PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
QUIZ: TRYING TO BE PERFECT? HOW TO LET LIFE LEAD YOU
IT’S TIME TO CELEBRATE
YOUR LIFE Choose good health, happiness and calm
PLUS COLDS & FLU: WHEN ANTIBIOTICS AREN’T THE ANSWER
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basedtreatments treatments ■■ Home based ■ Home ■Home based Home treatments based treatments
APD(Automated (AutomatedPeritoneal PeritonealDialysis) Dialysis) – –APD – APD (Automated – APD(Continuous (Automated Peritoneal Peritoneal Dialysis)Dialysis) –CAPD CAPD Ambulatory – (Continuous Ambulatory – CAPDPeritoneal –(Continuous CAPD (Continuous Ambulatory Ambulatory Dialysis) Peritoneal Dialysis) Peritoneal Peritoneal Dialysis) Dialysis)
Additional services offered: Additional services offered: Additional Additional services services offered: offered: supportand andeducation education ■■ Patient support ■ Patient ■Patient Patient support support and education and education co-ordination ■■ Transplant co-ordination ■ Transplant ■Transplant Transplant co-ordination co-ordination ■ Access to in-hospital doctorsand and ■ Access to in-hospital doctors ■ Access ■ Access to in-hospital to in-hospital doctors doctors and and
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Life is… Mother Nature keeps things in balance by bringing us new seasons with fresh prospects and possibilities, but, in life, many people still find it difficult to strike the right balance between work and home. Work-related stress is on the rise, but there are steps you and your employer can take to ensure your physical and mental health remains a priority. Read more on page 23. While you may be inclined to spend your downtime curled up on your couch, binge-watching your favourite television series, there are so many wonderful sites to see in your city – and they’re free. On page 28, Life Healthcare magazine shares some ideas, so you can take time out to enrich your mind, move your body and really connect with people in your city. Many Life Healthcare patients write to me and tell me about the wonderful, caring nurses who helped them heal, and treated them with compassion and thoughtfulness during their hospital stay. This year, Life College of Nursing is celebrating 20 years of training nurses and 12 May is International Nurses Day, so we are thanking and praising the sterling work these caregivers do on page 32. While every patient is important to Life Healthcare doctors and nurses, it’s the littlest patients, and their parents, who sometimes need a little extra TLC. With winter fast approaching, we investigate the effective use of antibiotics and how to ensure that your little one gets the best treatment – even if it’s not antibiotics. Read about it on page 42. There’s also a wealth of informative features, delicious recipes, brain-teasers and giveaways, so start reading and enjoy.
IMAGE ANGIE LAZARO
A PUBLICATION BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP
EDITORIAL COMMITTEE Yvonne Motsisi, Dr Sharon Vasuthevan, Janette Joubert, Dr Trevor Frankish, Liesel van Oudenhove, Lucy Balona (CANSA), Professor Pamela Naidoo (Heart and Stroke Foundation South Africa) MANAGEMENT Managing Director Lani Carstens General Manager Joanne Hope Account Director Angela Childs Production Director Nina Hendricks Financial Director Megan Paulse Human Resources Director Aashiqa Petersen
SAMANTHA PAGE EDITOR
ADVERTISING Advertising Sales Director (Johannesburg) Moyra Beeming email@example.com 011 507 9123; 082 375 4446 Advertising Sales Manager (Cape Town) Estelle Dietrich firstname.lastname@example.org 021 486 7609; 073 224 4996 PRODUCTION Production Manager Tessa Smith Reproduction Resolution Colour Printing Paarl Media Cape Life Healthcare magazine, 2nd Floor, Block A, North Side, Black River Park, Fir Street, Observatory, 7925 / PostNet Suite #2, Private Bag X11, Mowbray, 7705 Email: email@example.com Tel: 021 486 7600 Fax: 021 486 7614 www.johnbrownmedia.com For magazine-related queries, contact John Brown Media. Tel: 021 486 7600 Fax: 021 486 7614 PostNet Suite #2, Private Bag X11, Mowbray, 7705
Life Healthcare magazine is published by The Life Healthcare Group to provide patients, their families and the public with the most readable, interesting and relevant health and wellbeing journal available. Life Healthcare magazine is distributed quarterly to patients at all Life Healthcare hospitals and to privatesector doctors. It has a guaranteed print order of 90 000 per quarter, with an estimated readership of 240 000. Life Healthcare magazine can now also be read online. Visit www.lifehealthcare.co.za Disclaimer: the opinions expressed by the authors of the articles published in this magazine do not necessarily reflect the views of The Life Healthcare Group Ltd or John Brown Media. The Life Healthcare Group Ltd or John Brown Media do not accept any responsibility for information given in the articles featured in Life Healthcare magazine.
Visit our website at www.lifehealthcare.co.za to access previous issues of Life Healthcare magazine, get information about Life’s hospitals and specialists, and see all the latest Life Healthcare news. Making life better starts here...
EDITORIAL Editor Samantha Page firstname.lastname@example.org Art Director Anelia du Plessis Managing Editor Sharon McTavish Copy Editor Deidre Donnelly Managing Editor (Life Healthcare Group) Tanya Bennetts
Whilst The Life Healthcare Group Ltd has agreed to advertise products in this magazine, the Group makes no representations or warranties as to the efficacy or use of the products. The products are advertised on condition that readers will make their own determination, including seeking advice from their medical practitioner or healthcare professional as to the suitability of the product for the intended purpose, prior to use. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of use of the advertised products.
LOOK OUT FOR LIFE PLUS BOXES IN OUR MAGAZINE FOR EXTRA INFORMATION AND HEALTH TIPS FROM OUR EXPERTS
Contents THIS MONTH’S FOCUS: YOUR HEALTHIEST YOU
LIFE 01 LIFE IS…
A note from the editor
04 OVER TO YOU
Letters from our readers
Medical innovations, what’s new at Life Healthcare and latest reads
12 PHYSIOTHERAPY VS OCCUPATIONAL THERAPY: WHICH IS FOR YOU? What exactly are these modalities and how can they help? By Lisa Witepski
16 ‘I UNDERSTOOD THAT MY LIFE WOULD NEVER BE THE SAME…’
Samantha Naik recounts her harrowing recovery after a devastating burn accident As told to Lynne Gidish
18 CAESARIAN BIRTH: SAFETY IS THE PRIORITY
Whether your c-section is planned or not, you can have a magical birth experience By Charlene Yared-West
20 GLUTEN-FREE ISN’T FOR EVERYONE What is gluten intolerance and should you cut protein from your diet? By Sam Brighton
23 MANAGING WORK-RELATED STRESS
Overwork and stress is of great concern to employees and employers, so what can you do to manage challenges in the workplace and find a healthy balance? By Samantha Page
GOING, GOING GLUTEN!
