Bodylanguage issue 10 Winter 2016

creating a great healthcare experience altogether

Issue 10 | winter 2016

WHICH IS BETTER?

Running or walking?

Snoring...

OR SLEEP APNEA?

Grab & Go

BREAKFAST IDEAS

Blood pressure

NEED TO KNOW

HEALTH ADVICE

Ask our experts CARING FOR

Elderly Parents Intercare Salubrity

Tranquility

6

contents Issue 10 | winter 2016

Be personal 2 32

10

14

CEO Message your experts Your questions

Interact 3

Intercare News & Events

4

SNIPPETS Latest health news

30

Recipe Page Banana Flapjacks

Your body

20

follow on sociauls media!

18

all about Warts 'n' all

27

First Aid Concussions

From the experts 10

DIAGNOSIS Snoring & Sleep Apnea

16

Intercare Salubrity Tranquility

20

NEED TO KNOW Blood Pressure

24

How to Care for elderly parents

Your health 6

Health Strategy Running or walking?

14

health Treats Grab & Go Breakfasts

23

HEALTH FACTS Flu season

yo u. ..

W e wa nt to he ar fr om

24

30

tomers to air their ite all patients and cus We would like to inv this magazine. ing ard with input reg views and provide us l then be able wil remain relevant and In doing so, we can healthcare at gre a e eat and “cr to make a difference email us at ase Ple er� on a daily basis. experience altogeth are.co.za erc int ce@ en OR myexperi info@intercare.co.za ideas and topics you with any suggestions, out. would like to read ab orial Enquiries Advertisi ng & Edit ng: Health-B ytes Publishi health-b ytes.co.za sta@ 021 913 0504 | chri Grobler ista Chr or Publishing edit : Bernette Becker Design - Health-B ytes t | Printing BusinessPrin Proofing Albert Buhr

Advertisi ng: Language FREE copies of Bod y rcare are distributed at Inte tres.

Medical and Dental Cen act cont se To advertise, plea ent. our advertising departm

CEO message

CEO

message

highest levels of satisfaction. Such initiatives cannot be once-off endeavours and these processes will continue in an iterative fashion, with the Patient Experience iniative being entrenched in our culture. We invite you to continue sharing your experiences with us at myexperience@intercare.co.za.

The Intercare Group has seen phenomenal growth over the last few years and will continue setting new standards through the ongoing introduction of innovative products and services.

The Group currently has four Day Hospitals, four Sub-Acute and Rehabilitation Hospitals and now, with the opening of the Medical Centre in Panorama, Cape Town, on 8 June, a complement of seventeen Primary Care facilities.

In addition, Intercare Salubrity, a health-risk management company, was launched earlier this year. Salubrity by definition means “conducive or favourable to health and well-being”.

Intercare Salubrity makes great health possible by creating an environment conducive to preventative, holistic and coordinated care for individuals, irrespective of their age, gender or

Our patients’ satisfaction is our first priority, and it is important to understand their needs and expectations.

medical scheme status. With the introduction of two genetic screening products, Tranquility and Serenity (offered in collaboration with Genoma, a Swiss Biotechnology company), Intercare Salubrity shifts the focus from medicine for the average to medicine for the individual.

This is yet another example of how Intercare is

Once we understand our patients’ world, it

playing a leading role in changing the healthcare

is imperative that we act on it and redesign

landscape in South Africa.

our services to give them the best possible care. It is on this basis that we launched

On the 27th of May, 14 years ago, the first patient

the Patient Experience initiative last year.

walked into Intercare Glenfair. Although we didn’t

It consists of 2 phases. First, carefully

know what the future would bring, as we look

designed surveys were conducted and data

back today, it's been a wonderful journey. We’ve

were collected to give us objective insight

worked very hard and were blessed in abundance.

into our patients’ needs. This was followed

We will continue to fulfil our vision of “Creating

by the development and implementation

a Great Healthcare Experience Altogether” and

of a unique programme aimed at ensuring

to care for people the Intercare way.

that our staff and processes leave patients with the best possible impression, and

Dr Hendrik Hanekom (Chief Executive)

news and events Left hand side, near to far: Dr Brent Carstens (GP), Theresa du Toit (Practice Manager), Amanda Hanekom (Intercare Corporate), Dr Anne-Mique Snyman (GP), Dr Aneke Vrolijk (GP), Dr Alet Theron (GP), Dr William Barnard (GP)

ed ic al Ce nt re Op en in g of Pa no ra m a M

Right hand side, near to far: Adelia Schultz (Operations Executive), Dr Jonelle Malherbe (GP), Dr Koos van der Merwe (GP), Dr Hendrik Hanekom (Group CEO).

Intercare Panorama Medical Centre opened its doors on 8 June 2016. It is Intercare’s 17th medical centre and is situated in the Panorama Healthcare Centre in the northern suburbs of Cape Town. The centre offers an array of healthcare services, including aviation medicals, chronic disease management, Vitality wellness screenings, executive medicals and minor surgical procedures.

From left to right: Dr George Veliotes (Chairman, Intercare Group), Mr Gregory Roumeliotis (Industry Advisor, Genoma), Dr Frédéric Amar (CEO, Genoma), Dr Hendrik Hanekom (CEO, Intercare Group), Dr Cameron Meyer (Head, Intercare Salubrity)

lu br it y L au nc h of I nt er ca re Sa Intercare’s Centre for Lifestyle Management has been expanded, reformed and reborn as Intercare Salubrity – a company specialising in preventative, holistic and coordinated care for individual patients, medical-scheme members and company executives and employees.

“Salubrity” means conducive or favourable to health or well-being, and with that in mind, Intercare Salubrity introduced genetic screening services through an exclusive partnership with Genoma, a Swiss-based leader in clinical diagnostics. It was a privilege to have the CEO of Genoma, Dr Frédéric Amar, present at the launch function.

page 03

snippets

tHhEAeLTlaHtNeEsWtS Take a nap and

recharge!

These pointers will ensure that each time you take a quick snooze, you are left feeling refreshed and ready to take on the rest of your day.

• A nap doesn’t have to be long to be effective. A 10-20 minute “power nap” can help boost alertness and energy.

Napping for longer than 30 minutes can up your chances of falling into a deep sleep, leaving you feeling a bit groggy and even more tired.

• The position you sleep in can also affect your rest quality. Research has shown that resting on our sides, rather than our back or our stomach, helps our brains to discard waste products.

• Napping is beneficial no matter when you do it, but research says midafternoon is not only the most natural time of day to nap, it also may come with some extra health benefits, like lower blood pressure. Some European cultures still take a “siesta” or a break from their hectic days and lay down for a snooze.

Source: medicaldaily.com

Wakey, wakey!

Are you a “snoozer”?

“Snoozing” an alarm can waste an average of 85 hours a year or 173 days of your life.

Forgive and forget

– yourself and others!

According the a new study in the Journal of Health Psychology, forgiving folk are able to handle stress better and protect themselves against the toll it takes on mental health.

Researchers looked at the effects of lifetime stress on a person’s mental health, and how more forgiving people fared compared to people who weren’t so forgiving. People with greater exposure to stress over their lifetimes had worse mental and physical health. But the researchers also discovered that if people were highly forgiving of both themselves and others, that characteristic alone virtually eliminated the connection between stress and mental illness.

