W I N T E R 2 019
language creating a great healthcare experience altogether
06 THE WAR AGAINST PLASTIC | 12 MORE THAN BABY BLUES | 22 ALCOHOL AND ERECTILE DYSFUNCTION
Your mouth says a lot about your health. Improve your overall wellbeing. Book a dental check-up.
08 04 SNIPPETS 06 THE WAR AGAINST PLASTIC 08 GROWING UP WITH VACCINES 12 MORE THAN BABY BLUES
17 BLOOD WORKS 20 FIRST AID: SEVERE BLEEDING 22 ALCOHOL AND ERECTILE DYSFUNCTION 24 ANTIBIOTICS: ENEMY OR FRIEND 26 WHY DO WE CRAVE COMFORT FOOD IN WINTER? 28 TRAVELGROUND: COZY COTTAGE STAYS
30 RECIPE: TWO ‘LESS’ BURGER RECIPES 32 SNACKS - THE GOOD AND THE BAD WE WANT TO HEAR FROM YOU We would like to invite all patients and customers to air their views and provide us with input regarding this magazine. In doing so, we can remain relevant and will then be able to make a difference and “create a great healthcare experience altogether” on a daily basis. Please email us with any suggestion you would like to read about at email@example.com or firstname.lastname@example.org
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Body Language 01
THE CHIEF EXECUTIVE
Intercare is a leading-edge integrated healthcare organisation that combines state of the art facilities with best in class healthcare professionals, all working together to unconditionally serve the ultimate beneficiaries, who can be none other than the patients who entrust us with their care. The ethos of Intercare is to care for people the Intercare way. We have a strong commitment and continuously strive to demonstrably live our values, including putting the patient first, excellence, compassion, innovation and integrity. As a patient-centred organisation with a healthcare model that is focused on preventative healthcare and aims to keep people healthy, Intercare structures its services around the health status and needs of patients. Intercare offers consumers accessibility and convenience through the location of facilities and extended operating hours, high quality clinical care, and reduced costs amid an escalating disease burden. Wellness screenings play a large role in preventative healthcare. Our behaviour and lifestyle choices influence our health far more than we are willing to acknowledge, and as a healthcare brand we are extremely aware that everything we do today can help build the foundation for a healthy population in the future. Currently 22 multi-disciplinary medical and dental centres, 4 day hospitals, 4 sub-acute hospitals and 1 specialised hospital operates under the Intercare brand. The latest addition is Intercare Tramshed Medical and Dental Centre, located in the Pretoria CBD, which opened its doors on 5 August 2019. Intercare is an example of what is possible when one is willing to invest, collaborate and partner to make value-based healthcare a reality.
During June 2019 Intercare, in collaboration with the Dutch Reformed Church Tygerpoort, established the Tshwenyega Community Clinic offering basic healthcare services to the people of Kungwini and the Pretoria East community. This nurse-based facility offers general consultations for adults and children, health screenings, as well as preventative healthcare. Although we are facing many challenges in our country, let us reflect for a moment not only on the challenges, but also on the opportunities it brings about. Let us embrace a positive attitude and recognise the potential, rather than focus on the problems. Let us build the future on the good that has been done to ensure that tomorrow will be better than today.
Dr Hendrik Hanekom CHIEF EXECUTIVE OF INTERCARE GROUP
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NEWS & EVENTS
TSHWENYEGA COMMUNITY CLINIC OPENED ITS DOORS IN PRETORIA EAST
Sr Shoni Ngobeni and the first patient at the clinic
Dr Hendrik Hanekom (Chief Executive, Intercare Group), Corli de Vries (Operational Manager), Sr Shoni Ngobeni (Sister in charge), Dr Harold Amaler (Cipla), Ntombi Zitha & Lebo Matlala-Nhlabathi (Optometrists, Brown Eye Clinic), Dr Zander van der Westhuizen (Lead pastor Dutch Reformed Church Tygerpoort) & David Grier (Cipla).
The Tshwenyega Community Clinic has opened its doors in Pretoria East and true to the meaning of the name, “to care when someone suffers”, patients have already been taken care of since Saturday, 1 June 2019. After realizing the increasing need for basic healthcare services in the Kungwini and Pretoria East areas, a partnership was formed between the Dutch Reformed Church Tygerpoort, Intercare and Cipla to offer residents in the area easier access to basic healthcare services where previously they would have to travel far distances, endure long waits without any guarantee of being consulted by a medical professional. Tshwenyega Community Clinic is a nurse-based facility and offers
general consultations for adults and children, follow-ups, as well as health screenings including blood pressure, glucose, HIV and cholesterol. Emphasis is placed on preventative healthcare, and as such the clinic offers free breast examinations to patients who come to the clinic for their pap smears. Furthermore, family planning, antenatal baby care and wound care is also being offered. The fully equipped clinic has two consultation rooms, a reception area and an eye clinic. The nurses are supported by electronic systems that include mentoring by local doctors and pharmacists, as well as protocols enabling the nurses to not only make certain diagnoses, but also to know when to
refer patients to a doctor or a specialist. Networks are in place for the delivery of medication, and the nurses have a specialised app through which they run the clinic’s day-to-day business. Patients can be sponsored or subsidised privately, by their employers or by organisations such as church groups. Local businesses can also support the clinic through financial contributions or by making Tshwenyega Community Clinic the clinic of choice for their workers. By deploying essential healthcare services near underserviced communities, South Africans receive much better access to healthcare wherever they are. Body Language 03
SPOTTING EAR INFECTION WITH AN APP A cheap accessible invention is making patients the point-of-care.
Parents may soon be able to spot ear infections with a paper cone and an app. A team of researchers, from the University of Washington and the Seattle Children’s Research Institute are working on a smartphone app that could help diagnose ear infections with the help of a simple paper funnel. The app uses the phone’s microphone, its speaker and a small paper cone that might help parents detect fluid build-up in a child’s ear – one of the common symptoms of an ear infection. Sound can be used to detect ear fluid. To focus this sound, doctors and parents crafted a small funnel out of paper. The tip of the funnel fits into the ear canal. The app then sends short, soft pulses of sound “kind of like a bird chirping” into the ear canal. It then measures the echo of the sound, and an algorithm uses the reading to predict if there’s fluid behind the eardrum. If there is fluid behind the eardrum, the echoes will sound different from those in a healthy ear. The researchers hope this might help parents diagnose ear infections, but specialists point out that not all fluid behind the eardrum indicates an infection. Doctors really need to examine a child to make that diagnosis, which is based on looking into the ear, temperature and other clinical signs. Source: www.engadget.com; www.npr.org
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CAN YOU SPOT ALZHEIMER’S DISEASE? Alzheimer’s is a brain disease that causes a slow decline in memory, thinking and reasoning skills. It begins altering the brain long before it affects memory and thinking, but according to the American Alzheimer’s Association, the following are some early warning signs and symptoms of Alzheimer’s disease to look for: • • • • • • • • • •
Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks at home, at work or in leisure Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or social activities Changes in mood and personality
If you or a loved one are experiencing any of these symptoms – especially if it is not a typical agerelated change – don’t ignore them. Talk with your doctor and ask for a more in-depth evaluation of memory if symptoms are out of the ordinary and/or interfere with daily life.