24 WHEN FOOD MAKES YOU SICK
Eating disorders can be life-threatening if not recognised and treated appropriately. The earlier a person receives treatment, the greater the likelihood of recovery. Here’s what you need to know By Carla Hüsselmann
JUST A SORE THROAT?
26 ARE YOU OBSESSED WITH PERFECTION?
Many people feel they let themselves down and other people always fall short of their expectations because they are obsessed with perfection. Take our quiz to see where you can improve
28 THE BEST THINGS IN LIFE ARE FREE
There’s so much to see and do in your city and it won’t cost you a cent By Erin Coe
HEALTH 32 CELEBRATING 20 YEARS OF LIFE COLLEGE OF LEARNING
Our nursing college has been training nurses for two decades, so it’s the perfect time to look back – and ahead By Glynis Horning
38 LOOKING TO THE FUTURE
Take a tour of Life Carstenhof Hospital’s new state-of-the-art radiology and imaging unit, which is providing first-class, accurate and patient-centred services By Melanie Farrell
THE LATEST HEALTH NEWS
EASY AND DELICIOUS
40 TEENS AND DRUGS: WHAT YOU NEED TO KNOW
Drug trends are changing for the worse in South Africa: more teens are taking drugs than ever before. Stay informed By Mandy Collins
50 DON’T IGNORE A SORE THROAT
42 WHEN ANTIBIOTICS AREN’T THE ANSWER
52 ACNE: SEPARATING FACT FROM FICTION
You want the best care for your child when they have a cold or flu, but that doesn’t always mean antibiotics By Bridget McNulty
44 EVERYBODY’S TALKING ABOUT… LISTERIOSIS South Africa is in the grips of the biggest outbreak of the bacteria. These are the facts By Pippa Naudé
46 F IVE GOOD REASONS YOU SHOULD CONSIDER BLOOD DONATION
What you should know about rheumatic heart disease and how to prevent it By Gillian Warren-Brown
Life Healthcare magazine asked a dermatologist for the truth about acne By Ruth Rehbock
54 GOOD, HEALTHY FOOD EVERY DAY Author Lisa Clark shares how you can turn one quick meal into several appetising dishes
61 LIFE HEALTHCARE HERO
Pharmacist Teresa Ponte from Life Bedford Gardens Hospital As told to Melanie Farrell
Give the gift of life-saving blood on World Blood Donor Day, 14 June By Samantha Page
62 MIND GAMES
47 WHAT IS A UROLOGIST?
64 A RECIPROCAL ARRANGMENT
Dr Heinrich Voigt explains his role By Erin Coe
Take a break with our puzzles and crossword
Thoughts on friendship from author Jordan B. Petersen’s 12 Rules for life
OVER TO YOU We’d love to hear from you
THE RIGHT SUPPORT Last year was a rollercoaster ride, as my two-year-old daughter was admitted to Life Westville Hospital six times for bronchiolitis and tonsillitis. Dr Ahmed Manjra, a paediatric allergist, and Paediatrician Dr Andre Botha gave her the best care and the nurses were my pillars of strength. I also gave birth prematurely at Life The Crompton Hospital. My baby went to NICU, where Dr Ridwan Omar and the nurses were excellent, and Life Healthcare magazine kept me company. Thank you! Aamina Essack, KwaZulu-Natal
HEALING SONG In January this year, I was hospitalised at Life Robinson Private Hospital in Johannesburg for a stomach virus. From the time of admission, to when I was discharged, everything – from the staff to the food – was great. Best of all was the ‘praying song’ that woke me every day. It will always be a wonderful memory. Hettie Kahts, Gauteng
EASING THE STRESS I was recently admitted to Life Beacon Bay Hospital. As I entered the hospital, the administration staff were informative and the porters were helpful. It was my first time going to theatre, so I felt stressed, but the doctors and staff made the experience easy for me and my family, for which I am so grateful.
WINNING LETTER EMERGENCY HELP WHEN YOU NEED IT My niece is a British citizen and she was here on holiday when she became violently ill. My general practitioner suspected meningitis and sent us to Life Kingsbury Hospital. We rushed through and although there were people ahead of us, I explained that she was in excruciating pain and potentially contagious. The reception staff were highly efficient. They explained the situation to the people checking in and fast-tracked us. Due to severe head pain, my neice’s concentration was not good and because her husband was still at home with their child we had limited information for her. However, the staff admitted her and she was immediately attended to by the nursing staff and physician, who administered drugs for meningitis, until they could do the MRI and lumbar puncture, and confirm the diagnosis. Her pain subsided quickly – it was such a relief to see her relief. I then fetched her husband, who resolved the missing details of information at admissions. The Life Kingsbury staff used their initiative to assist wherever possible, and our overall experience was professional and made easier thanks to caring staff. As UK citizens, my niece and her husband mentioned a few times that they had received such good care and wondered whether the National Health Insurance (NHI) back home would have lived up to the same standards, so well done to Life Kingsbury Hospital. Iris Nel, Cape Town
IN SHORT… I spent six days at Life The Glynnwood Hospital and I was impressed by its size and organisation. Dr Terence Kourie, my specialist, and all the staff treated me like royalty. I commend them on their service and care. Lachlen K. McDiarmid, Gauteng
The staff of Life Chatsmed Garden Hospital are friendly, kind and excellent. I am a regular patient there and my vegetarian meals are always specially prepared. When I went to theatre recently, the nurse was with me, holding my hand. Thank you, Ward A, for your efficient care. Chandrika Pillay, KwaZulu-Natal
My husband, Freddie Herbst, was the life of the theatre as he was being prepped for surgery. He made the caring nurses giggle and left in good health. Thank you to General Surgeon Dr Ian Marr and all the staff at Life Kingsbury Hospital.
