Medical Clearance - Part II

Round 2

Took time off today after finishing my classes to go down to SATA CommHealth again.

Before that, I returned home, had a shower then went to see my GP. The two readings he took then were 130/90 and 135/90. I was pretty happy that both were below 140! It appeared that the medication was taking effect. Just in case though, I got him to write a note certifying that I had seen him and that my BP was 130/90 - he wrote the note but refused to certify it at 130/90, entering 135/90 instead. Armed with another months' supply of meds, I then made my way to SATA CommHealth.

He did mention that he wished my diastolic (the bottom number) figure was lower than 90 and asked if I was sure the SATA doctor had only mentioned getting my systolic figure below 140. Interestingly too, he added than prior to taking a blood pressure measurement, one should refrain from coffee, tea or even Milo (I just had a cup in the morning, a big one too!) When he found out about that, he actually suggested putting getting my blood pressure re-measured on another day.

Stubborn though, I think, is in my middle name.

Off to the medical centre I went. I had packed my blood pressure monitor with me in the bag so at the carpark, I took several measurements after resting for a while and suffice to say that the initial readings were NOT good. Whether it was from driving on the roads of Singapore or simple mental anxiety over the upcoming checkup - the measurements were way off the charts, equivalent to pre-medication status. There I stayed in the car, thinking happy thoughts, listening to calming music till it came down to a reasonable figure.

Left the car, rode the elevator to Room 12 and reported to the nurse whereupon I was advised to sit down and rest myself for 15 minutes before getting my reading done. Not too sure how long I waited as I had divested myself of my watch and smartphone in an attempt not to adversely affect my blood pressure. Whatsapp is a serious bane on work-life balance.

As I entered, I asked the nurse how many attempts I would get. Two to three attempts was her answer. The first measurement ended badly. I think I was stressed out by then ... it was 148/100. This was followed by a period of resting time. The second attemp yielded 139/95. I was elated till the nurse said that they were looking for a diastolic figure below 90. It's at moments like this that WTF was made for. More resting followed during which she attended to other patients and I secretly activated the blood pressure monitor a few more times, each one yielding a higher measurement - this was definitely not going well - I even reached 160/100 on one of them.

It was a good 15 minutes later that she was able to attend to me again. Final measurement. I don't know if it was the waiting, hence the rest that did the trick, but the measurement was 133/89! I had barely squeaked past. For good measure anyway, I handed over the note my GP had given me. With a happy sigh I departed from the medical centre, more relieved than I had felt in days.

A side note, when I got back home, I read up a little more on measuring blood pressure. You can read it here too. For the fun of it, I made an assumption that everything that could go wrong, went wrong.

• Blood Pressure Cuff is too tight - possible increase of 10 to 40mmHg (systolic)
• Blood Pressure Cuff used over clothing - possible increase of 10 to 50 mmHg (systolic)
• Not Resting enough (3 to 5 mins) - possible increase of 10 to 20 mmHg (systolic)
• Arm/Back/Feet Unsupported - back not supported - possible 6 mmHg (diastolic), crossing legs - 2 to 8 mmHg (systolic), positioning of upper arm below heart level = higher measurements, positioning upper arm above heart level = lower measurements - possible 2 mmHg for every inch of difference above/below heart level (systolic)
• Emotional State - large increases, they don't even want to put a figure on it.
• Talking - if talking while measurment is taking place - increase of 10 to 15 mmHg (systolic)
• Smoking - if done less than 30 mins before measurement - will increase blood pressure
• Alcohool/Caffeine - if done less than 30 mins before measurement - will spike blood pressure
• Temperature - blood pressure will increase when you feel cold.
• Full bladder - blood pressure will be higher with a full bladder - 10 to 15 mmHg (systolic)

I couldn't help wondering though if the measurement of blood pressure is so vagarious in nature, so prone to many factors, could it be an accurate barometer of a persons' health?

For the time being, the dream stays afloat.
Next up, we'll have to wait for the case officer to contact us before we can proceed with obtaining the Certificate of Clearance (CoC) from the Singapore Police.

High Blood Pressure

A quick summary of what I've been forced to learn over the past few days.

Blood Pressure is basically the force created by the heart as it pumps in order to move blood around the body. High Blood Pressure just indicates that my heart is doing it at a higher pressure than is considered normal.

It carries with it the risk of coronary artery disease and stroke. Untreated, it could also cause heart failure and renal failure (kidneys).

I also learnt in the midst of measuring my blood pressure that it should be taken under resting conditions and multiple readings are needed as it is prone to fluctuations.