How a forgiving personality protects a person from the ills of severe stress is hard to determine. The researchers speculate that people who are more forgiving may adopt better coping skills to deal with stress, or their reaction to ma jor stressors may be dulled.

The sample of people in the study is small (148), and more research is needed to fully understand the benefits of being more forgiving. But study author Loren Toussaint says he believes “100%” that forgiveness can be learned. Many therapists work to cultivate forgiveness in sessions, he says, and his own prior research has shown that saying a short prayer or a brief meditation on forgiveness can help people take the edge off.

“Forgiveness takes that bad connection between stress and mental illness and makes it zero,” he says. “I think most people want to feel good and it offers you the opportunity to do that.”

Source: www.time.com

HEALTHY KIDS...

all winter long

Aitishoo! Aitishoo!... We All Fall Down…

Early to bed…

Something as simple as a bedtime routine will help them stay on track with sleep throughout the week.

Keeping those germs away this winter season can be tough with children playing and staying indoors most of the time. Check out a few of our favourite ways to keep your kids healthy throughout these tough winter months.

Play to stay healthy…

Challenge your kids to an energising fun activity like a jump rope or hula-hoop contest.

Catch a cough or sneeze… Teach your kids to cough or sneeze into the

Source: Inspire Magazine

crook of their elbow if they can’t get a tissue in time.

Five a day keeps the doctor away… Help your family keep their immune systems up by eating five servings of fruits and veggies every day.

Keep those germs away!… Pack tissues and a small bottle of hand sanitiser in your child’s backpack and teach them how to use it.

Sugar has never been so controversial. Here are five Very simple ways to cut down on the sweet stuff:

Are you ready for sugar tax?

1. Get cooking

3. Know your labels

5. Train your taste buds

The best way to ensure your food contains no hidden nasties is to make it yourself.

The current focus on reducing sugar and showcasing fresh ingredients means the bookstores are full of inspiring recipe books.

Pasta and stir-fry sauces, cereals and even bread all contain “hidden” sugars. Check the nutritional content when buying processed food. The WHO currently recommends adults stick to 6–7 tsp of sugar a day (30g maximum; 1 tsp of sugar = 4.25g of sugar).

People who give up sugar for a period of time are amazed by how sweet things taste once they return to their normal foods. Adjust your palate by gradually making healthier switches to reduce your sugar intake. Mix your normal muesli with plain oats and nuts, go for chocolate with a higher cocoa content, try adding fresh fruit to natural yoghurt instead of buying high-sugar flavoured yoghurts, and switch to sugarfree nut butters. If you’re used to having something sweet after meals then try a chunk of cheese instead, some herbal tea (peppermint and liquorice has a lovely natural sweetness), or warm milk flavoured with cinnamon and nutmeg.

2. No sugary drinks

Fizzy drinks are real sugar bombs and, whilst fresh fruit juices contain vitamins and fibre, many commercial brands are laden with sugar. Stick to fresh juices with a high veggie content, and flavour water naturally with citrus wedges and fresh mint. Beware also of flavoured coffees and hot drinks with added syrups.

4. Keep the kitchen “junk food free”

Keep your kitchen stocked with delicious, healthy treats rather than sugary snacks. Munch on fresh veggie sticks with humus or guacamole as well as fresh fruit, and nuts. A bit of dark chocolate always goes down well (at least 85% cocoa).

Source: healthy-magazine.co.uk

page 05

health strategy

WHICH IS BETTER?

? g n i lk a w r o g n i n Run If you currently class yourself as a runner or a walker, you’re likely to be pretty happy in your camp.

But if you’re thinking about picking up the pace or even slowing it down or you’re new to the habitual exercise scene, read on to discover the good, the bad and the downright ugly.

Walking If your goal is exercising for overall health and to improve your longevity, then walking is ideal.

medical literature, a change

function to run well. It puts

in diet, not exercise, is the big

more pressure and stress on

driver of shedding the kilos.

the body and increases the risk

The ugly

for injuries like runner‘s knee, hamstring strains, and shin

Each year, thousands of regular

splints (which plague even the

walkers are hobbled due to a

most consistent runners).

walking-induced pain or an old

To avoid the consequences

As a lower-impact form of

exercise injury that has been

of the repetitive impact,

exercise, most people are

aggravated by walking.

regular runners need to

The good

capable of walking. Plus, a

develop management

daily walk delivers many

techniques like stretching,

cardiovascular health benefits. A recent study published in the Journal of the American College of Cardiology

Running

The good

massage, functional strength exercises and other crosstraining activities.

As a higher-intensity form of

suggests that moving at a

exercise, running has been

Intense training over the

gentler pace – a brisk walk or a

proven to offer greater

course of many years can

slow jog for 1 to 2,5 hours per

fitness, weight loss and

also lead to permanent

week – lowers your risk of

overall health benefits. This,

changes in your heart that

death by 25%.

of course, also means you don’t

can set the stage for serious

need to exercise for as long to

cardiovascular problems.

In a new study published in

stay fit. Running may regulate

Arteriosclerosis, Thrombosis,

appetite hormones better

and Vascular Biology, regular

than walking.

walkers turned out to be

The ugly

Apart from the chafing (need we say more?), excessive

healthier than their running

In another (small) study,

endurance training may also

counterparts. Risk for

after running or walking,

dampen your immune system

hypertension, high cholesterol,

female participants were

and increase your risk for

diabetes, and heart disease

invited to a buffet, where

illness.

all dropped more significantly

walkers consumed about 200

among walkers (more than

kilojoules more than they had

Researchers at the University

9%), compared with runners

burned and runners ate almost

of Illinois, Urbana-Champaign

(about 4,5%).

850 kilojoules fewer than

found that prolonged intense

they‘d burned. Researchers

activity increases levels of

think this may have to do with

certain inflammatory proteins

If your exercise goal is weight

runners‘ increased levels of the

that can allow viruses – such

loss, you’ll need to do a lot

hormone peptide YY, which

as the common cold – to

of walking. Walking is a

may suppress appetite.

thrive. That means you might

The bad

slow way to burn kilojoules and won’t challenge your

The bad

get sick more frequently, and feel worse during bouts

Running is hard on your

of illness, if you‘re taxing your

as much as running will.

body and you’ll need to have

body with vigorous exercise

But, as has been proven in the

a certain level of strength and

on a regular basis.

cardiovascular fitness levels

page 07

MELOMAG | 13 |

health strategy

Which one will JUST STARTING suit me?

OUT?

unusual pain or discomfort.

However, it is important to

As important as exercise is,

If you’re new to the world of

challenge yourself to the point

it‘s important to get the right

regular exercise, walking is

where you feel some level of

dose. More isn‘t necessarily

definitely the best way to start.

breathlessness or muscular

better. Most of us are guilty of

Most people don’t realise they

fatigue – without this, your

gravitating towards activities

need to get their body fit to

body can’t grow fitter and

we do well and avoiding those

run – not the other way around.

stronger.

Begin by determining the

we could improve upon.