Asanda Zibi, KwaZulu-Natal
Win a Harmony II speaker valued at R1 000 The DreamWave Harmony II is an elegantly designed premium speaker that brings the music to your ears the way the artist intended. The textured cognac leather strip, unique rust-orange honeycomb mesh and audio playing from both sides of the speaker make it a one-of-a-kind showpiece in any room. It comes with a soft velvet pouch, meaning you can take it with you and enjoy your music in the comfort of your home, office, car or even during your workout. Email email@example.com about how you experienced life, health and care at a Life Healthcare hospital or facility and you could win. Prize is non-transferable and cannot be exchanged for cash. 4
Lisha Herbst, Cape Town
We speak German!
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EZ Adjustable Bed Rail R 2199 R 1550
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Prices are subject to change without prior notice Tel. SA : 08611 PRIMA 086 11 77462
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LIFE CAESARIAN ADVICE / GOING GLUTEN-FREE / COPING WITH WORK STRESS
‘PEOPLE DON’T NOTICE WHETHER IT’S WINTER OR SUMMER WHEN THEY’RE HAPPY.’ ANTON CHEKOV
Medical innovations and Life Healthcare news
ASKED AND ANSWERED
HOW EFFECTIVE IS WATERLESS HAND SANITISER?
Adequate hand cleansing is largely dependent on access to a reliable water supply. However, given the water shortages in certain parts of the country, South Africans have had to re-evaluate how to best keep their hands clean and germ-free. According to the Centers for Disease Control and Prevention (CDC), washing your hands with soap and water is the best way to reduce the number of microbes on them in most situations, but when water is in short supply you can use an alcohol-based hand sanitiser that contains at least 60% alcohol. If, however, you can actually see dirt on your hands, soap and warm water is best because hand sanitiser is ineffective in the presence of dirt. It’s also important to note that hand sanitisers are ineffective against norovirus, which could cause stomach pain, nausea, diarrhoea and vomiting. For more on infection prevention through practising proper hand hygeine, visit https://www. lifehealthcare.co.za/patient-information/infection-prevention
Many people skimp on protein early in the day, then eat too much of it in a meaty dinner. Protein is vital for building and repairing tissue, but you can get some protein power from meat-free sources during the day. Here are some to try: • 1 cup of broccoli: 4.6g • 1 cup of quinoa: 11g • 1 cup of chickpeas: 14.5g • 2 tablespoons of peanut butter: 8g
What makes us happy? Researchers from Liverpool University have launched an online survey to explore the links between how we deal with life’s triumphs and trials and our mental health. The scientists believe that untangling different strands that make up our sense of happiness could stop mental health problems from developing. You can take the Secrets of Happiness online test here: https://secretsofhappiness.co.uk 8
FIT FOR LIFE
DIET AND TYPE 2 DIABETES Being diagnosed with type 2 diabetes doesn’t have to be a condition for life, according to a recent study published in The Lancet medical journal. The journal published the findings of research in which the disease was sent into remission without medication, but as a result of following a rigorous diet plan. ‘Our findings suggest that even if you have had type 2 diabetes for six years, putting the disease into remission is feasible,’ said Michael Lean, a professor from the University of Glascow in Scotland, who co-led the study. In addition, the study showed that after one year, participants had lost an average of 10 kilograms, and nearly half had reverted to a non-diabetic state without using any medication. The findings lend support to the widespread use of this type of intervention (rigorous diet management) in the routine care of type 2 diabetes across health services.
The latest reads to nurture your mind, body and soul
HOW CHILDREN SUCCEED by Paul Tough (Penguin Random House) Does academic success mean your child will be a successful adult? In his New York Times bestseller, author Paul Tough argues that parents should be paying more attention to character and aim to cultivate inner resilience, a sense of curiosity and confidence in their children rather than focus too heavily on exams. He says it is these qualities that will enable them to live happy, fulfilled and, yes, successful lives.
5 important reasons to have a GP
A GENERAL PRACTITIONER (GP) KNOWS YOUR HEALTH HISTORY – AND WHEN YOU HAVE AN ESTABLISHED RELATIONSHIP, THIS DOCTOR MAKES YOUR HEALTH A PRIORITY REASON
#1 You won’t have to wait
An established patient often finds it easier to get an appointment because there’s no new-patient paperwork to fill out.
#2 You won’t have to explain yourself
There’s no need to spell out everything from scratch each time you visit as your doctor already has your and your family’s history on file.
#3 You’ll have someone to talk to
If you’ve fallen prey to doing an online search of your condition, you’ll be able to discuss the results with a professional.
#4 You’ll have access to trusted specialists
If you have an issue that requires a specialist, your GP will recommend the best person and help to coordinate your care and treatment.
#5 You can easily refill your prescription
Visiting another town and you’ve forgotten you need more asthma inhalers? Your GP can approve refills of routine medications without an office consultation.
APP-ROPRIATE OR NOT?
August is Organ Donor Month
According to a study in the European Journal of Preventive Cardiology, heart-rate apps might not be as accurate as you think. ‘They tested four heart-rate applications and results were all over the place,’ says Ajay Yadlapati, MD, interventional cardiologist with South Denver Cardiology. This is partly due to the lack of regulation, he says, and suggests you stick to apps that motivate, such as nutrition apps that track kilojoules or exercise apps that record steps.
Visit www.odf.org.za to find out more about organ and tissue donation
Making lunch count
One person can donate up to 8 lifesaving organs. H EA
EAS WINTER 2018
TI N E S
• Leave your work area and enjoy a change of scenery. Simply going for a walk and getting some fresh air can make you feel revitalised. If you work near a park, use it. • Making time for something fulfilling in your working day can help you feel in control of your work-life balance. Look into activities in the surrounding area, like art galleries or libraries. • Take exercise with colleagues or go for a jog. Exercise helps to decrease levels of stress hormones in your system. It can also help you feel more alert and raise your energy levels. • Take time to relax by stretching and breathing deeply. This will help you stay mentally focused and prevent stiff muscles. Find a quiet space to spend 10 minutes with your eyes closed, focusing on an image that makes you feel happy and relaxed.