High Blood Pressure is a condition that can be exacerbated by alcohol consumption, smoking and obesity. I don't drink and smoke which places the blame entirely on my love for food. I must find a balance.

Symptoms of HBP are headaches, dizziness or alterations in vision.

Measures to take include eating a  healthy diet, exercising regularly, watching my weight (sigh), not smoking (not an issue) and taking it easy (NOT at all easy in Singapore).

Foods to avoid: Salt, Processed Meats, Frozen Pizza, Pickles, Canned Soup, Canned or Bottled Tomato Products, Sugar, Chicken skin, Packaged Foods, Red Meats, Butter, Full-Fat Dairy, Coffee and Alcohol

Hello healthy food!

Like a periodic table of blood pressure friendlies

The last sobering point? Treatment of hypertension for most people is life-long.

Medical Intervention

A continuation from the disaster that was my health check on the 24th of Jan.

I wasted little time after that seeing my GP on the 25th. I am pretty sure he had a grim sense of satisfaction from being proved right - after all my refusals to take medication, there I was asking him for help! Ah well.

He kindly disagreed with the SATA's doctors' assessment that it would take 2 to 3 days to get the blood pressure under control. The timeline he mentioned was more in line with 2 weeks to obtain discernible results. That did not bode well at all. In the end, we agreed that before I went down to SATA CommHealth again, that I would get my blood pressure measured at his clinic first to see if the medication had taken effect. I have decided that I'll take a little more than the 3 days suggested by the SATA doctor but less than the 2 weeks suggested by my GP.

He also suggested that I get a blood pressure monitor to guage how it was going on my own. I followed this advice, so for the past few days since, that little machine below, which I borrowed from Dad, was my best friend.

Borrowed this little fella from Dad

The version they use at SATA CommHealth

Incidentally, if you're interested in getting one of these, a quick Google search reveals that they retail in the range from SGD$89 to SGD$97.20. The difference in price stems from the bells and whistles available on each model.

It's been 5 days since that visit and I have been 'heartened' by the results. Haha. The blood pressure definitely has dropped, it's getting under control but it's not there yet. There are frequent spikes where the measurements go above 140/90.

The minimum acceptable standard appears to be Prehypertension

We'll see what tomorrow brings then eh?

Medical Clearance

The next part of our migration process required us to get our medical clearance and we had signed up for it as detailed in our last post on migration, so today, we went off to get our health checked.

SATA CommHealth in Bedok

We had opted for the medical branch in Bedok as it was open on a Saturday and offered both medical and radiological checks. The location wasn't difficult to find and it was a rather leisurely drive.

Upon arriving, register at the counter and obtain a queue number - do mention that you are there as a family for visa application health check as it would expedite things. You will have to pay up before any of the tests begin and there's a weekend charge too. We ended up paying for the adults, $148.73 - which covers the HIV screening, medical examination, urine test and chest x-rays. The children paid $75.97 but they only had to do the medical examination and urine test.

We started off with the x-rays and were done in no time. It was really efficient.

Following that we underwent a consultation with a doctor - who would peruse your medical history and run through some general checks - medications you are on, past hospital stays etc. As there were four of us, this took a bit of time.

Next up was Room 12, where the urine tests, height, weight, visual acuity, blood pressure and drawing of blood for the HIV screening, was to take place. J and the kids zipped through the tests without any complications and the kids had fun with their first experience of peeing into a cup.

It was a different story for me however. First off, I failed the urine test and had to redo it. That entailed many cups of water and a lot of waiting. The second test luckily showed that I had nothing to worry about. I blame the sugarcane drink I had had the night before. To be on the safe side though, I am going to cut down greatly on the amount of sugary drinks I consume. Forewarned is forearmed after all.

That wasn't the end of my misery though as my blood pressure was high, in the region of 160/100. More waiting ensued during which I sent J and the kids off for lunch without me. Despite various attempts, the best reading I had was 144/98 or thereabouts. Room 12 sent me back to the consultation doctor who told me to come back soon for another measurement of my blood pressure once I got back on my medication.

Yeah ... I need treatment

You see, I had been told by my general practioner that I needed to be on meds to control my blood pressure but being the stubborn mule that I am, I had decided to tackle that with weight loss and a healthier diet. Now we all know where that has gotten me.

I am pretty sure though that being in a hospital setting did not help much. I have grown over the years to dread being in a hospital but that is a different story for another day.

I queried the good doctor as to a good timeframe to return if I got back on my meds. The answer was three to four days. The target? Bring my systolic pressure (that's the upper number) below 140. I did not ask what would happen if I failed to get my blood pressure under control - I did not want to know the answer.