If you struggle to find

level of exercise you can

BEFORE YOU start...

motivation to run, and you‘ve

comfortably do – even if this is

If you have specific issues

always assumed walking isn‘t

just a 20-minute walk around

with any part of your body,

hardcore enough to improve

the shops. Then gradually

obtaining expert advice

your health, set those fears

build up to your workout goal

is important: a suitably

aside; walking appears to

by walking at least 5% further

qualified professional like

bestow all the same health

or faster each week.

a biokineticist can help to

benefits as running – without

identify your body’s weak

that either walking or running

want to pick up the pace?

is healthier than not doing

Listen to your body. Quite

capabilities. And a decent pair

either, whatever your health

often less is more, so don’t

of walking or running shoes is

goals.

push yourself through

a must.

the risks. It bears repeating

areas and recommend the best form of exercise to suit your

If you struggle to find motivation to run, and you’ve always assumed walking isn‘t hardcore enough to improve your health, set those fears aside; walking appears to bestow all the same health benefits as running – without the risks.

Cushioning Runners need more:

Runners who strike with their heel or midfoot should look for

What walkers should look for: Fitness walking shoes

Runners impact the ground

less built-up heels, while those

should not have a flared heel.

with three times their body

who land on the ball of their

Walkers strike the ground

weight with each step, while

foot need a more built-up heel.

with their heel, and a flared

walkers impact with only

heel impedes rolling forward

1.5 times their body weight.

Walkers will be striking with

through the step. A true fitness

Runners need more cushioning

their heel and rolling through

walking shoe would have an

in the heel and forefoot than

the step. They have no need

undercut heel rather than a

walkers, which is why you

for a higher heel.

flared heel or built-up heel.

see all of the hype about aircushioning systems.

What walkers should Flexibility look for: Walkers should look Both running shoes and walking

Walkers need less:

for running shoes with the least

shoes need to be flexible. Press

Walkers don't need extra

difference in height from the

down with the toe of the shoe

forefoot cushioning and

heel through the toe. This is

and see where the shoe bends.

most can do with less heel

called heel drop and often you

Many running shoe designs flex

cushioning. Extra cushioning

can find it listed in millimetres

most at the arch or midfoot.

adds extra weight, so it is a

(mm). Look for shoes with a

trade-off between a heavier

heel drop of less than 8mm,

But some designs flex most

shoe that lessens the trauma to

with 4mm or less being

at the forefoot. These suit the

your feet and legs, and a lighter

preferred. The shoe's outer sole

differing needs of runners who

shoe in which you may be able

can be deceptive: some may

strike at midfoot or with the ball

to run or walk faster.

appear to have higher heels,

of their foot. A shoe that bends

but the heel actually sits lower

at the arch does not provide

inside the shoe.

the platform they need.

Heel Height Runners strike the ground

A shoe that doesn’t bend at all

anywhere from the forward

Heel Flare

part of their heel through the

Running shoes may have a

many shoes marketed as

midfoot to the ball of the foot,

flared heel to provide extra

walking shoes do not flex at all.

depending on the individual.

stability for runners who strike

They are unsuited for fitness

Walkers should strike with

the ground at their midfoot or

walking. Fitness walking shoes

their heel. Running shoes are

forefoot. A flared heel is also

should flex at the forefoot, as

designed to provide stability

often seen on trail-running

walkers should push off with

for runners with a built-up heel.

shoes.

their toes.

is unacceptable. Unfortunately,

Sources: well.blogs.nytimes.com | www.greatist.com | www.walking.about.com

page 09

diagnosis

EA

PN A P E E L S D N A G N I R SNO

? e c n e r e f if d e h t is t Wha The big question is — How tired are you during the day?

throat and nasal tissue or

Normal snoring doesn’t

of your tongue can also get in

sleep and that of your family

interfere with the quality of

the way of smooth breathing.

members and roommates.

your sleep as much as sleep

Snoring can lead to poor

apnea does, so you’re less

Anybody can snore, but it has

sleep and daytime fatigue,

likely to suffer from extreme

been studied that more than

irritability, and increased

fatigue and sleepiness during

50% more men snore than

health problems. If your

the day.

women do. Men naturally

Just about everyone snores

occasionally, but if it happens frequently it can affect the quantity and quality of your

snoring keeps your partner

“floppy” tissue that is more prone to vibrate. The position

have narrower air passages

What is snoring?

compared to women, and

Snoring happens when

this increases their likelihood

Luckily, not everyone who

you can't move air freely

to snore. Although it can be

snores has sleep apnea, and

through your nose and throat

annoying to your bedmate,

not everyone who has sleep

during sleep. This makes the

snoring is not necessarily a

apnea snores. So how do you

surrounding tissues vibrate,

serious issue. But, there is the

tell the difference between

which produces the familiar

possibility that it could be a

normal snoring and a more

snoring sound. People who

sign of a dangerous medical

serious case of sleep apnea?

snore often have too much

issue and should be analysed.

awake, it can also create ma jor relationship problems.

Common causes of snoring

+ Being overweight or

+ The way you’re built.

may be due to a deviated

Men have narrower air

nasal septum, soft or cleft

passages than women and

palate, and swollen tonsils.

out of shape.

are more likely to snore.

+ Alcohol, smoking,

Fatty tissue and poor

A narrow throat, a cleft

and medications.

muscle tone contribute

palate, enlarged adenoids,

Alcohol intake, smoking,

to snoring. Even if you’re

and other physical

and certain medications,

not overweight in general,

attributes that contribute to

such as tranquilisers, can

carrying excess weight just

snoring are often hereditary.

increase muscle relaxation

around your neck or throat can cause snoring.

+ Age.

+ Nasal and sinus problems.

leading to more snoring.

+ Sleeping position.

Blocked airways or a stuffy

Sleeping flat on your back

As you reach middle age

nose make inhalation

causes the flesh of your

and beyond, our throat

difficult and create a

throat to relax, and your

becomes narrower and the

vacuum in the throat,

tongue to fall back and

muscle tone in our throat

leading to snoring. Other

block the airway. Changing

decreases.

causes of airway blockage

your sleep position can help.

Symptoms of snoring

Once the cause is identified, some symptoms can include:

may cause airways to become restricted.

+ Keep nasal passages clear,

Difference between snoring and sleep apnea

Snoring can be a symptom

High blood pressure, gasping

as a stuffy nose makes

of sleep apnea (which can be

for breath upon waking or

breathing difficult and

a potentially life-threatening

while sleeping, experiencing

creates a vacuum in the

medical condition, if left

a restless sleep, sore throat,

throat. Nasal washes or

untreated). When a person

feeling excessively tired

strips help you breathe

has sleep apnea, his or her

during the day and finding it

easier while sleeping.

breathing is irregular during

difficult to concentrate during

+ Dry air causes irritation

the daytime hours.

How to stop snoring?