C O M P I L E D BY SAMANTHA PAG E I M A G E S G ET TY/GALLO I MAG ES
DIGI-HEALTH DID YOU KNOW?
to occupancy and level of care required. The unit accommodates adults as well as paediatric patients, which is also unique.’
MAY IS BURN AWARENESS MONTH
HOPE FOR BURN VICTIMS Life Cosmos Hospital’s new burns unit provides critical care when it’s most needed. By Samantha Page
According to the South African Medical Research Council, approximately 3.2% of the South African population suffer from thermal injuries each year. In addition, we have a particularly high rate of childhood burns with as many as 1 300 burn-related deaths each year, which peaks during the winter months. Burn injuries therefore remain a major public health concern in terms of morbidity and long-term physical and psychosocial disability, making the need for effective care critical. On 5 March 2018, Life Cosmos Hospital opened a new burns unit – a first for Life Healthcare and the first in the private sector for Mpumalanga Province.
WHY THE NEED?
Mpumalanga is known for its coal mines, but it’s also an industrialised area that includes power stations, steel plants and a major petrochemical plant. Life Cosmos Hospital sees about 30% COID
(Compensation for Occupational Injuries and Diseases) patients from various industries with a variety of burn accidents – for example, gas, chemical and electrical – as well as patients burnt in domestic fires or as a result of a motor-vehicle accident. Since there was no specialised burns unit in the immediate area, the hospital had to transfer patients to other facilities, which meant families had to travel far to support injured loved ones.
Thermal injuries are painful and often life-threatening, so the equipment and techniques have to be highly specialised. ‘The unit consists of six isolation beds with individual air-conditioning and negative airflow, to keep infections low. The specialised beds help to prevent kidney failure and they have the unique feature of being able to weigh the patient, and detect fluid build-up and muscle loss,’ explains Mariette Pieterse, nursing manager. Dr Roux, who has done extensive research into the Meek technique (a burns intervention involving precisely defined skin grafts from the patient’s own skin, reducing chances of rejection), says a modernised version of the technique is being used successfully in the unit along with other practices, since burn treatment often needs a combination of techniques, equipment and specialisations. ‘With the new unit, we will be able to manage all categories of burn wounds,’ says Hospital Manager Jackie Simonato – good news for Life Cosmos; great news for the broader community.
LIFE PLUS WHERE TO FIND US
THE NEW UNIT
‘We have adopted a multidisciplinary approach in the unit with General Surgeon Dr Dawid Roux heading things up, supported by specialised nurses, doctors and auxillary services, such as nutritionists, physiotherapists and occupational therapists,’ says Christelle Matthee, marketing and communications coordinator at Life Cosmos Hospital. ‘The unit has six beds, but the staff complement will be determined according
Cosmos Hospital Life Cosmos Hospital 013 653 8000
FIT FOR LIFE
PHYSIOTHERAPY VS OCCUPATIONAL THERAPY:
WHICH IS FOR YOU? If you’ve suffered an injury, your medical professional may recommend a course of physiotherapy and/or occupational therapy (OT) as part of your rehabilitation. But what exactly do these modalities entail, and how can they help? By Lisa Witepski
PHYSIO: MAKING THE MOST OF MOVEMENT
Belinda le Roux, a physiotherapist at Life Rehabilitation based at Life Eugene Marais Hospital, explains that physiotherapy is all about movement – so, if you’ve been referred to a physiotherapist, you can expect a very hands-on approach that aims to restore your normal movement and functioning. Physiotherapy rehabilitation aims to optimise patient function and wellbeing, which helps them integrate back into activities at home or work. This form of therapy is often used as a way to minimise pain – by not only treating the pain, but also its source – and it can be helpful for both adults and children. ‘Our goal is to help people become as independent as possible,’ Belinda says, adding that physio also helps prevent injuries from recurring. A typical physiotherapy session starts with an assessment, followed by therapies to address your unique health issue. These can range from mobilisation to manipulation, massage and acupressure. Physiotherapists will augment this with a range of exercises tailored to improve posture, and to strengthen and build your problem areas. They may also talk you through some relaxation techniques or 12
You have to know your client well enough to recognise whether they will benefit more from a slowly, slowly approach or whether they need to be pushed incorporate hydrotherapy and biofeedback in your treatment. Chest physiotherapy is another area that can assist in rehabilitation. It helps to improve breathing by indirect removal of mucus from the breathing passages. Physiotherapists work with sophisticated equipment, including electrotherapy devices that channel electrical currents to stimulate muscles and manage pain. They may also work with traction or use heat and ice, splints or walking aids to assist healing, alleviating
pain and recovery. Patient education is a significant part of the treatment. Belinda notes that physiotherapy has a broad range of applications: mothers preparing for labour and birth benefit just as much as tiny babies or people with cerebral palsy fighting lung infections. It’s a useful tool for encouraging children and adults recovering from orthopaedic surgery, injury and even burns to regain their full range of movement. Physiotherapy is an effective weapon for older patients too, assisting in the analysis and treatment of aches occurring as part of the ageing process. Sportspeople often consult physiotherapists to enhance performance, and it can even be used to support learners with special needs.
‘Occupational therapy is all about occupation – not related to work, as you might think, but rather the tasks and activities that give our lives meaning,’ says Karin Weskamp, an occupational therapist at Life Rehabilitation based at Life Vincent Pallotti Hospital. Often, it’s these activities that are affected when people are injured, and the inability to complete routine tasks can be as damaging as the injury itself.
I MAG ES GETTY/GALLO IMAGES, SUPPLIED
This is why OT is crucial: it helps individuals regain abilities and, in cases where this is not possible, finds alternatives that will make them feel just as capable. ‘My job is to understand who my clients are so that I can restore them to their former state,’ Karin notes. This means that every OT case is different. However, each patient starts with an assessment that examines how they usually spend their days, taking into account work as well as hobbies. In particular, fine motor skills are assessed to determine if and how the dexterity of the coordination of small muscles in the hands and fingers has been affected through injury. ‘Imagine, for example, someone worked as a mechanic before they were injured. We would scrutinise all parts of
MEET OUR EXPERTS
their job, then try to work with the client so that they can do their job again. But if this is not possible, we would try to find ways to modify the job,’ Karin says. It’s all about getting people to engage with their lives once more. This makes the OT’s task a complex one, as it involves a degree of psychology. You have to know your client well enough to recognise whether they will benefit more from a slowly, slowly approach or whether they need to be pushed. Karin isn’t above a bit of tough love: ‘Sometimes, life is challenging and we need to face unpleasant emotions. This can make patients angry, but it’s indifference to what’s going on around them that can hinder their rehabilitation journey.’