Am not blind to the fact that a high blood pressure carries significant danger to my health - much more in fact than a failed visa application but at that moment it was all I could think of. If you are anywhere near the vicinity of the same boat as me - take your meds, get your medical situation under control before you head for that medical clearance.

Feeling down at the moment, might need to reassess our plans. 

Cooking Daddy: Meatballs-Meatballs-Meatballs

How to make Meatballs!

I love music. Now why am I telling you this in an article about making meatballs? I've always found it magical that a musician is capable of taking disparate notes and combining them into a beautiful melody. Sadly, an avid appreciation of music is all my genes have allowed me to have.

Cooking is akin to music in that ingredients are combined to create a flavourful dish and luckily for me, I have had better luck with cooking than making music. It helps a ton that I love cooking for my family. The only part of cooking that I abhor? Washing up. Anyone want to volunteer for that duty?

Anyway, meatballs. We decided to have spaghetti and we were too lazy to cook accompanying dishes so we wanted something that really went well together with spaghetti and most importantly, would pass the judges (my kids) table - so meatballs it was.

Ingredients used today:

• 1 packet of minced beef
• 1 packet of minced pork
• 1/2 cup of milk
• 1/2 cup of breadcrumbs
• 1 egg
• 1 tsp of salt
• A smattering of freshly ground black pepper
• 1/2 cup of Parmesan cheese
• 1/4 cup of minced parsley
• 1/2 cup of chopped onion
• 1 minced garlic clove

Instructions:

1. Combine the milk with the breadcrumbs so as to soggify (not a word I know) them.
2. Beat up the egg and once that is done, add in the salt, pepper, cheese and parsley.
3. Once your mixture is done, add it to the meat and make sure it's well mixed.
4. Add in the onions, garlic and soggy breadcrumbs. Make sure it's well mixed again.
5. Time to shape your meatballs!
6. Bake the meatballs (use a baking sheet) at 200°C for 30 minutes (your cooking time may vary if you are using a different mix of ground meats)

What I would have done differently?

• the only breadcrumbs I had on hand was a Parmesan cheese breadcrumb mix and together with the other cheese I added in, it definitely made for a cheesy meatballs. Next round I would go with regular breadcrumbs.

• Meatballs were oddly sized! Didn't bother me but it's still an area for improvement. I had roughly guaged the amount and obviously hadn't done too good a job. Will improve this in the future by shaping up the meatball mix into a huge rectangular slab on my cutting board and portioning it up before shaping them into meatballs.

• I might reduce the cooking time of the meatballs in the oven to about 25 minutes and finish them up on the stovetop, together with the spaghetti sauce for the last 5 minutes so that the meat absorbs the flavours from the sauce too.

Verdict - The kids and J loved them so this recipe is a keeper. It's a bonus too that it did not take too much work.

Breadcrumbs and milk

Oddly sized meatballs

31 meatballs in all

Only 6 left when dinner was done

Tech Stuff: LG G Watch R (update)

I last blogged about the LG G Watch R last week and I remembered that I wanted to update with some of the watch faces that are available.

Not satisfied with the way the photos of the watch faces turned out but here they are anyway.

An interesting nugget I discovered while trying to take photos of the watch faces was that if you have Google Camera as the default app on your phone, the G Watch R (or I suspect any Android Wear smartwatch) doubles up as a camera remote. So if you were so inclined to use your smartphone with a compatible tripod, you could move a Bluetooth distance away and snap the pic as and when you wish with your G Watch R.

Health Checks - signing up

The next part of the visa application to Australia is the Evidence of Health or health check if you prefer.

At the page where you are supposed to upload your supporting documents, you'll find a link titled "Organise your health examinations". This link appears for each and every applicant, so for my family there are 4 separate links. Upon clicking on the link, you will need your TRN (Transaction Reference Number) and password - obtained upon creation of your ImmiAccount and submission of your application.

A medical declaration will appear and once you've completed answering it, a referral letter will be generated. Each letter contains a unique HAP ID which will be used by the clinic to link your medical records to your visa application.

On this page you will find a list of physicians accepted for the purpose of this health check, namely a medical examination, HIV test and X-ray. Notice though that the clinics are Medical, Radiology and Medical and Radiology. Unless you wish to visit two separate clinics, do go for the Medical and Radiology clinic. There are two of them, one in Bedok and the other in Ang Mo Kio.

We used the online booking to arrange our appointments but the next day I received a call informing me that our appointments were canceled. The receptionist suggested that since we are a family and that we wanted to go through the tests together, to send our booking in via email. We were also informed that since we wanted to have our health checks on a Saturday, we could only go to the Bedok branch as the Ang Mo Kio branch did not open on Saturdays. The email address to use is enquiries@sata.com.sg. To be included in the email were pictures of our 4 referral letters.