ENJOY HEALTHIER RESTAURANT MEALS Restaurants often overdo portion sizes, butter, and salt. But with a few adjustments, restaurant meals can be a wonderful and healthful experience. Substitute white rice for brown, regular pasta for wholewheat, or potato chips for beans. Instead of having an entrée sautéed, ask for it to be boiled or steamed.
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THE WAR AGAINST
PLASTICS Plastic pollution is killing our planet! Itâ€™s choking our oceans, poisoning our food and water supply, and wreaking havoc on the health and well-being of humans and wildlife worldwide.
HOW HEAVY IS METRIC TONS? Humans have created about 8.3 billion metric tons of plastic to date, outgrowing all man-made materials other than steel and cement. 822,000 X EIFFEL TOWERS (10,100 METRIC TONS) 80 MILLION X BLUE WHALES (104,5 METRIC TONS)
25,000 X EMPIRE STATE BUILDINGS (331,000 METRIC TONS)
1 BILLION X ELEPHANTS (7.5 METRIC TONS)
THE RAPID RISE OF PLASTICS A world without plastics seems unimaginable today, yet their large-scale production and use only dates back to around 1950. GLOBAL PLASTICS PRODUCTION ESTIMATES
HOW DOES PLASTIC WASTE HARM ANIMALS? Plastic is killing more than and animals every year.
1.1 MILLION sea birds
OF BEACH LITTER WORLDWIDE IS PLASTIC. The litter includes filters from cigarette butts, bottles, bottle caps, food wrappers, grocery bags, and polystyrene containers. THE LIFECYCLE OF PLASTIC
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PLASTICS AND THE HUMAN BODY
How much plastic does the average human eat per year?
Pieces of microplastic
HEADACHE, DIZZINESS & UNCONSCIOUSNESS
BREATHING DIFFICULTIES, ASTHMA, RESPIRATORY PROBLEMS HEART PROBLEMS
TYPHOID, STOMACH ACHE, FOOD POISONING
INDIGESTION, DIARRHOEA, VOMITING
THE OF PLASTIC ABSORPTION BY THE BODY
HOW TO LIVE WITH LESS PLASTIC BRING YOUR OWN... 1. GLASS or REUSABLE STAINLESS STEEL WATER BOTTLE 2. REUSABLE SHOPPING BAG - keep it somewhere handy 3. CUTLERY - wood or stainless steel knife & fork 4. REUSABLE COFFEE CUP 5. Pack lunch in REUSABLE CONTAINERS 6. SKIP FAST FOOD - Dine in 7. USE GLASS JARS to store left overs
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NEED TO KNOW
GROWING UP WITH
On-time vaccination throughout childhood is essential because it helps provide immunity before children are exposed to potentially life-threatening diseases. Vaccines are tested to ensure that they are safe and effective for children to receive at the recommended ages. Vaccinating your baby ensures that their bodies develops its own immune response to that particular disease. This means that if he is later exposed to the disease, the body has already got its defence ready to protect him. VACCINATION FACTS: • 1 in 5 children worldwide are still not receiving the vaccines he or she needs. • 1 child still dies every 20 seconds from a vaccine preventable infectious disease. 08 Body Language
• Vaccines save 2-3 million children each year. • 10+ vaccines are recommended to protect children – 1 single vaccine (DtaP/IPV/Hib) prevents 5 diseases: Diptheria, Tetanus, Whooping cough, Polio and Haemophilus influenza type b • Vaccines eradicated smallpox worldwide for more than 30 years. • Vaccines are safe. As a result of medical research vaccinations are getting safer and more effective all the time. • The 4 deadliest vaccinepreventable diseases are: - Measles - Haemophilus influenza type b - Whooping Cough (Pertussis) - Neonatal tetanus • The key to prevention is herd immunity – If MOST get vaccinated, spreading is contained. Vaccinations
prevent the spread of disease within the community. HERE IS AN OUTLINE OF SOME OF THE VACCINES AND THE SERIOUS VACCINEPREVENTABLE DISEASES:
1. Diphtheria, tetanus, and pertussis (DTaP) vaccine DTaP VACCINE PROTECTS AGAINST THREE SERIOUS DISEASES: Diphtheria is a
serious infection that causes a thick covering in the back of the nose or throat. It can lead to difficulty breathing, heart failure, paralysis, and even death. WHY VACCINATE? Diphtheria is readily preventable by means of vaccination. In children younger than 5 who are not vaccinated, the mortality rate can be as high as 20%. Tetanus or lockjaw is a potentially
deadly infection that causes painful muscle stiffness and lockjaw.
2. Measles, mumps, rubella (MMR) vaccine
WHY VACCINATE? Worldwide, about 50% of people who have tetanus die. Preventing tetanus is far better than treating tetanus.
MMR VACCINE PROTECTS AGAINST THREE SERIOUS DISEASES: The measles virus
Tetanus rarely develops in people who have completed a primary series of tetanus vaccinations and have had vaccinations every 10 years as recommended. Whooping cough, or pertussis, is a highly contagious disease known for uncontrollable, violent coughing that often makes it hard to breathe. It can be deadly for babies. WHY VACCINATE? Complications of pertussis can include pneumonia, ear infections and in rare instances brain damage. Active immunisation is part of the standard childhood vaccination schedule.
can cause a fever that can get very high, a distinctive rash, cough, runny nose, and red eyes. Sometimes, it can also cause diarrhea and ear infection. It can also lead to pneumonia (infection in the lungs), brain damage, deafness, and death. WHY VACCINATE? Worldwide, measles infects about 20 million people annually, causing about 200 000 deaths, primarily in children. Complications can be severe and include pneumonia, encephalitis (infection of the brain) and middle ear infections. Mumps typically starts with a fever, headache, muscle aches, tiredness, and loss of appetite. Then, most peopleâ€™s salivary glands swell, which causes puffy cheeks and a swollen jaw.
WHY VACCINATE? Mumps is pretty mild in most people but can sometimes cause lasting problems, such as deafness, meningitis (infection of the covering around the brain and spinal cord), and swelling of the brain, testicles, ovaries, or breasts. Rubella may cause a rash or fever, but many people have no symptoms. WHY VACCINATE? Rubella can cause miscarriage or serious birth defects in a developing baby if a woman is infected while she is pregnant. Infected children can spread rubella to pregnant women.
3. Haemophilus influenzae type b (Hib) vaccine This protects against Hib disease, which ranges from mild ear infections to serious bloodstream infections, pneumonia (infection in the lungs), and meningitis (infection of the covering around the brain and spinal cord).
Immunisation is one of the most successful and cost-effective means to help children grow into healthy adults.
World Health Organization
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WHY VACCINATE? Vaccines are available for children older than 6 weeks of age in South Africa and have decreased the incidence of serious infection by 99%. Hib disease can cause brain damage, hearing loss, or even death.
4. Polio (IPV) vaccine
6 WEEKS OPV, RV, DTaP-IPV-Hib, HBV & PCV
IPV vaccine protects against polio, a highly infectious disease caused by a virus that can invade the brain and spinal cord. WHY VACCINATE? Polio can cause lifelong paralysis and even death. Extensive vaccination has almost eradicated polio in developed countries. However, cases still occur in regions with incomplete vaccination such as sub-Saharan Africa and Southern Asia. The injectable polio vaccine given during childhood produces protection in more than 95% of recipients.