There are plenty of self-help ways to stop or reduce

sleep. Typically, someone

in the nose and throat

with sleep apnea will actually

membranes, so an effective

stop breathing for short

humidifier will keep air

amounts of time 30 to 300

moist while you sleep.

times a night. It can be a big

+ Raising your head

problem if the person doesn't

snoring, and they include

approximately four inches

(but are not limited to):

and sleeping on your side

+ Losing weight to reduce

may help stop annoying

If you are constantly tired

snoring noises.

during the day, then you

excess fatty tissue

+ Exercise and working with

+ Avoid soy-based products,

get enough oxygen.

should consider being tested

hand weights to tone your

dairy, caffeine and heavy

for sleep apnea. Normal

entire body (including

meals at least two hours

snoring usually doesn’t

throat muscles)

before heading to bed.

interfere with your quality

+ If you smoke, the chances

+ Singing has been known to

of sleep, and it should not

that you will snore are high,

help control throat muscles

cause you to wake up feeling

as smoking causes irritation

and reduce snoring due to

unrested.

in the throat and nose and

relaxed muscles.

page 11

diagnosis What is sleep apnea?

of apnea during sleep your

resumes with a gasp or a

Obstructive sleep apnea

brain will automatically wake

choking sound. If you have

(OSA) is defined as the

you up, usually with a very

obstructive sleep apnea

cessation of airflow during

loud snore or snort, in order

(OSA), you probably won’t

sleep, preventing air from

to breathe again. People with

remember these awakenings.

entering the lungs due to an

OSA will experience these

obstruction. These periods

wakening episodes many

Most of the time, you’ll stir

of 'stopping breathing' only

times during the night and

just enough to tighten your

become clinically significant

consequently feel very sleepy

throat muscles and open your

if the cessation lasts for more

during the day: they have an

windpipe. In central sleep

than 10 seconds each time

airway that is more likely to

apnea, you may be conscious

and occurs more than 10

collapse than normal.

of your awakenings.

Anatomy of a sleep apnea episode

How do I know I have sleep apnea?

airway to collapse. During

sleep apnea episode, the

complain of excessive

the day we have sufficient

oxygen level in your blood

daytime sleepiness, often with

muscle tone to keep the

drops. Your brain responds

irritability or restlessness. But

airway open, allowing for

by briefly disturbing your

it is normally the bed partner,

normal breathing. When

sleep enough to kick-start

family or friends who notice

you experience an episode

breathing – which often

the symptoms first.

Sufferers may experience

will necessarily have sleep

+ A thick neck (neck

some of the following:

apnea. We possibly all suffer

circumference greater than

from these symptoms from

40cm)

times every hour. OSA only happens during sleep, as it is a lack of muscle tone in your upper airway that causes the

+ Extremely loud, heavy

As airflow stops during a

People with sleep apnea may

time to time but people with

snoring, often interrupted

sleep apnea demonstrate

Other physical attributes that

by pauses and gasps

some or all of these

put you at risk for obstructive

symptoms all the time.

sleep apnea include a

+ Excessive daytime sleepiness, like falling asleep at work, whilst driving, during conversation or when watching TV

+ Irritability, short temper + Morning headaches + Forgetfulness + Changes in mood or behaviour

+ Anxiety or depression + Decreased interest in sex Remember, not everyone who has these symptoms

Sleep apnea causes and risk factors

deviated septum, receding chin, or enlarged tonsils or adenoids (the most common

Certain risk factors have

cause of sleep apnea in

been associated with sleep

children). Your airway may be

apnea. You have a higher risk

blocked or narrowed during

if you are (or have):

sleep simply because your

+ Overweight + Male + Related to someone who

throat muscles tend to relax

has sleep apnea

+ Over the age of 50 + A smoker + High blood pressure

more than normal.

Allergies or other medical conditions that cause nasal congestion and blockage can also contribute to sleep apnea.

People with sleep apnea may complain of excessive daytime sleepiness, often with irritability or restlessness.

But it is normally the bed partner, family or friends who notice the symptoms first.

Treating sleep apnea

prescribed. CPAP is the gold

every day, and can be done

There are several forms of

standard treatment for OSA.

while commuting, walking

treatment for sleep apnea.

When wearing a CPAP mask,

or showering. Examples of

In mild and moderate cases

the machine will blow air into

throat exercises include:

weight loss and the use of

your airways to keep them

+ With a closed mouth, purse

dental devices (fitted by a

open throughout the night.

professional dentist), which

your lips and hold for 30-second intervals.

+ Out loud, repeat the vowels

are similar to an athlete’s

Address possible

mouth guard, can be wholly

allergens in your bedroom

(a-e-i-o-u) several times

successful. Two common oral

that may interfere with

during the day for three to

devices are the mandibular

your breathing such as:

repositioning device and

removing pets and washing

the tongue retaining device.

the bedding regularly in hot

behind your top front teeth

These devices open your

water to remove any mold

and move back and forth for

airway by bringing your

spores and dust.

five minutes each time.

+ Put the tip of your tongue

several minutes each day.

+ With your mouth open,

lower jaw or your tongue forward during sleep. In

Throat strengthening

move your jaw to one side

moderate and severe cases

exercises may help to reduce

and hold for at least 30

a dental device or nasal

or completely cease snoring.

seconds and repeat on the

continuous positive airway

These types of exercises

other side.

pressure (CPAP) are normally

should be done 30 minutes Source: Harvard Health Publications, www.helpguide.org

page 13

health treats

GRAB-AND-GO

s a e d I t s a f k Brea Fruit and cheese

A balanced, easy-to-assemble makeahead morning meal: Grab an apple, wrap a few cubes of Cheddar in plastic, and toss Âź cup of fibre- and protein-rich nuts into a resealable plastic bag.

Peanut butter waffle Instead of dousing a waffle in syrup, cut the sugar and boost the protein and fibre by spreading it with peanut butter. You can also sprinkle on some raisins, sesame seeds, or extra peanuts for even more fibre, which helps deliver the meal's nutrients slowly and steadily.

Strawberry shake In a shaker, combine vanilla or strawberry instant-breakfast porridge (look for the no-sugar-added kind) and 1 cup of low-fat strawberry cow's milk or soy milk. (You can also mix this the night before.) If you have time, use a blender to add strawberries or a frozen banana.

Cereal "sundae" A bowl of fibre-rich bran flakes (about 1½ cups) with low-fat milk is nearly the perfect breakfast. Make it portable by replacing the milk with vanilla yogurt and mixing it in a to-go container.

Increase the fibre and vitamins by adding nuts or fresh or dried fruit, such as chopped pecans or blueberries.

Egg tortilla One of the most “portable” proteins is a hard-boiled egg, but it has no fibre or carbohydrates. So slice it, then roll it in a wholewheat tortilla with a piece of macon or pastrami and, if you like, a slice of cheese. Add a tablespoon of salsa for a shot of flavour and a smidgen of vitamin C.

Breakfast muffin This sandwich packs protein from egg, calcium from cheese, and fibre and B vitamins from the wholegrain muffin.

Halve the muffin, spread chutney over the bottom half; top with two pastrami slices, one fried egg, and cheese. Place top half of the muffin over the bottom.

Morning pizza slice You could have a slice of last night's pizza (preferable to filling up on sugar or skipping breakfast). Or try a more sophisticated spin: Take a slice of crusty bread, spread it with three tablespoons of ricotta, and add tomatoes. Finish with a drizzle of olive oil (about one teaspoon) and a little salt and pepper.

page 15

Intercare Salubrity

Tranquility For more information about this test or to access Genetic Counselling, please call 086 999 0669 or send an email to genetics@salubrity.co.za.

Non-Invasive Prenatal Testing

An individual’s genetic material is divided into packages called chromosomes, which are stored in the nucleus of a cell. Humans have 46 of these chromosomes, consisting of 23 pairs with one chromosome of each pair inherited from each parent.