Sample referral letter with HAP ID blanked out.

More of the health checks later when we have finally completed them.

Simplicity

Simplicity is an acquired taste. Mankind, left free, instinctively complicates life --- Katharine Elizabeth Fullerton Gerould

I happened to come across the above-mentioned quote while I was reading some news. If you have been reading the news recently, you know that things have been bad around the world, with a sense of things seemingly spiralling out of control.

So the quote above, touched a nerve.

I couldn't help but wonder, how much of the chaos rippling through the world now is a consequence of humanity's propensity for complication. How many wars can be traced back to a decision taken ages ago in the name of doing what was perceived to be good and right? How much of the rage swirling around the world has its roots in people feeling wronged, slighted and imprisoned by the social systems we create to impose order on the world?



Life.

Life is simple so let us not over-complicate things.

Walk out that door
Close your eyes
Let the sunlight warm your face as the wind tousles your hair.
Take a deep breath
Life is that simple.

migration

Well, it's done. We applied for the visa today.

Basically, login to your SkillSelect account and you'll see under your EOI that a button now says "Apply Visa"

Click that and you'll receive a message prompting you if you wished to start logding your visa application. To cut a long story short, you'll soon find yourself at ImmiAccount where you'll be prompted to create an account and then import your information and invitation over from SkillSelect.

A reference number will then be allocated to your case. Next up was a 17 step process of entering information into ImmiAccount. If you're at this step, it would be a great help if you had another pair of eyes with you.

We also settled the visa application fee which was AUD$7000 or so. There was an additional administrative fee of $30 or $40, I can't recall the exact figure. I had read somewhere that it had cost only $3060 for an entire family for applications lodged before 1 July 2013. Pretty hefty increase wouldn't you agree?

Anyway, once you are done with entering all the information and paying the fee, you then have the option of uploading all the relevant documents that are required - proof of age, language ability, skills assessment, just to name a few. There are two that you wouldn't be able to do right away - Evidence of Health and Evidence of Character.

It was really late when we completed entering most of the data so we decided to tackle the health and character checks on another day.

A sign of things to come?

Been running into car trouble recently.

The battery died on us while were parked in a shopping centre on a public holiday, luckily a kind soul helped us jumpstart the car so that we could get to a workshop. Oh and a few months before that, the tyres blew out whilst we were out for a drive on another public holiday - that eventually necessitated the change of the whole set of tyres.

Then J scraped against another car at a carpark (she insists it's the other drivers' fault) but the settlement from the repairs eventually came up to roughly $5000. Thank goodness for insurance but surely the other driver had taken advantage of the accident and rectified other parts of his car. We are not looking forward to the increase in our insurance premiums.

The latest incident came in the form of a broken down aircon radiator in the car, which necessitated the change of the whole radiator. We considered holding off on the repairs but driving in Singapore without the airconditioner is rather unplatable. How do those drivers in convertibles get by? Is the need to be seen cruising in an open-top worth the heat beating down on them and the breathing in of exhaust fumes?

We even considered momentarily if we should have driven into Johor Bahru to save on the costs of repair but eventually decided that it wasn't worth the hassle. Hats off though to the money-smart Singaporeans who patronize JB.

The recent breakdowns also caused us to ponder what it would be like if our car were to break down in Australia. Would help be readily available? Would repairs there be more costly? Cheaper? J jokingly suggested that we should take up automotive courses if we were over there - which actually is not that bad an idea.

Imagine breaking down on one the many long stretches of road with no cell coverage and no town in sight!

Anyway, back to the story at hand. Is our government on to something? Do cars really only have a shelf life of 10 years before they start breaking down all over the place? Our Toyota Wish is probably in its last 2 years of its' current 10 year COE (Certificate of Entitlement), so maybe all these breakdowns are a sign that we should give up driving. It's getting too prohibitive to own a car in Singapore.

A quick check shows that the COE for this week is $75,829 (yup, you pay this price to qualify to purchase a car) and a new Toyota Wish costs $151,888 (with a guaranteed COE). Ludicrous prices.

SkillSelect invitation

I've been checking the SkillSelect website pretty much daily despite knowing that the next invitational round for visa applications would be on 9th Jan.

It was nice then to check my email and realise that the invitation to apply for a Skilled - Independent (Subclass 189) had come in at about 9 pmish on the 8th of Jan.