Belinda le Roux works as a physiotherapist with a special interest in physical rehabilitation, neurological rehabilitation and stroke rehabilitation at Life Eugene Marais Hospital in Pretoria.
The OT’s psychology skills may be used in other ways, too. For example, if the client can’t resume their former pastimes, talking about other hobbies or things they used to enjoy in childhood may help unearth potential new interests. The fact that someone enjoys cycling, say, but doesn’t particularly like soccer may be a hint that they prefer solitary pursuits over team activities. OTs will often collaborate with a multidisciplinary team. As a specialist in hand injuries, Karin frequently partners with orthopaedic surgeons, prosthetics specialists and physiotherapists. Nurses and nutritionists may also be invited to share their expertise. ‘Ultimately, we’re working to help people rediscover their sense of purpose,’ Karin concludes.
Karin Weskamp graduated from the University of Stellenbosch in 1984. She is a founding member of the Cape Hand Clinic, and a founding member of the Amputation Clinic located at Life Vincent Pallotti Hospital in Cape Town.
Key to Diagnostic Excellence Key to Diagnostic Excellence Constantly improving Constantly laboratory testing improving technology aiming laboratory testing to provide technology aiming efficient turn to provide around times efficient turn around times
Continuously seeking strategic Continuously Private Public seeking strategic Partnerships (PPP) to Private Public contribute towards Partnerships (PPP) to a healthier contribute towards South Africa a healthier South Africa
Over 115 pathologists Over 115 with pathologists specialised with expertise specialised expertise
Rapid & efficient Rapid & delivery of results efficient to support clinical delivery of results decision to support clinical making decision making
Electronic access to Electronic laboratory access to results at laboratory your fingertips resultson atthe available your fingertips Lancet Mobile available Appon the Lancet Mobile App Available on the
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Available on the play Google
24 hour 24 Laboratory hour services Laboratory
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A South African Footprint A South covering all African Footprint Provinces covering and all extending into the Provinces and African Continent extending into the African Continent
Providing a full range of SANAS Providing a full accredited diagnostic range of SANAS services including accredited diagnostic Microbiology, Molecular services including Pathology, Virology, Histology & Microbiology, Molecular Cytology, Chemical Pathology, Pathology, Virology, Histology & Coagulation, Haematology, Cytology, Chemical Pathology, Occupational health and Coagulation, Haematology, Newborn Screening Occupational health and Newborn Screening
Regional Head Ofďż˝ces: JHB: 0027 (0) 11 358 0800 | PTA: 0027 (0) 12 483 0100 | CPT: 0027 (0) 21 673 1700
Regional Head Ofďż˝ces: DURBAN: 0027 (0) 31 308 6500 | POLOKWANE: 0027 (0) 15 294 0400
RUSTENBURG: (0) 14| PTA: 597 8500 0027 (0) 13 745(0)9000 JHB: 0027 (0) 110027 358 0800 0027| NELSPRUIT: (0) 12 483 0100 | CPT: 0027 21 673 1700 BLOEMFONTEIN: (0)6500 51 410 1700 | KIMBERLEY: 0027 (0) 53 836 4460 DURBAN: 0027 (0) 0027 31 308 | POLOKWANE: 0027 (0) 15 294 0400 RUSTENBURG: 0027 (0) 14 597 8500 | NELSPRUIT: 0027 (0) 13 745 9000 BLOEMFONTEIN: 0027 (0) 51 410 1700 | KIMBERLEY: 0027 (0) 53 836 4460
Key to Diagnostic
DISCOVER MORE ABOUT YOUR BABY’S HEALTH
The NIPT is a DNA screening test that provides you with genetic information about your baby.
WHAT IS NIPT TEST? Non-invasive Prenatal Testing (NIPT) is a simple procedure where a blood sample from the mother is used to analyse DNA which is present in the placenta. NIPT tests for certain chromosome conditions that could affect a baby’s health.
WHAT DOES NIPT TEST SCREEN FOR?
Singleton Pregnancies Twin Pregnancies Identical Twins Egg donor or Surrogate Pregnancies
Identical or Fraternal twins
Microdeletions incl. 22q11.2
Monosomy X Turner Syndrome
Trisomy 13 Patau Syndrome
Trisomy 18 Edwards Syndrome
Trisomy 21 Down Syndrome
The test can be done as early as 9 weeks.
Continuousl seeking strate Private Publ Partnerships (PP contribute towa a healthier South Africa
Over 115 pathologists with specialised expertise
WHEN SHOULD YOU CONSIDER NIPT? If you would like to know whether your baby is at risk for certain genetic conditions, the NIPT may be the right option for you. The first step is to talk with our healthcare provider. A South
If you are over the age of 35 years and have a family history or have had an abnormal ultrasoundFootprint African finding including abnormal blood test results irrespective of your age, there is an increased chance of all covering your baby being affected with certain chromosomes conditions, e.g. Down syndrome.
Provinces and extending into the African Continent Most results will be returned to your doctor within 7 – 10 working days. Your results will be returned to WHEN WILL I GET MY NIPT RESULTS? your treating specialist or referring doctor.