Chromosomes can be abnormal in terms of their number or structure, which can result in a vast array of possible conditions in a child. Down Syndrome, caused by an additional copy of chromosome number 21, is the most well known of these.

There is an increased risk of chromosomal abnormalities in the following situations, and women may want to consult a Genetic Counsellor if any are present in their family:

Luckily for expectant parents, there has been exciting new progress in the field of genetic screening in the unborn baby, with the advent of Non-Invasive Prenatal Testing (NIPT).

Research has revealed that a foetus’s DNA enters the mother’s bloodstream from the fifth week of pregnancy. This DNA can be obtained by simply drawing blood from the mother, as would normally be done for any other test (such as a glucose test). Non-Invasive Prenatal Testing (NIPT) is the method of collecting this blood, isolating the foetus’s DNA and then testing it for abnormalities.

NIPT is considered a great step forward in the field of foetal screening for a number of reasons:

+ A history of a chromosomal

condition in the family + A woman who has had a

previous pregnancy or child with chromosomal abnormality + Other tests have demonstrated possible abnormal findings, such as blood tests and ultrasound + Women who are older than 35 years

+ It assesses the foetal DNA

rather than indirect markers considered proxies for chromosomal abnormalities.

It is thus much more accurate and reliable than the standard methods of screening, with correct results in 99.9% of tests + It can be done as early as the 10th week of pregnancy.

This allows the parents the maximum amount of time to consider options should the result be positive. + It can detect the following conditions, which represent a significant proportion of chromosomal abnormalities, in addition to confirming the baby’s gender: Trisomy 21 (Down syndrome) Trisomy 18 (Edwards Syndrome) Trisomy 13 (Patau Syndrome) Monosomy X (Turner Syndrome) Triple X Klinefelter Syndrome Jacobs Syndrome Microdeletion disorders including Prader-Willi, DiGeorge, Cri-du-chat syndromes Intercare Salubrity is excited to now offer this testing through its exclusive partnership with Genoma, a Swiss-based biotechnology company with the largest genetic clinical diagnostics platform in Europe and who specialises in genetic testing. Genetic counselling can also be arranged to help assess your risk and determine the need for testing.

page 17

all about

W’aArLtsL

’N

Many of us have had a wart somewhere on our bodies at some time. Other than being a nuisance, most warts are harmless and go away on their own.

Are Warts Contagious?

THINK PREVENTION

caused by viruses of the

Warts can be seen as

Although there’s no way to

human papillomavirus

contagious, but the risk of

prevent warts, it’s always

(HPV) family.

passing them on to other

a good idea to encourage

people is quite low as close

kids to wash their hands

skin-to-skin contact is needed.

and skin regularly and well.

area of the body, but tend to

The infection can however

If your child has a cut or

invade warm, moist places,

be transmitted indirectly

scratch, use soap and water

like small cuts or scratches

from contaminated objects

to clean the area because

on fingers, hands, elbows

or surfaces, such as a towel

open wounds are more

and bottoms of feet.

or the area surrounding a

susceptible to warts and

swimming pool. After being in

other infections. It’s also

Warts are usually painless

contact with the virus, it can

wise to have kids wear

unless they’re on the soles

take weeks or even months

waterproof sandals or flip-

of the feet or another part of

for a wart to appear. A tiny

flops in public showers,

the body that gets bumped

cut or scratch can make any

locker rooms, and around

or touched all the time. There

area of skin more vulnerable

public pools (this can help

are several types of warts,

to warts. Also, picking at a

protect against plantar

including common warts,

wart can spread warts to

warts and other infections,

flat warts and plantar warts.

other parts of the body.

like athlete’s foot).

More common in kids and teenagers than in adults, warts are skin infections

They can affect any

TREATING WARTS Warts don’t generally cause any problems, so it’s not always necessary to have

Wart

+ freezing the wart with liquid nitrogen (called cryosurgery) + using laser treatment (with recalcitrant warts)

them removed. Without treatment, it can take anywhere from six months

Within a few days after

to two years for a wart to

the doctor’s treatment, the

go away. A doctor might

wart may fall off, but some

decide to remove a wart if

stubborn warts may require

it’s painful or interferes with

additional treatments.

Signs and Symptoms OF:

Also make sure that your child:

common warts: • located on back of hands, around nails, and in the mouth, or at the site of cuts and scratches • small flesh-coloured bump • rough surface that looks like cauliflower • pink or white soft bumps in the mouth • tiny black dots inside the wart

activities because of the discomfort.

+ keeps the area of the wart covered while the medicine works + knows not to rub, scratch, or pick at it, to avoid spreading the virus to another part of the body or causing the wart to become infected

WHEN TO VISIT YOUR DOCTOR Talk with your doctor before LASER TREATMENT

Doctors have different ways of removing warts, including: + using over-the-counter or

using any over-the-counter wart medicine on the face, genitals or rectum. If you are diabetic please consult your doctor before using any treatments.

topical applications

Also call the doctor if a wart or surrounding skin is:

containing salicylic acid is

+ painful, red or swollen

effective in getting rid of

+ bleeding

warts.

+ changing in appearance

prescription medications to put on the wart – these

+ burning the wart off using a light electrical current

+ oozing pus

HPVinfected cells

Blood vessels

Flat warts: • located on the face, neck, arms, or legs • size of a pinhead • small smooth bumps with a flat top • flesh-coloured or pink to light brown • may occur in groups of 20 to 100 plantar warts: • located on the sole of the foot • pressed into the skin • tiny black dots inside • may be painful and uncomfortable – like walking on a small stone

+ spreads Source: kidshealth.org

page 19

need to know

10 things that can raise your

blood pressure

Around one in four South Africans has high blood pressure (although only half of them know it) – a major risk factor for heart attacks and strokes. Do you know the key causes?

There's no way of telling

To imagine the strain this puts

are more vulnerable. Smoking

from the outside if you have

on your heart, think of the

markedly increases the risk

high blood pressure. You can

pressure you need to blow

of heart disease or stroke for

feel perfectly well and yet

up a round balloon compared

a given level of high blood

the force of blood pressing

to how much you need to

pressure compared to a non-

against the walls of your

blow up one of those long

smoker.

arteries can be high enough

skinny balloons used to make

to be slowly causing damage

balloon animals.

that increases your risk of heart disease, strokes and

2. Family history

4. Excess alcohol

Regular alcohol intake is clearly associated with high

Have one or both of your

blood pressure. It seems to

parents had high blood

have an especially marked

pressure? Family history

effect on the blood pressure

contributes anywhere

of older women who smoke.

between 2% and 10% of your

For them, two standard

risk of developing high blood

drinks can elevate blood

pressure, depending on your

pressure. Regular heavy or

Sixty per cent of people aged

age and whether one or both

binge drinking, however, can

60 or more have high blood

parents had a blood pressure-

cause substantial rises in

pressure. Our arteries stiffen

problem.

blood pressure, sometimes

kidney failure.

But there are some known key factors that increase your risk:

1. Age

with age. This means the same volume of blood is forced into a smaller area and your blood

3. Smoking

extreme enough to lead to a stroke. Alcohol can also

This adds to the risk of

impact on the effectiveness

pressure may rise, sometimes

developing high blood

of blood-pressure-lowering

dramatically.

pressure and older people

medication.

