tips about weight loss. But before we venture into this interesting stage, let us know what we are dealing with first of all.

Today I want to discuss an entity called obesity.

OBESITY

 This is a condition characterised by the excessive accumulation and storage of fat in the body. This is both a nutritional and medical problem.

- Nutritional problem because it connotes overnutrition which is a form of malnutrition.

- Medical problem as it has been linked to a number of health risks, such as hypertension, coronary heart disease, osteoarthritis, diabetes mellitus etc.

The picture below summarises the disadvantages of obesity.

How do we classify obesity

We usually classify obesity using the WHO classification which makes use of Body Mass Index (BMI), but it may also be classified using the following:

 - waist / hip ratio

 - waist circumference 

 - hip circumference, 

In younger children, mid upper arm circumference, head circumference etc may be done.

Body Mass Index

This is calculated using both weight and height of the individual. The unit is kg/ m2.

Thus BMI= weight(kg)/ height2 (m2).

It is important to know your BMI as this will guide you in your weight loss program. 

Below is the WHO classification of obesity based on BMI.

Underweight.   = <18kg/m2

Normal weight = 18-24.9kg/m2

Overweight.     = 25-29.9kg/m2

Obesity class 1= 30-34.9kg/m2

Obesity class 2= 35-39.9kg/m2

Morbid Obesity=>40kg/m2

Please note that morbid obesity means that the obesity has become a disease.

So, today step on your weighing scale to check your weight, get someone to help check your height, then calculate your BMI to know which level you are. Then we can go on into the next stage of losing the weight.

I watched a program recently on TLC about 42 stone mom. She was a Haitian woman with 6 daughters and divorced. She weighed 625lb (284kg). How is that healthy for goodness sakes. It got so bad she was confined to the bed permanently yet she didn't stop eating. She practically ate herself to death. She did not comply with healthy diet. She just kept eating and eating and gained more weight (of course) and the doctor out of compassion for her took her in for gastric bypass surgery at weight 689lb (313kg). While she was in recovery she called 911 that they should rescue her! Unfortunately she died shortly after. Imagine that. 

Below is a typical picture of an obese person eating as usual. You would say why eat?  And a hot dog at that! But that is what big people do best. They eat and eat instead of trying to burn the calories.

 I know that might be to the extreme but as long as you eat any food you don't need, you are indirectly killing yourself. It is not unusual here in Nigeria to drink an Orobo bottle of coke after downing a full plate of food just to show how affluent you are. You have just drank enough calories to last you a whole day on top of a full plate packed with calories as well!

  It is imperative for us to adopt healthy lifestyles and you can start by substituting all your beverages with water. Yes, water. Water is life and it does not add any calories. It even helps to flush out your whole system. So, drink at least three(3) litres per day.

We shall continue from here next time peeps. Thanks for your time. Love you lots