WHO CAN I SPEAK TO FOR MORE INFORMATION? For free pre/post genetic counselling please contact Dr Karen Milstein on email Karen.firstname.lastname@example.org or call 086 153 6238
HOW CAN I AFFORD THIS TEST? Lancet Laboratories has an agreement with the Discovery Medical Aid. Discovery will cover the test under its MATERNITY BENEFIT SCHEME. Should you not be a Discovery Medical Aid member, Lancet also offers an affordable payment plan. For further information please email email@example.com
‘I UNDERSTOOD THAT MY LIFE WOULD NEVER BE THE SAME…’ For practising architect and MBA student Samantha Naik, life as she knew it came to an end on 3 June 2017, when her boyfriend Dean was trying to refill her fireplace. Ethanol exploded out of the bottle he was holding, burning his hand before engulfing her in flames… By Lynne Gidish
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remember Dean pouring water over me, but I only have a vague recollection of extreme pain. I remember directing Dean to Life Fourways Hospital – and then everything goes blank. I knew nothing about what was happening to me during the two months I spent in ICU. I was isolated, sedated and in a coma, fighting for my life, with second- and third-degree burns over about 25% of my body – mostly on my face, hands, tummy and thighs. There was concern about my eyesight and my lungs. The inhalation injuries came with their own set of complications, and I developed pneumonia and other infections. ‘They nearly lost me twice. I remember coming round and seeing familiar faces ... hearing voices telling me everything was going to be all right. And then realising that my face, hands and other parts of my body were fully bandaged, which is when I understood that my life would never be the same… ‘My recollections of my time in ICU are vague. I felt confused and frustrated as I was unable to communicate due to the tube in my throat. My feelings of helplessness tortured me. I only understood I was in for the long haul when I was moved to the surgical ward, my new home for the next six weeks. I thought it would be a quick fix – after all, I had the best medical team and treatment available – and I was convinced that everything would be sorted out soon. That was until my doctor sat down and clearly explained that this was a process: healing was going to take time. ‘I underwent 19 surgeries, including a tracheotomy, carpal tunnel release and some cutting-edge stem-cell treatments, which my body rejected. There was also one skin graft after another as my body rejected my own skin, too. The bandage changing and debriding seemed to continue in a never-ending cycle. ‘I had many moments when I’d simply break down – at times, I still do. For a long time I refused to look at my face, so the angels in Surgical 1 covered the mirrors in my room. I fell apart when I initially saw what I looked like – it’s still a shock every now and again as I tend to forget – but it is getting easier. I’ve slowly started to see myself as I am now and not as the Samantha with the long hair and
It’s still too raw for me right now, but just like my body is a work in progress, I know that I’ll get there one day perfect skin, and it helps that my family and friends treat me exactly the same as they did before. It was a big surprise when Dean proposed soon after I was discharged. Getting engaged not only gave me the strength to carry on reclaiming my life, it also reinforced the belief that I was still the same old me. ‘Dean had to have surgery for the severe burns on his hand, but he still managed to be constantly at my side together with my family and friends. So was the Life Fourways Hospital medical team who became my “other” family. Every one of them was amazing, from the nurses to the rehab experts to the various specialists who treated me. They looked after me with kindness, and were gentle and caring despite their busy schedules. ‘I know that I still have a long way to go. I’m on a journey that requires patience. I’m fully committed to my recovery and I’m doing my best to come to terms with what happened, but it’s still too raw for me to be completely accepting right now. But just like my body is a work in progress, I know that I’ll get there one day.’
Our engagem ent: ‘Dea hands now si n and I joke that we ha ve nce his were also burnt in matching the fire.’
Before the accident: ‘Long hair and perfect skin, but although it’s still hard, I’m starting to accept my new reality.’
IN HER DOCTOR’S WORDS Dr Lee-Ann Spoolder, physician, Life Fourways Hospital ‘I will never forget the day that I was first asked to see Samantha Naik in ICU. I knew immediately that hers would be a long, hard and painful struggle, but at that point I did not know the resilience and courage of my new patient. Over the passing weeks and months that Sam spent in our care, we all grew to love and admire her, and I’m proud to say that she has become a beloved friend to many of us. ‘My heart broke for her on many occasions, but burst with happiness to eventually see her leave hospital and slowly reclaim her life with enthusiasm. Her engagement to Dean was an absolute delight for us all, and I wish them a lifetime of love and happiness. Patients like Samantha give me the motivation to keep doing what I do, and that is the greatest privilege that my career in internal medicine has ever offered me.’
SAFETY IS THE PRIORITY
Childbirth is one of lifeâ€™s most significant experiences. When it comes to having a c-section, knowing how to prepare, what to expect, and how to ensure you and baby stay safe helps your medical team care for you. Charlene Yared-West asked Dr Jacky Searle, an obstetriciangynaecologist at Life Vincent Pallotti Hospital, about the risks and benefits of caesareans 18
CLINICAL INDICATIONS FOR A PLANNED CAESAREAN INCLUDE: • Placenta praevia (a low-lying placenta) • Breech presentation • Previous caesarean section • Previous shoulder dystocia • An elective caesarean delivery, also called Caesarean Delivery on Maternal Request (CDMR), in the absence of a medical or obstetric reason for avoiding a vaginal birth
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CLINICAL INDICATIONS FOR AN EMERGENCY CAESAREAN INCLUDE: • Cephalopelvic disproportion (when the baby’s head does not fit through the mother’s pelvis) • Foetal distress • Congenital malformations of the baby • Pelvic abnormalities • Infection of the mother • Situations where labour isn’t recommended, such as eclampsia (seizures resulting from high blood pressure) or prematurity of the baby BEFORE: PREPARING FOR A CAESAREAN ‘For a scheduled caesarean, a protocol is followed, which includes not eating or drinking for six to eight hours before surgery,’ explains Dr Searle. ‘On arrival at hospital, there are forms to fill out and the anaesthetist will meet you to make a preoperative assessment before surgery. You will also meet the attending paediatrician shortly before the procedure.’ Dr Searle adds that women may choose to have a doula accompany them. ‘She will often arrive with you at the hospital and pamper you before going into theatre. This can help a mother relax and connect to her baby and the imminent birth,’ says Dr Searle. In an emergency caesarean, the surgery is usually done within 30 minutes of the decision being made. The mother will be accompanied by her partner and her doula, if she has one. ‘This can be stressful and traumatic for the parents, but an adequate explanation of the necessity of the caesarean should be given, enabling them to process the experience,’ Dr Searle says. ‘Pregnant women should know that the outcome of labour is unpredictable, but a caring team can support them through the process, helping them feel held throughout.’