5. Rotavirus (RV) vaccine RV vaccine protects against a contagious virus that causes severe diarrhea, often with vomiting, fever, and abdominal pain, requiring hospitalisation. It is most common in infants and young children. Adults who get rotavirus tend to have milder symptoms. WHY VACCINATE? In South Africa approximately 6 children die every day from severe rotavirus. Worldwide, approximately 600 000 children die each year from rotavirus. Vaccines, like any medication, can cause side effects. The most common side effects are mild and the likelihood of these side effects have reduced dramatically within the last couple of years, due to newer and better vaccinations. However, many vaccine-preventable disease symptoms can be serious, or even deadlyâ€“ and vaccination is the best way to prevent them. Here is an outline of visits and vaccinations needed at your medical centre schedule. Talk to your doctor and childâ€™s doctor about which vaccines they recommend.
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BIRTH OPV & BCG
10 WEEKS RV, PCV, DTaP-IP-Hib & HBV 14 weeks RV, PCV & DTaP-IPV/Hib 6 months + Influenza (Flu) vaccine 9 months MMR & MCV 12 - 15 months PCV, MMR, Varicella, HAV (Repeat 6 months later) & MCV 18 months DTaP-IPV/Hib, Measles vaccine & HBV 18-21 months HAV 4-6 years Td, DTaP, MMR & Varicella 9+ years and 6 months later HPV 12 years TdaP-IPV DIFFERENT TYPES OF VACCINES: Oral Polio Vaccine (OPV) Tuberculosis Vaccine (BCG) Rotavirus Vaccine (RV) Diptheria, Inactive Polio, Haemophilus Influenza Type b Vaccine (DTap-IPV-Hib) Hepatitis B Vaccine (HBV) Pneumococcal conjugated vaccine (PCV) Measles vaccine or Measles, Mumps and Rubella (MMR) vaccine Meningococcal conjugate vaccine (MCV) Hepatitis A Vaccine (HAV) Tetanus (Td) Diptheria vaccine (DTaP) Human Papilloma Virus (HPV)
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NEED TO KNOW
MORE THAN BABY BLUES: Depression During & After Pregnancy
Pregnancy are thought to be a time of emotional wellbeing for women, but studies now show that during pregnancy women are not necessarily protected from mood disorders. Life changes around pregnancy can make women more vulnerable to mental illness, therefor women are at higher risk of developing depression or anxiety during pregnancy and the postpartum period. Many people know about postnatal or postpartum depression, but how many know it can occur even before the baby is born? Postpartum depression is only one type of mood disorder in a wider spectrum of perinatal mood and anxiety disorders. The perinatal period refers to the time from conception to the end of the first year after the birth. Not everyone experiences the deep sadness and disconnection of postpartum depression. What used to be called Postnatal Depression is now increasingly being renamed Perinatal Distress (PND) as the medical fraternity recognises it can occur both during and after pregnancy as typical depression and/ or heightened anxiety. Although PND is highly treatable, and detectable it’s generally underdiagnosed in our society. This means many women struggle unnecessarily, with repercussions that can negatively affect marriages, families, careers and communities. Approximately 1 in 3 families is affected by PND in South Africa, according to the South African Depression and Anxiety Group (SADAG). That translates to around 50 000 women per year. Worldwide 10 to 20% of women will experience depression during pregnancy. Women who suffer from depression during pregnancy are also far more likely to develop postnatal depression. 12 Body Language
Depression can lead to unhealthy behavioural changes and depression during pregnancy is no exception. It has been associated with poor prenatal care and an increase in obstetric complications. Depressed women are less likely to take care of their own health than women without depression. This may have several negative consequences such as poor attendance to their obstetric appointments, poor nutrition and an increase in alcohol consumption and smoking. Several obstetric complications such as high blood pressure, premature labour and an increase in operative deliveries (e.g. vacuum-assist delivery, forceps delivery and caesarean section) are associated with depression. As a result, the newborn’s growth and development may be negatively affected as well.
TYPES OF DEPRESSION DURING & AFTER PREGNANCY Certain conditions such as maternity blues are so common (about 70% of women will experience baby blues) that it is deemed a ‘normal’ experience. Typically, the symptoms commence around the fourth day after birth.
Depression during and after pregnancy is typically divided into three types: baby blues, perinatal distress (encompassing prenatal and postpartum depression) and postpartum psychosis. Signs and symptoms of depression after childbirth vary, depending on the type of depression: 1. BABY BLUES These signs and symptoms last
only for a few days to a week or two. • Mood swings • Anxiety or angst • Touchiness • Sleeplessness • Unhappiness or melancholy • Crying and weeping • Decreased concentration
Psychological support is the only treatment for maternity or baby blues. The ‘baby blues’ needs to be monitored carefully as about 20% of women who experience the ‘baby blues’, will progress to having postpartum depression or perinatal distress, a major depressive disorder. 2. PERINATAL DISTRESS Essentially, the
symptoms of antenatal (during pregnancy) and postpartum depression are the same as those seen in non-pregnant women and presents like a major depressive disorder. The challenge with diagnosing PND is that many normal pregnancy symptoms and ‘new mother’ difficulties – such as changes in mood, appetite or sleep patterns, fatigue and guilt feelings– can mimic depressive symptoms. Similarly, many tired, expectant or new mums don’t have the time that they used to for personal grooming or hobbies. Prominent anxiety symptoms typically increase the distress of these women. However, when these symptoms become severe: interfering with a woman’s ability to cope with daily life and connecting with her child, leading to negative consequences for both the baby and the mother; action should be taken to help her immediately. The exact cause of PND is unknown but it is suspected that genetic factors and hormonal changes pre and post-delivery could be the cause of PND. Perinatal distress frequently cooccurs with other psychiatric problems such as anxiety or substance abuse.
WHO IS AT RISK OF DEVELOPING PND? Those
who are more at risk of developing perinatal distress are women who have: • Previously been diagnosed with depression • A family history of depression • Poor social and financial support (e.g. being a single parent). • Unplanned or unwanted pregnancies • Perinatal anxiety • Unplanned or unwanted pregnancies • Attended fertility clinics • Stopped their antidepressant medication abruptly • Anxiety related to child birth The signs and symptoms associated with postpartum depression may initially seem to be the baby blues, but they are more intense and last longer and can eventually hinder your ability to care for your baby and go about your everyday activities and responsibilities. If postpartum depression is left untreated, these symptoms can continue for several months or longer. SOME SIGNS TO WATCH OUT FOR ARE: • Loss of joy and humour in life • Disinterest in things that previously brought them pleasure • Isolation or withdrawal from family and friends • Increased self-criticism, sense of humiliation, remorse or inadequacy • Anxiety and/or panic • Poor self-care, personal grooming • Changes in appetite and/or sleep (too much or too little), insomnia • Concentration problems, forgetfulness, and making decisions • Extreme sadness/misery • Overwhelming exhaustion/lethargy/ fatigue • Reduced ability to cope with daily life • Intense irritability and anger • A strong sense of failure or inadequacy • Severe mood swings • Excessive crying • Physical symptoms such as body aches and pains • Feelings of worthlessness/ helplessness/ hopelessness • Frightening thoughts of harming herself and/or her children • Thoughts of running away or escaping. Body Language 13
There is a wealth of literature on the importance of a healthy bond between a mother and her baby, especially during the first months of the baby’s life. If this first relationship is secure, it provides a stable, healthy base for the baby to explore and face the world. Depression may alter this bonding experience, making the baby more vulnerable to emotional difficulties later in its life. THE IMPACT OF POSTNATAL DEPRESSION ON THE NEWBORN IS: • poor bonding with the mother • failure to thrive • harm or neglect of the child • neurodevelopmental abnormalities. THE IMPACT OF UNTREATED POSTNATAL DEPRESSION IN THE MOTHER IS: • poor bonding with infant • poor self-care and • suicidality or self-harm. It is thus very important to treat depression during the perinatal period (during pregnancy and the first year after birth). The course of PND varies in severity and the symptoms may resolve spontaneously or require active management.