5. Being overweight or obese

stages of high blood pressure

6 grams a day, but most of

is likely to develop kidney

us eat more than this. Some

Obesity increases the risk

disease in the next six years

take-away pizzas contain

of developing high blood

if they don't receive blood-

13 grams per single pizza!

pressure in the next four years

pressure treatment.

Bread alone contributes 20

by 6%. Extra body fat around your middle carries the greatest risk.

6. Kidney disease

7. Excess salt in the diet

per cent of dietary salt intake and processed meats 15 per

Sodium chloride (salt) is

cent. Condiments, sauces and

the main source of sodium

marinades we add to food are

in most foods. As sodium

often very high in salt.

Inflammation and infection

in our blood increases, the

(among other things) can

blood vessels retain water

cause kidney disease, which

to try to balance the sodium

is a major cause of high blood

concentration. This extra

more common in people with

pressure. And once you have

water increases the volume

diabetes (60% of people with

high blood pressure, it can

of blood in vessels, causing

type 2 diabetes and 40% of

make kidney disease worse.

high blood pressure. The

people with type 1 have high

Someone with normal kidney

recommended maximum

blood pressure.

function who is in the early

salt intake is less than

8. Diabetes

High blood pressure is much

Source: WebMD

page 21

need to know 9. Low physical activity People who spend a lot of

time watching TV and little

What do blood pressure numbers mean?

A normal systolic blood pressure is below 120.

A systolic blood pressure

time on physical activity have been shown to have

Knowing both your systolic

of 120 to 139 means you

higher blood pressure than

(top number) and diastolic

have prehypertension,

more active people.

(bottom number) blood

or borderline high blood

pressure numbers is

pressure. Even people with

important and could save

prehypertension are at a

your life.

higher risk of developing

10. Rare causes

About 5 per cent of people

heart disease. A systolic

with high blood pressure have a specific underlying

Blood pressure is measured

blood pressure number of

cause, generally related to

in millimetres of mercury,

140 or higher is considered

their kidneys, their aorta (the

as two figures, for example

to be hypertension, or high

major artery which takes

124/80 mmHg.

blood pressure.

+ The first number (124 in

A normal diastolic blood

blood away from the heart) or hormonal conditions. Unlike the most common forms of

this case) is known

pressure number is less

high blood pressure, which

as systolic pressure –

than 80.

generally require lifelong

pressure in the arteries

treatment, many of these

when the heart contracts.

pressure are curable.

A diastolic blood pressure between 80 and 89 indicates

rare causes of high blood

+ The second number (80

prehypertension. A diastolic

here) is diastolic pressure

blood pressure number of

– the pressure in the

90 or higher is considered

arteries when the heart

to be hypertension or high

rests between beats.

blood pressure.

Where does your blood pressure measure up?

HEALTH FACTS

Flu Season llion ult in between 3 and 5 mi Annual flu epidemics res 00 0,0 50 d between 250,000 and cases of severe illness an the world. deaths every year around

year! suffer from flu every le op pe VE FI F O UT ONE O

161km/h

The single best way

48 hours

ect Adults may be able to inf re others 1 day befo to symptoms develop and up

to prevent the flu is to get a flu vaccine every season.

is the speed the flu virus can travel through the air.

The length of time the flu virus can survive on surfaces.

k.

ng sic 5-7 days after becomi

What is the best treatment for flu?

inly Flu viruses spread ma made by droplets flu the th wi le when peop k. tal or cough, sneeze

Rest, liquids and antiviral medication.

tween May and August! be e ar els lev u fl ak pe e th Watch out,

More than 200

viruses can trigger a runny nose, sore throat, sneezing or coughing.

32.8° C

The temperature inside the human nose and the appropriate temperature at which rhinoviruses (flu germs) grow best.

A sneeze can spray

3000 infectious

droplets into the air.

page 23

how to

Care for your

elderly parents Is dad forgetting routine activities? Is mom having trouble managing the budget?

Have you noticed that your parents’ driving skills have become dangerous to themselves and others? These are common signs that your loved ones may be having cognitive changes and potential memory loss. Now is the best time to talk with them about their health and well-being. Although these are hard conversations to have, start by bringing up your concerns with your loved one.

Concerned about your ageing parents’ health? Use this guide to gauge how your ELDERLY parents are keeping up – and what to do if they need help.

become angry when you bring

and resources to help them be

up your concerns, or that they

the best they can be. If you’re

ignore the concern by laughing

thinking about transitioning to

it off, you can call their doctor

a retirement village or nursing

to express your concerns in

home, plan ahead and get on

private.

a waiting list.

Typically, a doctor will refer

Even if your loved one isn’t

patients to occupational

ready to transition, in most

Suggest scheduling a doctor’s

therapy to either test cognitive

cases, you can stay on the

appointment where the three

performance or screen them to

waiting list until a spot opens.

of you can talk through your

see if they should still be driving

cares and concerns, while

and are able to perform routine

creating a long-term care

tasks at home. Once the test

plan.

results come back, together with the doctor, you and your

If you find that your parents

loved one can look at next steps

As your parents get older, how can you be sure they’re taking care of themselves and staying healthy?

When you are visiting your parents, consider the following questions: Mood and Brain Health

+ Does your loved one have

Memory and Thinking

+ Have there been problems

sudden or frequent

with wandering or getting

sadness?

lost?

+ Is there a loss of interest

forgetting about the stove

enjoy?

or other appliances or home

personality change? + Is your loved one experiencing excessive or unusual worrying? + Is organisation a problem? + Have you noticed difficulty in their learning new things? + Are there new difficulties with mental tasks? + Is there a lack of social or purposeful activities? + Does your loved one

+ Are there problems paying bills on time?

+ Have there been issues

in activities they used to + Has there been a

Trouble managing finances

equipment? + Is there concern about poor safety awareness or poor

+ Are you concerned about scams?

Health

+ Has your loved one had any falls? + Have there been

judgment? + Do they fail to take medication on time? + Are there spoiled foods in the fridge? + Is there a noticeable change

repeated trips to the emergency room (ER) or hospital?

Driving

+ Do passengers feel

in hygiene? + Have there been troubles with problem-solving? + Have they been calling more

suddenly seem or feel

frequently with an increase in

lonely?

concerns and questions?

worried? + Have there been any accidents or close calls?

Source: www.mayoclinic.com | www.healthpartnerslocalcare.org

page 25

how to

Taking action

depressed mood, memory

someone to clean the house

loss or other signs and

and run errands. A home

There are many steps you can

symptoms, encourage your

healthcare aide could help

take to ensure your parents’

parent to schedule a doctor‘s

your parents with daily

health and well-being, even if

visit.

activities, such as bathing.

you don't live nearby.

For example:

+ Share your concerns with your parents:

+ Address safety issues:

Point out any potential safety issues to your parents – then

+ Contact the doctor for guidance: If your parents dismiss

make a plan to address the

your concerns, consider

problems. If your parents are

contacting the doctor

Talk to your parents. Your

no longer able to drive safely,

directly. Your insights can

concern might motivate

suggest other transportation

help the doctor understand

your parents to see a doctor

options.

what to look for during

or make other changes.