SAM SUTER’S EMPOWERING EMERGENCY CAESAREAN ‘I’d always wanted a natural birth, although I’m hesitant to use the word “natural” now, as no birth is “unnatural”. A birth is a birth, no matter how the baby is delivered. At 39 weeks pregnant, I was induced to attempt Sam and her husband, James, share a mome a vaginal birth because my blood pressure nt of intimacy after their baby’s safe was climbing to dangerous levels. By c-section delivery 10pm that night, although contractions had begun, they were slight and my blood pressure remained elevated. The decision to have a caesarean was made because of the risk of stroke. ‘I believe all birth experiences have an element of trauma, but for me the euphoria, and the memory of seeing Tom for the first time, far outweighed any negativity. What I didn’t know at the time is that even if you have a c-section, nature takes over, and the “love and bonding” hormone oxytocin is released – in both mom and baby. Looking back, I was definitely feeling its effects. It was the most incredible human experience I’ve ever had. While the birth experience wasn’t “perfect” or how I’d envisioned it, I had to go with the flow and remember to think about what was best for my baby and me. That is a huge lesson for parenthood in general.’ DURING: IN THEATRE FOR A CAESAREAN In theatre, the mother will have a drip inserted and anaesthesia is almost always regional (awake) – either spinal or epidural. A urinary catheter will be inserted once the anaesthetic is working. ‘Women, especially those who haven’t chosen a caesarean, are often pleasantly surprised to discover that it can be a truly beautiful experience for a mother and her partner,’ says Dr Searle.
AFTER: POST-RECOVERY FROM A CAESAREAN Analgesia will be prescribed to manage post-operative pain, explains Dr Searle. ‘Mothers generally recover well as they are motivated to get moving and are distracted from discomfort by their baby. Breastfeeding assistance is provided for all new mothers in the maternity wards at all Life Healthcare hospitals. Mothers usually stay in hospital for four days/three nights after a caesarean section,’ she says.
A GENTLE CAESAREAN A ‘gentle caesarean’ refers to minimising the medicalisation of the process, where possible, and enhancing bonding. ‘I’m proud to say that this is routine at Life Vincent Pallotti Hospital,’ says Dr Searle.
VBAC: VAGINAL BIRTH AFTER CAESAREAN ‘It’s appropriate for any woman who has a single pregnancy, with a baby in the head-down position, and who has had one previous lower-section caesarean to consider a VBAC,’ says Dr Searle. ‘A successful VBAC is more likely in women who have also had a previous vaginal birth, taller women, women less than 40 years old, where labour occurs before 40 completed weeks, and where baby’s birth weight is less than 4kg.’
A GENTLE CAESAREAN INCLUDES: • Limiting noise and dimming the lights • Early skin-to-skin contact and latching • Playing the parents’ choice of music • Keeping mother and baby close after the birth
Dr Jacky Searle is an obstetrician-gynaecologist at Life Vincent Pallotti Hospital in Cape Town. She specialised at the University of Cape Town, gaining work experience at Groote Schuur Hospital, Mowbray Maternity Hospital, Somerset Hospital and 2 Military Hospital. She aims to offer sensible guidance to pregnant women, helping them achieve a safe outcome.
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GLUTEN-FREE ISNâ€™T FOR EVERYONE A gluten-free diet makes the world of difference to those who suffer ill effects from this particular set of proteins, but itâ€™s a drastic lifestyle change that should be considered carefully in consultation with a physician. By Sam Brighton
he sharp rise in the availability of gluten-free products in supermarkets and restaurants has highlighted the prevalence of gluten-related disorders, such as coeliac disease, among the population. Not surprisingly, the global gluten-free market was an almost US$5 billion industry in 2015 – and it’s expected to grow to in excess of US$7 billion by 2020. Dr David Epstein, a gastroenterologist at Life Vincent Pallotti Hospital in Cape Town, says there are three groups of gluten-related disorders: 1) Wheat allergy; 2) autoimmune disorder (like coeliac disease); and 3) non-coeliac gluten sensitivity. Symptoms of a wheat allergy are similar to other food allergies, including hives, wheezing and swelling. The autoimmune condition coeliac disease can present with varied symptoms, but common experiences include bloating, abdominal pain and fatigue. Non-coeliac gluten sensitivity also presents with a range of symptoms, but conclusively they are not related to coeliac disease.
WHAT, EXACTLY, IS GLUTEN?
The ‘free from’ movement has resulted in making gluten a dirty word. However, it’s nothing more than a protein. ‘Gluten is the major storage protein of wheat, barley and rye. It is the tough, sticky substance remaining when wheat flour is washed to remove the starch, and it gives dough its elastic character,’ Dr Epstein explains. If you’re not experiencing any symptoms or discomfort when eating gluten, it is a perfectly good thing to eat.
GET A PROPER DIAGNOSIS
Dr Epstein has seen an increase in patients with coeliac disease over the years. ‘But,’ he says, ‘this is probably due to better awareness of the condition and improved diagnostic tests.’ There are three recognised ways to diagnose coeliac disease and all of them involve visiting your doctor (as opposed to your symptom-checker app). The first test is a blood test that searches for certain antibodies produced in response to gluten. The second is a genetic test that looks for the specific
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DID YOU KNOW?
• Researchers are currently looking into food additives or enzymes that destroy gluten, rendering it harmless for coeliac patients, so perhaps one day they can also ‘have their cake and eat it’. • Coeliac disease affects one to three percent of the Western population. • A typical gluten-free shopping list includes items such as (but not limited to) cornflour, unflavoured meat and fish, fruit and veg, and plain beans and legumes (no sauces added). genetic fingerprints that could reveal you have the potential to develop the disease (it is not a foregone conclusion). The third diagnostic test is a biopsy taken from the first part of the small intestine, which, if the patient does in fact have coeliac disease, will show signs of inflammation. Dr Epstein says that many people are diagnosed with coeliac disease without having undergone any of these tests, and embark on a restrictive, gluten-free diet without knowing exactly what their body is reacting to and how.
SHOULD WE ALL BE GLUTEN-FREE?
‘No,’ says Solandi Nel, a registered dietitian at Life Mercantile Hospital in Port Elizabeth. She also believes we should not be self-diagnosing. ‘Coeliac disease is often misdiagnosed as irritable bowel syndrome (IBS), gluten sensitivity, or wheat or lactose intolerance. Visit your GP for a diagnosis, then visit a registered dietitian with a special interest in gut health,’ Solandi advises. In fact, embarking on a strict gluten-free diet (without a diagnosis) could leave you lacking. ‘Being on a gluten-free diet, without a medical need, can be too restrictive and limit access to certain nutrients,’ Solandi says. Below, Dr Epstein has considered the most common gut disorders to show what role a gluten-free diet can play in easing symptoms. AUTOIMMUNE DISORDER?