The management requires identification of symptoms and a team approach with monitoring of both baby and mother. Simple measures such as improved self-care (bathing, sleeping and eating) and improved social support may improve the pregnant woman’s or new mother’s mental health. Psychological management in the form of supportive therapy, interpersonal therapy and cognitive behaviour therapy may be the sole form of treatment or can be used in conjunction with pharmacotherapy; depending on the severity of the depressive symptoms. Patients with moderate to severe depressive symptoms or patients who are high risk may require the use of an antidepressant. Certain serotonin re-uptake inhibitors are relatively safe in pregnancy and breastfeeding. The impact of management of the baby and mother are a decreased risk with regard to harm, improved ability to function and improved bonding. If medication is required, the risk and benefits need to be weighed as certain medications can negatively impact the baby or foetus. 3. POSTPARTUM PSYCHOSIS Postpartum psychosis is a rare condition that typically develops within the first two weeks after delivery. The signs and symptoms of this condition are severe and may include: • Paranoia • Hallucinations and delusions • Confusion and disorientation • Attempts to harm yourself or your baby. WHEN TO VISIT YOUR DOCTOR? Pregnant and new mothers who find themselves overwhelmed, frustrated, anxious, persistently teary, or depressed should not be silent or ashamed. You should call your doctor if the symptoms as mentioned in this article are still present after two weeks or if they become more intense during your pregnancy. If you feel that it is difficult to care for yourself or your newborn and to attend to your daily responsibilities or if you have thoughts of harming yourself or your baby it is paramount that you visit your doctor. Getting help is a gift to both you and your child.
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Did you know? 1. PARTNERS GETS SAD TOO Many factors are known to contribute to postnatal depression in new fathers. The most common is maternal postnatal depression. Fathers whose partners have postnatal depression are about two-and-a-half times more likely to have symptoms of depression six weeks after the birth of a child. Fathers with depression struggle to support the partner and children; this increases a motherâ€™s risk of depression. New fathers are also more likely than new mothers to return to work sooner and, in many parts of society, men are still expected to be the breadwinners. Yet new fathers are also expected to play an active role in childcare, and difficulties managing an early return to work with childcare responsibilities can contribute to symptoms of depression.
New fathers can also have difficulty developing an emotional bond with their child compared with mothers, which may increase feelings of helplessness. Depression in fathers is believed to be just as treatable, but it often is not recognized. 2. A SEVERE FEAR OF GIVING BIRTH IS CALLED TOKOPHOBIA, which literally means a phobia of childbirth. Itâ€™s very common for women to feel anxious about labour and birth. Worries about the pain of contractions, interventions and the uncertainty of the process are not unusual. But for some women, the fear of labour and birth can be so overwhelming that it overshadows their pregnancy and affects daily functioning. >> Body Language 15
Key points to remember Review your lifestyle when planning to fall pregnant. Regular exercise and good nutrition, including supplements such as folate, are beneficial to both physical and mental health. Alcohol and cigarette smoking should be avoided completely from the time the decision to conceive is made. The key take home message of this article is early identification and appropriate management of depressive symptoms.
QUESTIONS TO ASK YOUR DOCTOR: 1. What is the difference between baby blues and postpartum depression? 2. How long does it take to recover from postpartum depression? 3. Do I have to take medication to be treated for postpartum depression or anxiety? 4. Can you get postpartum depression or anxiety after adopting a baby or child? 5. Can I be treated with medication for my perinatal mood or anxiety and keep breastfeeding? 6. Does postpartum depression go away on its own? 7. What could happen if I choose not to get professional help? If you feel like you need help, contact SADAG (The South African Depression and Anxiety Group): • To contact a counsellor between 8am-8pm Monday to Sunday, Call: 011 234 4837 • For a suicidal Emergency contact 0800 567 567 • 24hr Helpline 0800 12 13 14
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Sources: 1. South African Depression and Anxiety Group (SADAG) www.all4women.co.za/1531970/news/south-african-news/over-40-of-sa-women-suffer-fromantenatal-postnatal-depression 2. https://theconversation.com/this-is-what-postnatal-depression-really-feels-like-112350 3. Perinatal Mental Health Project. University of Cape Town. 2018. Available from: https://pmhp.za.org/resources/mmh-facts/prevalence/ 4. Maternal mental health. World Health Organisation. 2018. Availablefrom: http://www.who.int/ mental_health/maternal-child/maternal_mental_health/en/
EVERY BLOOD TEST TELLS A STORY ABOUT YOU (AND YOUR HEALTH).
A BLOOD TEST IS A LABORATORY ANALYSIS OF CERTAIN ELEMENTS THAT MAY BE FOUND IN YOUR BLOOD. BLOOD TESTS CAN GIVE YOUR HEALTHCARE PROVIDER A LOT OF INFORMATION BUT ARE ONLY PART OF YOUR HEALTH STORY - WHEN COMBINED WITH THE CARE PROVIDED BY YOUR DOCTOR, THEY PROVIDE A FULL HEALTH SCREENING PICTURE.
system is having problems fighting infections • Diagnose anaemia, such as iron-deficiency anaemia, pernicious anaemia, aplastic anaemia, or haemolytic anaemia • Monitor chronic health conditions and diseases • As preventative screening tests to detect health problems in their early stages.
Screening tests are an BLOOD TESTS ARE ORDERED BY important part of preventive HEALTHCARE PROFESSIONALS health care. Getting regular TO: screening tests for common health problems is a simple and • Find out how well organs effective first step. such as your kidneys, liver, heart, or thyroid are working Your doctor can order a blood • Help diagnose diseases such test: as cancer, diabetes, coronary heart disease, and HIV/AIDS • As part of a routine medical • Find out if your medicine is examination working to make you better • When you have signs and • Diagnose bleeding or clotting symptoms that may be disorders related to a condition that • Find out if your immune affects blood cells
• At regular intervals to monitor treatment or • When you are receiving treatment known to affect blood cells. Be sure to consult your general practitioner regarding the appropriate timing and frequency of all screening tests based on your age, overall health, and medical history. THE FOLLOWING ARE SNAPSHOTS OF COMMON BLOOD SCREENING TESTS: Complete Blood Count The complete blood count (CBC) is often used as a broad screening test to determine an individual’s general health status. WHY GET TESTED? To determine your general health status; to screen for, diagnose, or monitor any one of a variety of diseases >> Body Language 17
and conditions that affect blood cells, such as anaemia, infection, inflammation, bleeding disorder or cancer.
