+27 (0)21 397 6029 robertrapiti@gmail.com

Lifestyle Disease Management

Dr Rapiti maintains that people with asthma should lead as normal a life as possible like anyone else. He encourages his asthmatics to use their pumps correctly so that they can participate in sports at a competitive level with people, who do not have asthma. According to DR Rapiti, far too many people with asthma pass through life undiagnosed, and if they are diagnosed, many are poorly managed. The oldest patient that he diagnosed with asthma for the first time was an 82 year old female. The question he asks is: why did she have to suffer for so long before being diagnosed?

What We Offer

Diabetes

Patients, with the assistance of their healthcare provider, should keep their blood sugar within the correct range to prevent them from getting into comas and to ensure that they do not end up with the complications like kidney failure, failing vision, erectile dysfunctions or amputations of the limbs.

Dr Rapiti attributes the growing number of diabetes in South Africa and the rest of the world to spiralling obesity.

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Rule of Halves

  1. Half the people in the world with diabetes are undiagnosed
  2. Of the half diagnosed, only half are treated
  3. Of the half treated, only half are treated properly.

Early introduction of insulin is key

The main reason for complications from diabetes, like failing vision, heart attacks, erectile dysfunction and chronic kidney disease is because of poor control of diabetes. One of the main reasons for this poor control is because insulin is introduced way too late. Patients are reluctant to go onto insulin out of fear and ignorance. Patients should therefore be properly educated on the benefits of insulin in order to ease the introduction of insulin. Dr Rapiti maintains that many patients end up severe complications because they are introduced to insulin too late.

Obesity & Its Statistics

1) Obesity is a serious health issue in South Africa and the rest of the world. The WHO (World Health Organisation) estimates that there are 1 billion overweight people in the world.

2) The diabetes population will double due to obesity in the next 20 years in Sub-Saharan Africa.

3) One in five children is obese in South Africa.

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Continued:

4) More adolescents are being treated for type 2 diabetes, which was mainly an adult disorder.

5) More than 50% of adolescents over the age of 15 are obese.

6) In 2013, a 9 year old boy died of sleep apnoea because of his obesity.

7) Once a person moves from childhood into adolescence carrying excess weight, there is a 70-percent chance of him/her becoming an overweight or obese adult

8) South Africa has the highest number of obese people in Sub-Saharan Africa.

9) Research has shown that the risk of developing cardiovascular disease, cancer; diabetes, osteoarthritis and chronic kidney disease increase when a person’s weight-to-height ratio, also called a body mass index, exceeds 23.

10) The waist circumference is a better indicator of one’s health than the BMI. The ideal waist circumference is 94cms for males and 88cms for females or, the circumference should be half the person’s height.

11) America, where 61% of its population is overweight or obese, realised that their healthcare system is heading for bankruptcy in 30 years by the growing diabetes epidemic and has decided to tackle obesity seriously as obesity is now being regarded as the leading cause of diabetes.

12) Obesity is a treatable disorder. If we do not deal with our country’s obesity now then it is quite likely that our health care system will eventually collapse in the next 20 years

What is the eating plan?

  1. The main meal of the day should be in the morning or before going to work. It should consist of protein (meat, chicken, fish, eggs and sausage) and vegetables. Obese and overweight people should avoid carbohydrates like cereals, bread, cakes, puddings and deserts. Fresh fruit is the best desert, but not in large quantities.
  2. A fruit should be eaten at about 1 pm.
  3. The next main meal should be at about 3 pm and should consist of protein and vegetables.
  4. Supper should be a small snack of protein about 4 hours before retiring to bed.
  5. Supper has to be the smallest meal because the body’s metabolic rate and need for calories in the resting state is minimal.
  6. Tea breaks should be avoided completely. People should rather relax at the tea interval to rest their minds by listening to soft music.
  1. Coffee, tea, gas cool drinks and juices should also be avoided. One glass of cool drink or fruit juice has about 4 teaspoons of sugar or is equal to 2 slices of bread.
  2. Water is the best fluid but small amounts are required because there is a fair amount of water in vegetables and fruits to meet our daily requirements.
  3. One should not wait till hungry to eat because this leads to overeating. Ideally, if eating times are planned, there is no need to be hungry at all. Hunger leads to anger and affects one’s work performance and wellbeing.
  4. Food portion: it should be about the size of one’s fist.
  5. Avoid 4 course meals and buffets because they encourage over-eating.

Eating Plan

Dr Rapiti has a special interest in the treatment of obesity. A healthy eating plan is available for download here. In most patients, a safe weight loss of up 1 to 2 kgs per week may be achieved by following a healthy eating plan such as this one.

Click HERE to download a PDF on how to lose 5 Kg a month! 

Read About the Eating Plan

 

What is the eating plan?

  1. The main meal of the day should be in the morning or before going to work. It should consist of protein (meat, chicken, fish, eggs and sausage) and vegetables. Obese and overweight people should avoid carbohydrates like cereals, bread, cakes, puddings and deserts. Fresh fruit is the best desert, but not in large quantities.
  2. A fruit should be eaten at about 1 pm.
  3. The next main meal should be at about 3 pm and should consist of protein and vegetables.
  4. Supper should be a small snack of protein about 4 hours before retiring to bed.
  5. Supper has to be the smallest meal because the body’s metabolic rate and need for calories in the resting state is minimal.
  6. Tea breaks should be avoided completely. People should rather relax at the tea interval to rest their minds by listening to soft music.
  1. Coffee, tea, gas cool drinks and juices should also be avoided. One glass of cool drink or fruit juice has about 4 teaspoons of sugar or is equal to 2 slices of bread.
  2. Water is the best fluid but small amounts are required because there is a fair amount of water in vegetables and fruits to meet our daily requirements.
  3. One should not wait till hungry to eat because this leads to overeating. Ideally, if eating times are planned, there is no need to be hungry at all. Hunger leads to anger and affects one’s work performance and wellbeing.
  4. Food portion: it should be about the size of one’s fist.
  5. Avoid 4 course meals and buffets because they encourage over-eating.

Asthma

Asthma can be diagnosed in children as young as 6 months and or even older adults who may simply never have realised that they had asthma. Patients should be educated on how to use their pumps so that they can achieve optimal lung function. 

Click HERE to download a PDF on how Asthma is more than a tight chest booklet! 

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Asthmatics should be encouraged to use their pumps regularly in order to help them to lead full active lives. Asthma pumps are neither addicting nor does it weaken the heart. According to DR Rapiti, this is and age old myth, which must be destroyed because far too many asthmatics are undertreated because of this myth.

Another myth is that people think they should only use their pumps when their chest is tight. That is a big mistake. Often patients are unaware that their chest is closed.

Sometimes, the only symptom of asthma is cough especially at night and the only way to stop the cough of asthma is to use a preventer pump. A good night’s sleep, free of coughing will avoid daytime drowsiness in asthmatics. This is important for working people and school children.

 

 

Getting to the heart of the problem

+27 (0)21 397 6029

robertrapiti@gmail.com

17 Cinderella Crescent, Eastridge, Mitchells Plain