This little tracker which had for days been showing as Status: Submitted

Key points to note is that the invitation to apply is valid for 60 days from the date of the letter (email) that you receive. All you have to do if you have reached this stage is to log into the SkillSelect website and click on "Apply Visa". Also, now that I have been issued an invitation, my EOI is locked. Meaning that if I apply within this invitation period, I do not have to worry about my score for my points test dropping below the minumum of 60, due to my age.


Should I choose not to apply within this window, the EOI would be re-activated after the window had lapsed and I'd be in the queue again for the next invitational round. However, if no valid visa application is made after receiving 2 invitations, the EOI would be removed from SkillSelect.

Important too to realize that being invited to apply is not equivalent to being guaranteed that I'll be able to make a valid application or granted a visa.

Just another small step in a long process!

Will I be saying goodbye to this?

Photographs

Photographs.

To trace the way I have felt towards photographs is a gradual realization that I've changed over the years.

When I was young, I hated being in photos and in all honesty, still don't really like being in photos. Trawling through pictures of my younger self, I couldn't help but wonder what I was being surly about in every scowl I presented.

I even remember proudly declaring once that photos were for those with a lousy memory - Ah, the arrogrance of youth. I was definitely too young then, perhaps with too little of note to hold on to. For what have the young to worry about? A favourite book, beloved parents and some toys constituted my whole world. I think I failed to comprehend back then how many special memories I would gather through life and how my memory would fail me, not by forgetting incidents but by smudging up the details.

What I've gained since then is a healthy respect for photos. Loss will do that to you, I think. Losing loved ones and realising with time, that no matter how hard you hold on to their memory, they start growing fuzzy around the edges, losing definition over time. The feelings? They don't change, they remain steadfast but the mind starts losing the image of the ones we've lost in life. Photos change that. They help us hold on to an image of all we've loved. Does that prevent me from moving on in life? Perhaps, but then there are some things I don't want to move on from - completely.

I'm still not in love with the idea of being in a photo but I've come to understand the purpose they can serve in our lives. It probably stems from my need to hold on to the past, to hold on to pieces of my children as they were growing up. I am still enjoying their growth but I can forsee a time when photos will be the triggers for me to relive memories of them growing up with me.

Imagine how dense I must be that it has taken so long to realize something so simple.

Ironically, I love being behind the lens, the framing of the shot, the wait and then the capture of a moment. Now that's a beautiful thing.

Tech Stuff: LG G Watch R

I had been planning to purchase a smartwatch for a while now and had in fact had my eyes on the Moto 360 but was put off by the dead space at the bottom of the watch face. That defeated the whole purpose of having a round watch face.

The LG G Watch R doesn't suffer from the same problem and there is no dead space anywhere on the screen. In fact the screen on the G Watch R looks gorgeous. It weighs in with a pixel density of 348ppi against the Moto 360s' 205ppi.

I usually wear a Casio G Shock and the G Watch R (it's a mouthful typing it everytime, LG should have really come up with something a little more catchy) is slightly smaller than that. It is lighter than the G Shock but I do worry about scratching the screen.

The salesperson assured me that I could step into any watch shop, purchase any 22mm bands and it would fit the watch. I'm still using the leather straps that came with the watch and after a week of use, they are starting to feel more comfortable.

The G Watch R is also IP67 rated which means it can stay up to 1m underwater for 30 minutes, which is pretty cool if you forget and bring the watch into the shower or plunge into the pool.

Batterywise, the G Watch R comes with a 410 mAh battery which based on my week of usage is plenty to last through 2 days. This is with the always-on feature activated. Sadly, the watch comes with its own dock. A future version with wireless charging would be a great improvement.

I also cannot fail to mention how much I love the vibrant watch faces and I have pretty much left it on a photo watch face displaying gorgeous pictures at random intervals. (will see about putting a photo up of that later)

The watch has made replying to Hangout messages pretty painless - all you have to do is say "Ok Google" and proceed to send your messages. I like to think that it makes it safer to use your phone while driving. It can be tricky though to get the diction correct or you'd be sending out all sorts of weird messages. I know I have!

The G Watch R runs Android Wear and is thus compatible with any Android device and is not limited to LG smartphones. I use the watch together with a Samsung Note 3 and face no problems at all. A huge downside though is the battery drain on the Note 3. With Bluetooth and location services turned on at all times, I found myself having to top up the battery on the smartphone from time to time.

All in all, I've been pretty pleased with the purchase. It did take a bit of hunting to purchase one of them in Singapore. They are availble at the telcos for $398 but I bought mine for $350 with a little shopping around.

The box it comes in.

G Watch R in its box

And out of the box