What is being tested? A lipid profile includes testing the following lipid levels:
• Total cholesterol What is being tested? • High-density lipoprotein The complete blood count is a cholesterol (HDL), often test that evaluates the cells that called “good cholesterol” circulate in blood: because it removes excess cholesterol and carries it to • White blood cells, that are the liver for removal. part of the body’s defence • Low-density lipoprotein system against infections and cholesterol (LDL), often cancer and also play a role in called “bad cholesterol” allergies and inflammation. because it deposits excess • Red blood cells, the cells that cholesterol in walls of blood transport oxygen throughout vessels, which can contribute the body. to atherosclerosis. • Platelets, the special cell • Triglycerides, a form of fragments that are vital for fat and a major source of normal blood clotting. energy for the body. This test measures the amount of The results of a CBC can triglycerides in the blood. provide information about not only the number of cell types How to prepare for the test? but also can give an indication Typically, fasting for 9-12 hours of the physical characteristics (water only) before having your of some of the cells Significant blood drawn is required. abnormalities in one or more of the blood cell populations can People with a high level of LDL indicate the presence of one or cholesterol and triglycerides more conditions. in their blood sample have a higher risk for heart disease, SCREENING FOR HEART than those with cholesterol in the normal range. It is DISEASE RISK important to understand, however, that people can still Cholesterol Levels (Lipid have heart disease even with Profile) Lipids are fats and cholesterol levels in the normal fat-like substances that range. are important parts of cells and sources of energy. Two SCREENING FOR DIABETES important lipids, cholesterol and triglycerides, are Glucose Test (Blood Sugar transported in the blood by Profile) One out of three people lipoprotein particles. with diabetes are undiagnosed. This panel of tests gives an A lipid panel measures the overall picture of the body’s use level of specific lipids in blood to help assess someone’s risk of of glucose. heart (cardiovascular) disease WHY GET TESTED? (CVD). It helps to determine if your blood glucose level is within WHY GET TESTED? To assess your risk of developing a healthy range; to screen for and diagnose diabetes and cardiovascular disease (CVD); prediabetes and to monitor for to monitor treatment 18 Body Language
high and low blood glucose. What is being tested? Glucose is the primary energy source for the body’s cells and the only energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood. A blood sugar profile measures the following levels: • Fasting glucose: This test measures the level of glucose in the blood after fasting for at least 8 hours. • Haemoglobin A1c: This test may be used as an alternative to glucose testing for screening and diagnosis. • Fasting Insulin (if blood sugar is an issue): This test measures the amount of insulin in the blood. Glucose blood tests are also used to screen pregnant women for gestational diabetes between their 24th and 28th week of pregnancy. How to prepare for the test? In general, it is recommended that you fast (nothing to eat or drink except water) for at least 8 hours before having a blood glucose test. For people with diabetes, glucose levels are often checked both while fasting and after meals to provide the best control of diabetes. SCREENING FOR PROSTATE CANCER Prostate specific antigen (PSA) Prostate cancer is the most common cancer found in men after skin cancer. It tends to be a slow-growing cancer, but there are also aggressive,
fast-growing types of prostate cancer. WHY GET TESTED? The measurement of the prostate specific antigen (PSA) levels in the blood has become a valuable tool in the diagnosis of cancer of the prostate. PSA is only a screening test and should be used in combination with rectal examination. The role of PSA is to help identify those patients at highest risk or cancer, who will need a biopsy. What is being tested? The PSA levels, which can be elevated in the presence of prostate cancer. Antigens are any substances that evoke responses from a person’s immune system. However, PSA is prostate-specific, but not cancer-specific.
It is important to understand that other benign (noncancerous) prostate conditions may also elevate PSA, such as benign prostatic hyperplasia (BPH), which is noncancerous swelling of the prostate. Remember, none of this is personalised advice and must not replace the advice you get from your doctor. Please use this information for educational purposes only. This information is not intended to diagnose or treat any health condition. Find out why tests need to be done, how they will be done, and what your doctor expects to learn from them. Your doctor is the best person to answer these questions. Make some notes to take along if this helps.
Questions to ask your doctor... • Why does this test need to be done? • How could it change the course of my care? • What do I need to know or do before the test? • What factors can affect the results? • What happens during the sample collection? • How much will it hurt or cause inconvenience? • How long will it be before my results are available? • Where do I need to go to take the test? • What does an abnormal result mean? • Will an abnormal result mean I need further tests? • What course of action may be next, after the test? Your doctor is the best person to answer these questions.
Body Language 19 Source: labtestsonline.org
THESE TIPS CAN HELP YOU SAVE A LIFE
BLEEDING OUT IS THE NUMBER ONE MOST PREVENTABLE DEATH IN ANY TYPE OF TRAUMATIC INJURY. LEARNING FIRST AID SKILLS IS ABOUT PREPARING FOR THE WORST, BUT NOT EVERYONE KNOWS THE SIMPLE STEPS THAT CAN BE TAKEN TO STOP SOMEONE FROM DYING OF BLOOD LOSS. Accidents and traumatic incidents happen every day, which is why emergency professionals across the nation are encouraging people to know how to save lives after a traumatic injury.
When confronted with someone who is bleeding out, there are a few simple steps to follow: Firstly, ensure your own safety. Protect yourself by wearing gloves. 1. Follow the ABCs:
Ambulance: Your efforts can help keep people alive for hours, but only professionals can save them. Call an ambulance or emergency help or ask a bystander to do so.
Uncontrolled bleeding can lead to loss of life in as few as three minutes, and techniques to control excessive blood loss aren’t as commonly known and understood as how to fight fire. By stopping the bleeding before first responders arrive, bystanders can help stabilize patients and expedite treatment in the emergency room.
Bleeding: find it and stop it. Remove, cut or
This is a set of skills that are valuable to everyone, even if it seems like an intimidating topic. If you find yourself in an emergency situation, the ABC’s of “Stop the Bleed” can help give you a little more confidence and take the steps you need to take to save a life.
Compress: Place a sterile bandage, gauze
20 08Body BodyLanguage Language
tear away any clothing. Don’t remove large or deeply embedded objects, because it may be acting as a plug to reduce the bleeding. Don’t probe the wound or attempt to clean it yet. Your first job is to stop the bleeding. Wear disposable protective gloves if available. or clean cloth in and around the wound, then apply firm, direct, steady pressure to the bleeding site with your palm or with both hands, if possible. Apply constant pressure until the bleeding stops.
2. Maintain pressure by binding the wound with a thick bandage or a piece of clean cloth. Don’t put direct pressure on an eye injury or embedded object.
5. Apply a tourniquet or anything you can tie tightly to a wounded limb, 5 – 8 cm closer to the torso from the bleeding. Continue tightening until the bleeding stops.
3. Firmly secure the bandage with adhesive tape or continue to maintain pressure with your hands. If possible, raise an injured limb above the level of the heart.
6. When emergency help arrives, explain how long the tourniquet has been in place. A second tourniquet can also be used above the first.
4. If bleeding is severe and you are not able to stop it with direct pressure, you can apply a tourniquet. A tourniquet is effective in controlling life-threatening bleeding from a limb.
7. Do not remove or reposition your tourniquet or your pressure until you are immediately relieved by another bystander or emergency responder.
WHAT IS A TOURNIQUET? A tourniquet is a simple device that uses mechanical advantage to apply pressure to a limb, clamping shut major blood vessels to mitigate blood loss from major wounds. The first recorded use of tourniquets was in the fourth century BC, but they didn’t find widespread acceptance in modern times beyond operating rooms until the early 2000s.
That’s because applying a tourniquet comes with risks. Clamping down on a person’s limb with incredible force for a prolonged period of time, a tourniquet may damage the nerves and blood vessels in that limb and create a variety of other problems that may end up killing the leg or arm you’re trying to save. But a tourniquet is also the only way to quickly and surely shut down arterial bleeding in a limb and easily maintain that pressure through casualty transport.