+ Encourage regular medical checkups:

+ Consider home care services:

If your parents are having

If you’re worried about

trouble taking care of

a parent’s weight loss,

themselves, you could hire

upcoming visits.

Sometimes parents won’t admit they need help, and others don’t realise they need help...

That’s where you come in.

Being human and understanding

If you and your siblings or

Make sure your parents

will take you a long way.

family members are all on

understand the problem

Sometimes cognitive

the same page, this is a

and your proposed solution.

impairments are to blame

huge help. Always think of

Remind your parents that you

or stubborn family members

the serenity prayer when

care about them and that you

are the culprit. Whatever the

it comes to helping ageing

want to help promote their

problem, it will most likely be a

people: “Please grant me the

health and well-being, both

challenge; but it’s important to

serenity to accept the things

today and in the years to

separate what you need from

I cannot change, the courage

come.

what your parent needs.

to change the things I can, and the wisdom to know the difference.”

Unfortunately, that last part is often hard to sort out when it comes to seniors, but getting help from people with geriatrics training can help.

And family members are key to helping their loved ones through the challenges of ageing.

E D I U G D I A T S R FI us

Concussions are serio

Athletes take on

to serious injuries. Doctors

cause the brain to bounce

numerous risks each

may describe concussions

around or twist in the skull,

time they step on the

as “mild” because they are

stretching and damaging

field, hop in the pool,

usuall y not life-threatening,

the brain cells and creating

or climb on a bike.

but the effects can be

chemical changes in the

serious and you should seek

brain.

One of those risks is head

medical attention.

injuries. Regardless of whether or not an athlete participates in contact

WHAT IS A Concussion?

sports, a sport-related

Signs and Symptoms Athletes who show or report one or more of the

concussion could happen to

A concussion is a type of

signs and symptoms listed

almost any athlete, at any

traumatic brain injury (TBI)

below, or simply say they

time.

caused by a bump, blow,

just “don‘t feel right” after

or jolt to the head or by a

a bump, blow, or jolt to the

P articip ating in sports is

hit to the body that causes

head or body, may have a

thrilling and fun for all ages,

the head and brain to move

concussion or more serious

but high-imp act contact and

rapidly back and forth.

brain injury.

slippery surfaces can lead

This sudden movement can

page 27

first aid

Concussion Symptoms Reported

Concussion Signs Observed

Signs and symptoms

+ Headache or “pressure”

+ Can’t recall events prior to

not know how serious the

+ Nausea or vomiting. + Balance problems or

+ Appears dazed or stunned. + Forgets an instruction, is

in the head.

dizziness, or double or blurry vision.

+ Bothered by light or noise. + Feeling sluggish, hazy, foggy, or groggy.

+ Confusion, or

concentration or memory problems.

+ Just not “feeling right”, or “feeling down”.

Action plan:

or after a hit or fall.

generall y show up soon after the injury. However, you may injury is at first and some symptoms may not show up for hours or days.

confused about an

You should continue to check

assignment or position,

for signs of concussion right

or is unsure of the game,

after the injury and a few

score, or opponent.

days after the injury.

(even briefly).

If the concussion signs or symptoms get worse, you should take him or her to the emergency department right away.

+ Moves clumsily. + Answers questions slowly. + Loses consciousness + Shows mood, behaviour, or personality changes.

Anybody with a possible concussion needs to be seen by a doctor.

1. Remove From Play If the concussion happens while playing sports, you should also: 1. Remove the athlete from

affecting your child for a lifetime.

2. Seek Medical Care Most athletes are treated in

play. When in doubt, sit

the emergency department

them out!

or in a doctor’s office after

2. Keep the athlete out of

a concussion and get to go

• Any memory loss right after the injury • Any seizures right after the injury • Number of previous concussions (if any)

3. Tests for Concussion and Brain Injury

play the day of the

home. However, when the

injury and until a doctor,

injury is more serious, they

The doctor may do a CT scan

experienced in evaluating

may need to stay in the

of his or her brain to look for

for concussion, says he or

hospital overnight.

signs of a more serious brain

she is symptom-free and

injury. Other tests such as What to Tell the doctor

“neuropsychological” or

Tell the doctor if the athlete

“neurocognitive” tests may

Children or teens who return

is taking any medications.

also be performed. These

to play too soon – while the

Share the following:

tests help assess the athlete’s

brain is still healing – risk a

• Cause of the injury and

learning and memory skills,

it’s OK to return to play.

greater chance of having a

force of the hit or blow to

the ability to pay attention

repeat concussion. Repeat

the head or body

or concentrate, and how

or later concussions can be

• Any loss of consciousness

very serious. They can cause

(passed out/knocked out)

permanent brain damage,

and if so, for how long

quickly he or she can think and solve problems.

4. Get Concussion Care Instructions

5. Recovery From Concussion

After a concussion, physical

Ask for instructions from

Rest is very important after

and learning – should be

the athlete’s doctor on

a concussion because it

carefully watched by a

return to play. These

helps the brain heal. The

medical provider. As the

instructions should include

injured athlete may need

days go by, the patient can

information about when

to limit activities while he

expect to slowly feel better.

they can return to play and

or she is recovering from a

what steps you should take

concussion.

Keys to Recovery

to play. Before returning to

Any physical activities or

• Rest.

play an athlete should:

activities that involve a

• Take it slow.

• Be back to doing their

lot of concentration, such

• Talk to your healthcare

and cognitive activities – such as concentration

to help them safely return

regular school activities.

• Not have any symptoms

as studying, working on

provider.

the computer, or playing

from the injury when

video games or solving any

doing normal activities.

kind of puzzles may cause

• Have the green light from

concussion symptoms

their healthcare provider

(such as headache or

to begin the return-to-

tiredness) to come back

play process.

or get worse.

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.

Sources: www.cdc.gov; HEADS UP resource centre, www.brainline.org

page 29

recipe

BANANA

Flapjacks

OPTION ONE

py on the outside, and Fluffy on the inside, cris bananas and vanilla – h wit delicately flavoured top them with sliced or drizzle them with honey ting of icing sugar. dus a and ries ber or s banana Prep time: 10 minutes tes Cook time: 20 minu tes Total time: 30 minu cks

Makes 12 “big” flapja

Ingredients For Flapjacks

Instructions 1. In a medium bowl, whisk

griddle, and swirl it around.

6. Drop the batter by ¼-

cupfuls onto the griddle,

• 375ml flour

together the flour, sugar,

spacing the flapjacks. Cook

• 30ml sugar

baking powder and salt.

until a few holes form on

• 12,5ml baking powder

2. In a small bowl, mash

• 2,5ml salt

the banana with a fork until

• 1 small, over-ripe banana,

almost smooth.

peeled (the browner, the better) • 280ml milk • 2 large eggs

3. Whisk in the eggs, then

top of each flapjack and the underside is golden brown, about 2 minutes.

7. Flip the flapjacks and cook

add the milk and vanilla and

until the bottom is golden

whisk until well blended.

brown and the top is

4. Pour the banana mixture

puffed, 1 to 2 minutes

• 2,5ml vanilla extract

and the melted butter into

more. Using the spatula,

• 45ml unsalted butter, melted

the flour mixture. Fold the

transfer the flapjacks to a

For Cooking

batter gently with a rubber spatula until just blended;

serving plate.