Body Language 21
NEED TO KNOW
ERECTILE DYSFUNCTION Boozing puts SA men at risk of erectile dysfunction
ALMOST HALF OF SOUTH AFRICAN MEN ARE LIKELY TO EXPERIENCE PROBLEMS IN THE BEDROOM BECAUSE OF BOOZING. A survey conducted by Pharma Dynamics, a generics pharmaceutical firm specialising in men’s sexual health, among others, found that 44% of SA men could be at risk of erectile dysfunction (ED) or impotence as a result of excessive drinking. Erectile dysfunction is a condition in which a man is unable to get an erection that is firm enough for sexual intercourse. In some cases, the man is able to achieve an erection, but unable to maintain it long enough to complete the sex act or to reach an orgasm. Most men will be familiar with the term “brewer’s droop”, a temporary form of alcohol related impotence that occurs when the average drinker consumes “one too many”, but this is different from ED. According to the Mayo Clinic, those with ED will fail to achieve an erection at least 25 percent of the time. ED has several causes and alcohol consumption can be one of them. While alcohol may succeed as an aphrodisiac, 22 Body Language
stimulating your sex drive, it can dampen sexual responses. As Shakespeare so eloquently put it, alcohol “provokes the desire, but takes away the performance” and studies have proven this to be true. Clinical studies suggest that three or more standard alcoholic drinks per week significantly impairs erectile function and sexual satisfaction. A sobering thought, since more than 31% of SA males already consume over and above five standard glasses of alcohol per week and 13% toss back at least three glasses a week on a regular basis. During an erection, the penis fills with blood then the vessels close, preventing backflow, so that the penis remains erect. In the short term, overconsumption of alcohol causes the blood vessels in the penis to expand, allowing for more blood flow, but prevents those vessels from closing. As a result, the penis may become erect but not remain so, as there is nothing to prevent backflow. In the long term, overconsumption of alcohol damages the blood vessels and contributes to hypertension and even heart disease, both contributing factors to ED. Case studies have shown that long-term alcohol abuse causes ED
in men even when they are sober. Apart from the damage caused to the nervous system by alcoholism, it’s believed that the associated decline in physical and psychological health can contribute to this. Many of the adverse physical and psychological effects caused by boozing can be reversed or overcome if the problem is treated early enough. Excessive alcohol use and alcohol abuse can also cause scarring of the liver, high blood pressure and an increased risk of some cancers. In healthy men, moderate alcohol consumption should not cause erectile dysfunction. If you have erectile dysfunction issues, and you’re a heavy drinker, chances are the alcohol is a major contributor, if not the main cause. The key here is to cut back on your alcohol consumption as much as possible. With the World Cup Rugby season almost upon us, alcoholic drinks will be flowing more freely than usual around “braais”, restaurants and bars throughout the country, especially over weekends. But if you’re at a match-bash and there’s social pressure to drink, it can be difficult to cut back.
QUICK FACTS ON ALCOHOL AND ERECTILE DYSFUNCTION • Alcohol abuse in men can cause impaired testosterone production and shrinkage of the testes (i.e. testicular atrophy). • Alcohol dilates and expands the blood vessels in the penis. If you are able to achieve an erection during this state, the alcohol in your system actually keeps the blood vessels open, allowing the blood to drain out quickly, returning the penis to a relaxed state. • Long-term alcohol abuse affects the nervous system and impairs the impulses between the brain’s pituitary gland and the genitals. • Clinical studies have shown that chronic alcohol use causes irreversible damage to the nerves in the penis, resulting in alcohol impotence.
KEY MESSAGE If you have erectile dysfunction, you may want to consider how alcohol can influence your sexual health and performance.
Here are a few suggestions to reduce the impact of alcoholic drinks. 1. Try to eat something high in protein or fat first, then wait 15 minutes before drinking. These foods line the stomach and sponge up the alcohol, slowing its absorption. 2. Dilute your drinks with lots of ice and water to lower the concentration of alcohol. 3. Stay away from carbonated mixes as this speed up the absorption of alcohol because the bubbles create pressure that pushes the liquid through the stomach wall. 4. Wine and beer are absorbed less rapidly than hard liquor because they contain non-alcoholic substances that slow absorption. 5. Avoid salty snacks since they increase thirst which will encourage you to drink more and faster.
Sources and References: 1. Pharma Dynamics Press Release, Mayo Clinic, https://www.bostonmedicalgroup. com/ed/alcohol-and-erectile-dysfunction/ 2. https://www.livestrong.com/article/28126-can-alcohol-cause-erectiledysfunction/ 3. https://www.alcoholproblemsandsolutions.org/alcohol-and-erectiledysfunction/
Body Language 23
ENEMY OR FRIEND The last century saw a revolution in the tools that we have available to fight contagious diseases. Two of the most important are antibiotics and vaccines.
24 Body Language
n 1928, Scottish biologist Alexander Fleming accidentally discovered a bacteria-killing chemical from a mould growing in his culture plates. Penicillin became the most effective life-saving drug in the world, conquering such dreaded diseases as syphilis, gonorrhoea, tuberculosis, gangrene, pneumonia, diphtheria, and scarlet fever. Many more antibiotics were discovered because of it, and by the middle of the 20th century, antibiotics had become the treatment of choice for diseases caused by infections. It is estimated that penicillin has saved at least 200 million lives since its first use as a medicine in 1942. Fleming also discovered very early that bacteria developed antibiotic resistance whenever too little penicillin was used or when it was used for too short a period. However, decades of overuse, created new antibiotic-resistant “superbugs”, which are resistant to several types of antibiotics. Do you really think you need a prescription for antibiotics? Think again. Up to 50% of antibiotic prescriptions are unnecessary. It is time to rethink the why, when and what of antibiotic use in order to ward off a global health crisis. Even though general practitioners educate and advise patients regarding the use of antibiotics, patients still believe that a prescription for an antibiotic is the one-andonly treatment they need to get better. Your doctor may be able to determine whether an illness is
viral or bacterial by listening to your medical history, doing a physical exam and assessing your symptoms. A viral infection usually presents with flu like symptoms like: • body pain • headaches • abdominal pain • watery diarrhoea and • a clear runny nose. Fevers usually peak every 4 to 6 hours on the first day, spacing to 8 and 10-hourly on the second day and lasting an average of 3 to 4 days. A fine rash often appears on the third day. ANTIBIOTICS ARE NOT EFFECTIVE AGAINST A VIRAL INFECTION. Children and adults respond well to over-thecounter (OTC) medicine containing paracetamol, anti-inflammatories and antihistamines as well as other remedies to help them feel better like rest, keeping hydrated, saline nasal sprays, and humidifiers. Call your doctor if you or your loved one still feel sick or seem to be getting worse. Patients should be 24 hours temperature (fever) free before they can return to school or work. When you’re diagnosed with a bacterial infection, the benefits of taking an antibiotic outweigh the risks. But if you have a viral infection, taking an antibiotic will not clear up the condition and it does more harm than good.
A bacterial infection typically presents with symptoms like: • an abnormally smelly breath • constant sore throat • painful ears • sticky eyes • discoloured mucus • shortness of breath • burning urine • bloody stool • neck stiffness • headaches accompanied by vomiting, as well as • fevers lasting longer than three days. Trust your doctor to decide whether you have a viral or a bacterial infection and don’t insist on an antibiotic if he or she advises otherwise. Do not ask the pharmacist for an antibiotic, either. Rather ask your doctor to review you in 24 hours if your symptoms persist, than pushing for an antibiotic when he/she decides not to prescribe it. Specific bacteria will need a specific type of antibiotic. Using antibiotics recklessly leads to resistance whereas limiting use could keep you healthier in the long run. Next time: Don’t insist on a prescription for an antibiotic if you have a viral infection. Trust your doctor’s diagnosis and rather just wait and see. References: 1. The Case Against Antibiotics, available at: https://www.johnshopkinshealthreview.com/issues/ spring-summer-2018/articles/the-case-againstantibiotics 2. Inventions that drive modern life expectancy, available at: https://aperioncare.com/blog/ page/2/ 3. Alexander Fleming, available at: http://www. newworldencyclopedia.org/entry/Alexander_ Fleming Sources: Dr Desere Ferreira (Intercare Irene & Umhlanga) World Health Organization Center for Disease Control
Body Language 25
DID YOU KNOW?
By Megan Lee and Jacqui Yoxall
IT’S WINTER AND MANY OF US FIND OURSELVES DRAWN TO BOWLS OF CHEESY PASTA, OOZING PUDDINGS, WARMING SOUPS, AND HOT CHOCOLATE WITH MARSHMALLOWS. THESE AND OTHER COMFORT FOODS CAN MAKE US FEEL GOOD. BUT WHY? AND WHY DO WE CRAVE THEM IN WINTER AND NOT IN SUMMER? RESEARCH TELLS US THERE ARE THREE GOOD REASONS. 1. THE GUT ‘SPEAKS’ TO THE BRAIN We know from the relatively new field of nutritional psychiatry that our stomachs produce the “happiness chemicals” dopamine and serotonin. When we eat, a complex process involving the brain means these neurochemicals trigger feelings of happiness and well-being.
26 Body Language
These happiness chemicals are also produced when we exercise and are exposed to sunlight, which decline in winter. This results in a change in the fine balance between the good and bad bacteria that live in our stomachs, and consequently, the relationship between the gut and the brain. So, in winter when we eat our favourite comfort foods, we get a rush of happiness chemicals sent from the gut to our brain and this make us feel happy and content. 2. EVOLUTION MAY HAVE A HAND The second reason we crave more comfort foods during the winter months could be evolutionary. Before we enjoyed technological advances such as housing, heating, supermarkets and clothing, humans who increased their body weight
during winter to keep warm were more likely to survive their environmental conditions. Craving carbohydrate and sugar rich foods was therefore a protective mechanism. Although we are not still living in shelters or foraging for food today, food cravings in winter may still be programmed into our biology. 3. PSYCHOLOGY, CRAVING AND MOOD Social learning theory says people learn from each other through observing, imitating and modelling. In the context of food cravings this suggests that what our caregivers gave to us in winter as children has a striking impact on what we choose to eat in winter as adults. A review of studies on the psychological reasons behind
eating comfort food says this food may play a role in alleviating loneliness and boosting positive thoughts of childhood social interaction. We may also naturally experience lower mood in winter and low mood has been linked to emotional eating.
longer term, can increase the risk of heart disease and diabetes. However, not all comfort foods are created equally, nor are they all bad for our health. You still get a comforting feeling with a hearty bowl of soup, but without the extra calories.
In winter due to it being darker and colder, we tend to stay indoors longer and self-medicate with foods that are carbohydrate and sugar rich. These types of foods release glucose straight to our brain which gives us an instant feeling of happiness when we are feeling cold, sad, tired or bored.
You can get the same comforting feelings from winter foods containing ingredients that are good for you. For example, a hearty bowl of soup with a slice of wholegrain bread can give you all the components you need for optimal physical and psychological health. Steaming
COMFORT FOOD CAN BE HEALTHY For all the comfort they provide, comfort foods generally receive a bad rap because they are usually energy and calorie dense; they can be high in sugar, fat and refined carbohydrates. These types of foods are usually linked to weight gain in winter and if you eat too much over the
bowls of chilli and curries can provide immunity boosting properties with the use of their warming spices. So too are all the wonderful citrus fruits that become available in the winter. If you are craving something that is carbohydrate rich, try swapping white varieties for wholegrain versions that will dampen carbohydrate cravings. If you crave a hot chocolate try
swapping the cocoa powder for cacao which has a higher concentration of vitamins and minerals.
MORE GOOD NEWS The good news for all of us who crave comfort foods in winter is studies that assess intuitive eating â€“ eating when you are hungry, stopping when you are full and listening to what your body is telling you to eat â€“ suggest people who eat this way are happier with their body image, feel better psychologically and are less likely to have disordered eating. So, embrace this wonderful chilly weather. Rug up in your favourite woolly jumper, sit by the fire, cuddle up with a loved one, make some healthier swaps to your classic comfort foods, remove the food guilt and listen to what your body is telling you it needs during these cold winter months. This article was originally published on The Conversation (www.theconversation.com).
Body Language 27
KEEP THE WINTER BLUES AT BAY WITH THESE SNUG STAYS ALL ACROSS SA. Whether you want to whisk your special person away on a romantic escape or build puzzles with your family in the glow of a fire, weâ€™ve got a whole range of hot hideaways to choose from.
The Stables and Loft @ Glenogle, Magoebaskloof, Limpopo from R1550 per night for 2. No children allowed in The Loft. The Loft is an exclusive romantic hideaway amongst pine trees on a private estate. It boasts exquisite views of the forest and a well-stocked trout dam.
Snyderskloof Karoo Cottage, Matjiesfontein, Western Cape From R2650 per night for 6. No children under 12. This secluded stone dwelling promises Karoo tranquillity, starry nights and picturesque sunrises and sunsets. There is no electricity, but gas power, oil lamps and a fireplace will ensure a comfy stay.
Dumbe Cottages, Retief Pass, KZN From R1270 per night for 2. No children under 12. Situated along Retief Pass, these five cottages offer intimate, luxurious accommodation which is ideally suited for couples and offers unparalleled views of the majestic mountains. 28 Body Language
The Gatehouse Cottage, Midlands Meander, KZN From R1800 per night for 4.
Stone House Letlapa Pula Game Farm, Waterberg, Limpopo From R1300 per night for 2. No children under 18. Situated on a game farm in the heart of the Bushveld, this secluded stone house boast a large fireplace, a deck with magnificent views and, with no TV, you’ll be sure to spend some quality time.
This rustic family cottage is set on the banks of a dam on a picturesque farm where guests can enjoy hiking, mountain biking and bass fishing. Pets are allowed by arrangement.
Ons Huisie, McGregor, Wes-Kaap From R890 per night for 4. This traditional, whitewashed cottage is nestled in an artists’ village. Cosy up in front of the cob fireplace or enjoy the winter sun in the garden which is fenced for kids’ and pets’ safety.
Oakhurst Farm Cottages, Wilderness, Western Cape From R1450 per night for 4. Dream Lodge, Bonajala, North West From R1800 per night for 2. If you’re in need of a romantic retreat, the two stone cottages on this picturesque farm are the ideal off-the-grid escape. Dinner and breakfast are included and you can arrange to bring Fluffy along.