8. Wipe the griddle clean

• Vegetable oil

do not over-mix. The batter

with paper towels, add

• Unsalted butter

will be thick and lumpy.

more butter and oil, and

For Serving

5. Set a griddle or non-stick

repeat with the remaining

pan over medium heat

batter. Serve the flapjacks

• Honey

until hot. Put a pad of

while still hot with honey,

• Sliced bananas

butter and one tablespoon

sliced bananas and icing

• Icing sugar (optional)

vegetable oil onto the

sugar if desired.

Flourless

ck s BANANA Fly reaallypareja made with

– the Gluten-free and dairy-free up with seems like you’d just end It s. egg and s ana ban just resembles y trul t duc pro l fina but the scrambled banana-eggs, edges. py cris h wit , golden brown a flapjack. Piping hot and tes | Cook time: 15 minu Prep time: 10 minutes cks pja fla all sm tes | Makes 8 Total time: 25 minu

Ingredients For Flapjacks

eggs together until the yolks

OPTION TWO 7. Flip the flapjacks: It is best

and whites are completely

to do this very gently and

combined. Add the vanilla

fairly slowly — the opposite

extract. Pour the mix over

of regular pancakes.

the banana and stir until

Gently work a spatula

• 2 eggs

the eggs are completely

about halfway under the

• ¼ teaspoon vanilla extract

combined. The batter will

flapjack, then lift until the

• Extra toppings like chopped

be very loose and liquidy,

unsupported half is just

more like whisked eggs

barely lifted off the pan.

than regular flapjack batter.

Lay the flapjack back down

• 1½ large bananas, ripe to overripe

nuts

For Cooking • Unsalted butter

For Serving

• Honey, butter, or blueberries, to serve

Instructions

1. Mash the banana: Peel the bananas and break it up

3. Heat a non-stick frying pan

on its other side. Some

over medium heat: Melt a

of the loose batter will

little butter in the pan to

probably spill onto the pan

prevent sticking, if you like.

as you do this; just be sure

4. Drop roughly 2

tablespoons of batter onto the hot griddle. It should sizzle immediately — if not, turn up the heat slightly.

5. Cook the pancakes until

to lay the flapjack on top of the spill and nudge any excess back under it.

8. Cook the flapjacks for another minute or so, until the other side is also

into several big chunks

the bottoms look browned

golden-brown. You can flip

in a bowl. Use a fork to

and golden when you lift

the flapjacks a few times

thoroughly mash the

a corner — about 1 minute.

if you need to in order to

bananas. Continue mashing

The edges should also be

get them evenly browned.

until the banana has a

starting to look set, but the

(Flipping is much easier

pudding-like consistency

middle will still be loose

once the second side is set!)

and no large lumps remain;

like barely set jelly.

Keep the finished flapjacks

a few small lumps are ok.

6. Sprinkle any loose

You should have ⅓ to ½

toppings, like nuts over the

cup of mashed bananas.

top of the flapjacks as the

2. Stir in the eggs: Whisk the

warm in the oven if cooking more than a single batch.

9. Serve while still hot.

first side cooks.

page 31

your experts

YOUR s to Email your question .za experts@intercare.co

Stress or thyroid?

I am a 36 year old woman suffering from lack of energy, hair loss and constipation. Is it stress or can it be my thyroid?

People get information from the internet and social media, and then try and treat their symptoms with overthe-counter products (like vitamin B compounds for lack of energy or iron supplements for hair loss). This may lead to a delayed diagnosis. Yes, stress can lead to hair loss and lack of energy, but so may hypothyroidism (underactive thyroid function), iron deficiency anaemia or even pregnancy (and a whole list of other conditions)!

The best advice with any concerning or non-specific symptoms is to rather see your GP (and not try and diagnose yourself with Google)! A GP would be able to take a good, comprehensive history and then do a general examination. This may or may not be followed by selective blood tests to exclude or maybe diagnose an underactive thyroid.

Dr Yolande Louw – GP Silver Lakes Intercare

Bed-wetting

My son is six years old and still wets his bed, although infrequently. At what point should I worry about my child’s bed-wetting?

Enuresis (bed-wetting) is defined as the involuntary or voluntary repeated discharge of urine into clothes or beds at a stage when bladder control should have been established. Most children with a mental age of five have obtained bladder control during the day and night. The diagnosis of enuresis is made when urine is voided twice a week on at least three consecutive months. The incidence of enuresis at five years is 7% for males and 3% for females. At age 10 it is 3% for males and 2% for females. At age 18 it is 1% for males and extremely rare in females. There is a marked familial incidence.

Dr Ernst Teichler – Paediatrician Silver Lakes Intercare

How serious was my fall?

I fell several days ago. The cut on my leg doesn’t seem to be getting better.

Do I need to see a doctor?

Yes, visit your doctor to evaluate the severity of the wound. The healing process can be influenced by several conditions – uncontrolled hypertension, high cholesterol levels and high blood glucose levels. The doctor needs to check for these conditions also.

Dr Wilma Bergh – GP Silver Lakes Intercare

Contact our Intercare experts at INTERCARE SILVER LAKES Tel: 012 809 6000 | Fax: 012 809 6001 Email: silverlakes@intercare.co.za Hazeldean Square, Corner of Lynnwood and Silver Lakes Roads, Silver Lakes, Pretoria

TAKING RADIOLOGY INTO THE FUTURE

Morton and Partners is proud to have been able to provide radiology services to patients and doctors in Cape Town over many years. We have radiology departments in 9 hospitals and 6 X-ray centres extending from Tableview to Tokai.

Why choose Morton and Partners?

•

We offer a comprehensive radiological service.

•

Our radiology team is a mix of experienced general radiologists and internationally trained super-specialists.

•

We offer specialized radiology such as MRI of the female pelvis, MRI of the prostate and gastro-intestinal tract, digital mammography/tomosynthesis, interventional radiology, musculoskeletal ultrasound and image guided injections.

•

Our large geographic footprint ensures that your radiology studies performed at any Morton & Partners department will be made available to any doctor you consult in a hospital we serve.

•

Up-to-date equipment including 3T MRI, wide-bore MRI, digital mammography with tomosynthesis, cardiac CT scanners and high frequency musculoskeletal ultrasound probes.

•

Our picture archiving and communication system enables storage of images and reports. Your doctor can view your studies in the consulting room, at the bedside, at home or on a mobile tablet.

www.morton.co.za

Broad Road Medical Centre, Wynberg 021 797-4160

Life Vincent Pallotti Hospital, Pinelands 021 531-7635

Chris Barnard Memorial Hospital, Cape Town Cape Town 021 424-8090

Mediclinic Cape Town, Gardens 021 424-2332

Intercare Century City 021 834 9680

Mediclinic Milnerton 021 551-6330 Melomed Bellville Hospital 021 946-1020

Life Orthopaedic Hospital, Pinelands 021 531-7814

Melomed Gatesville Hospital 021 637-8121 Melomed Tokai Hospital 021 276 1789 Rondebosch Medical Centre 021 689-7717/8 Women’s Imaging Tokai 021 276 1790

Medicross Practices: Kenilworth: 021 670-7660 | Langeberg: 021-980 5117 | Parow: 021 936-7311 | Tableview: 021 521-1009 | Tokai: 021 701-9958