From waterfall walking trails, hiking, fishing and climbing walls, this dairy farm has loads of activities to suit all ages. So, choose one of their ten stunning cottages and have a look for yourself!
Klipspringer Berghuisie, McGregor, Western Cape From R1000 per night for 2. No children under 18.
Little Oak Cottage, Greyton, Western Cape From R1420 per night for 2. This delightful one-bedroom cottage is situated in a picturesque village with a variety of eateries, shops, and galleries, not to mention the biking, hiking and running trails and the Saturday market.
Seclusion is the name of the game at this self-catering mountain cottage. A 4x4 is needed to reach the cottage, but, once there, gas and solar appliances and the indoor braai will ensure good times.
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MEAT-LESS VEGETABLE LASAGNE Serves 6 INGREDIENTS 1 medium (750 g) butternut, cubed 4-5 baby marrows, thickly sliced 250 g mushrooms, quartered (optional) 1 onion, thickly sliced 1 tomato, cut in wedges 3 tbsp (45 ml) grape vinegar 2 tsp (10 ml) sugar 1 tbsp (15 ml) sunflower oil 2 tsp (10 ml) dried origanum or rosemary lemon juice and black pepper to taste 1 x 410 g tin butter beans, drained 12 no-cook lasagne sheets or any pasta of your choice 1 2 / tsp (2,5 ml) salt 2 tbsp (30 ml) chopped fresh origanum or parsley WHITE SAUCE 3 tbsp (45 ml) cake flour 600 ml low-fat or fat-free milk 1 tsp (5 ml) Worcester sauce 1 tsp (5 ml) prepared mustard 1 /2 tsp (2,5 ml) salt lemon juice and black pepper to taste METHOD: 1. Preheat oven to 180°C. Place veggies in a single layer in an oven dish. 2. Mix vinegar, sugar, half the oil, dried herbs and season with lemon juice and pepper. 3. Pour vinegar mixture over veggies and toss until well coated. Roast for 30-45 minutes or until the veggies are cooked. Stir in the beans to warm through. Keep warm. 30 Body Language
4. White sauce: Meanwhile, mix cake ﬂour with a little bit of the milk in a small pot to make a paste. 5. Heat gently and gradually stir in the rest of the milk until a smooth mixture forms. 6. Simmer for a few minutes until the sauce thickens and season with remaining ingredients. 7. Assemble the lasagne by layering the lasagne sheets or noodles, roasted vegetables and sauce. Sprinkle with fresh herbs. 8. Bake for 30-35 minutes at 180°C or until golden brown.
Tips 1. Fry veggies in the vinegar mixture in a large pan. Reduce heat and simmer with a lid for 30 minutes or until the veggies are cooked. Stir into beans and use as above. 2. For a gluten-free vegetable lasagne, use glutenfree pasta or use vegetables. Layer long slices of eggplant in place of the pasta. Roast them with the other vegetables. 3. For a dairy-free vegetable lasagne, swap the milk in the white sauce for soy or almond milk. You can also use vegan-ricotta.
METHOD: 1. Heat the oil in a large frying pan and fry the bacon till crisp. Remove and set aside. 2. Add the mince, onions and garlic to the pan and fry until mince is no longer pink (about 6 minutes).
PASTA-LESS CABBAGE LASAGNE Serves 6 - 8 Cabbage makes an excellent replacement for pasta. Gluten-free and keto friendly it swaps out lasagne sheets in this low carb Italian dish.
INGREDIENTS: 2 tbsp (30 ml) oil 125 g streaky bacon, chopped 500 g beef mince 2 onions, chopped 2 garlic cloves, crushed 1 large carrot, peeled and grated, 1 large cabbage, shredded 1 x 400 g can tomatoes, chopped Pinch of ground nutmeg 1 tsp (5 ml) dried origanum Salt and Pepper 3 tbsp (45 g) butter 3 tbsp (45 ml) flour 600 ml milk 1 tsp (5 ml) mustard powder 200 g cheddar cheese, or a combination of cheddar and mozzarella, grated
3. Add carrot and cabbage and stir-fry over a high heat for 3-5 minutes. 4. Stir in the tomatoes and their juice. 5. Return the bacon to the pan with the nutmeg and oregano and season. 6. Cook over medium heat for 10 minutes. 7. To make the sauce: - Melt the butter in a saucepan and stir in the flour to form a paste (roux). - Remove from heat and add milk. - Return to the heat and stir constantly until it thickens. - Season and add the mustard power and three quarters of the cheese. 8. Combine the cabbage-mince mixture and white sauce and pour into an ovenproof dish. 9. Sprinkle remaining cheese over the top and bake at 180Â°C for 30 minutes until golden brown. Body Language 31
A high-protein snack , rich in iron that can satisfy your hunger and maintain your energy levels during the workday.
You might simply be thirsty when you think you’re hungry.
Mixed nuts and dried fruit or Trail mix This combo has a good balance of all three macronutrients, with healthy fats and protein from nuts and carbs from dried fruit. Steer clear of nuts and fruits covered in chocolate, or even so-called ‘yoghurt’, which often is just another kind of chocolate.
Handful of almonds Eating a handful of almonds or another type of nut for a snack is a simple way to fill up on protein.
Snacks THE GOOD
& the bad.
These are loaded with fat and sugar – even the ones that masquerade as ‘health’ muffins.
Anything this sweet will give you an energy spike and leave you just more drained afterwards. Snacking on organic dark chocolate that’s at least 70 percent cacao is a healthier way to satisfy your sweet tooth.
With a whopping 570 calories, containing on average 70g carbs, 25g fat and 22g protein you will need an hour of running to burn these calories. Not worth it.
Egg Muffins or crustless quiches
Egg muffins are made by mixing eggs with vegetables and then baking them in a muffin tin. The main benefits are the protein from the eggs and fibre from the veggies.
Berries and yoghurt
Berries are not only highly nutritious but also a low-carb fruit choice. For a delicious, low-carb snack, combine 1/2 cup of blueberries with 2 tablespoons of full cream Greek yoghurt.
Fruit Juice or Iced Tea These drink are loaded with sugar. In fact, fruit juice and sweetened iced tea contains just as much sugar and calories as a sugary fizzy drink ... and sometimes even more.
High in fat, high carbs, high GI. Don’t go there.
Fizzy drinks Besides that the fizziness can give you unpleasant side effects, the sugar is just plain bad. Want the sugar-free kind? Artificial sweeteners are even worse for you than sugar.
You’ve hit the 4 o’clock slump, and a deli or the garage convenience shop is around the corner. What will give you a healthy boost and help you stay energised and productive? Many snack foods available today are high in refined carbs and sugar, which can leave you feeling unsatisfied and craving more food. Whatever you do, you need to choose something that will fill you up and increase your energy without railroading your healthy eating plan. As always, look for snacks high in protein as these promotes fullness and are the best to keep blood sugar levels stable. A garage pie is not the only snack solution.
Get a check up. It’s good for everyone.
Staying healthy doesn’t just benefit you. It’s good for your family, friends and career. Book a wellness screening at www.intercare.co.za
Snippets The War against Plastic Growing up with Vaccines More than Baby Blues Blood Works First id: Severe Bleeding Alcohol and Erectile Dy...
Published on Aug 21, 2019
Snippets The War against Plastic Growing up with Vaccines More than Baby Blues Blood Works First id: Severe Bleeding Alcohol and Erectile Dy...