RELIEF FROM GLUTEN-FREE DIET?
Bloating, diarrhoea, fatigue, abdominal pain, changes in bowel habits
Irritable bowel syndrome
Bloating, fatigue, abdominal pain, change in bowel habits
Seldom, but reducing fermentable carbohydrates is more effective (following a low-FODMAP diet)
Non-coeliac gluten sensitivity
Gastrointestinal discomfort, headaches, tiredness, muscle and joint pain
Yes – symptoms will recur with gluten reintroduction
Solandi Nel is a registered dietitian who graduated from the University of Stellenbosch in 2013. She practises independently at Life Mercantile Hospital in Port Elizabeth, providing special services in diet, nutrition and wellness.
Dr David Epstein is a gastroenterologist in private practice at Life Vincent Pallotti Hospital in Cape Town. He is a member of the South African Gastroenterology Society and the European Crohn’s and Colitis Organisation. He is the founder and director of Inflammatory Bowel Disease Africa, which is a non-profit organisation aimed at improving inflammatory bowel disease (Crohn’s disease and ulcerative colitis) care in South Africa.
STRESS DOESN’T WORK Work stress has a direct effect on employee health. Especially in insecure labour markets, where job strain and insecurity dominate worker attitudes. Job strain flows from high job demands coupled with low control over the work situation. That is, a low ability to make decisions about how and when they will perform their tasks (also, the extent to which the job involves skills development). In countries like SA where unemployment is currently as high as 26.7%, job insecurity is heightened even amongst the employed: a problem exacerbated by the use of temporary workers. Job strain and insecurity
have a wide-ranging impact on worker health; causing cardiovascular problems, high blood pressure, angina, obesity, absenteeism and frequent GP visits. High job strain also increases levels of depression and anxiety to dangerous levels. These factors ultimately impact on employees at all levels. There are many ways to manage the stresses of working life: they all begin by understanding the processes involved and the development of a workable solution. Creating a work-life balance between home and work is an excellent way to start!
Ask your doctor about Sun Pharma’s medicines for the treatment of depression.
Reaching People. Touching Lives. References: The health effects of jobs: Status, working conditions, or both? Rennie M. D’Souza et al. Source: tradingeconomics.com/statistics South Africa
Overwork and stress continue to plague employees, costing companies and countries a fortune. Samantha Page investigates
t’s a modern-day refrain: I’m so busy. I’m so stressed. I can’t cope with work. Stress may be part of life, but what if you’re anxious all the time when you’re at work and it follows you home in the evening, so you snap at your partner and kids, and you lie awake at night wondering how you can find some relief from the relentless anxiety? Well, you’re not alone.
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In 2017, a survey by the American Psychological Association found that 61% of respondents said they’re stressed on the job, making work the third most common source of stress overall. Furthermore, 37% of workers reported that they experience chronic work stress – meaning it’s there all the time, and not just as a result of specific projects or deadlines. ‘The increasing demands of today’s fast-paced business environment means employees need more personal health, wellness and lifestyle support than ever before. It’s well documented that happy, healthy employees are more efficient and productive,’ says Dr Leanne Mandim, Head: Employee Health and Wellness Solutions for Life Employee Health Solutions. Research points to a set of common reasons for work-related stress, which can manifest physically and psychosocially. These reasons include employee workload, job demands, lack of clarity regarding roles, lack of decision-making, poor internal change management, poor communication in the organisation as well as harassment and potential violence within the company. According to a recent World Health Organisation study, depression and anxiety account for the most frequent occurrences in occupational disability, and depression and/or anxiety is expected to account for 15% of the global disease burden by 2020. It is estimated that between three and 10% of GDP is lost annually as a result of stress-related sick leave. ‘A well-managed, comprehensive and holistic wellness programme can have definite benefits in positively managing risks around depression and anxiety,’ says Dr Mandim.
• Improving employee engagement • Building a rich and productive company culture • Attracting future employees and retaining current talent • Improving the company’s reputation With on-the-job stress at an all-time high, workers should also take a critical look at their work life to identify potential sources of stress and deal with them decisively for their own mental and physical wellbeing. Some techniques are: Take time off Don’t put off taking leave. There’s never a good time, but your body, mind and soul need an opportunity to recharge – particularly when you’re feeling stressed. Disconnect for relief Our hyper-connected world is one of the triggers for modern-day stress. Unplug when you get home or schedule downtime when you are disonnected from devices, so you can really connect with friends and family. Get moving Exercise should be part of your workday wind-down so that you feed your cells and muscles with oxygen, get your blood pumping and focus on something other than work. Make planning a priority Getting organised is the first step to a more structured work and home life. Having a calendar of what you need to prepare will help you feel more in control. Speak up If you’re not coping, let someone know. Share your load instead of allowing destructive emotions to harm your body and mind.
WHAT CAN WORKERS AND EMPLOYERS DO?
Given that work-related stress is costing companies a fortune annually in lost productivity, it makes sense that employers are seeing the benefits of investing in the health and wellbeing of their employees. Some of those benefits are: • Reducing safety risk
For more information about Life Employee Health Solutions, visit http:// employeehealthsolutions.co.za, email firstname.lastname@example.org or call 086 123 4123
WHEN FOOD MAKES YOU SICK Eating disorders aren’t fads, phases or lifestyle choices – they’re complex psychiatric diseases that can decimate a person’s health and life. By Carla Hüsselmann
ou don’t have an eating disorder (ED) if you maintain a ‘healthy’ weight. Men don’t get EDs. Anorexia is cured if a healthy weight is restored. These are a few of the misperceptions that exist about EDs, which are extremely complex psychiatric diseases, says Dr Judy Bentley, a psychiatrist at Life St Vincent’s based at Life Vincent Pallotti Hospital in Cape Town. ‘While many EDs are triggered by dieting to lose a little weight and achieve an “ideal” body shape or weight that may be within a healthy range, once the eating disorder sets in the person’s perception of what they look like and how much they’re eating is distorted.
Behaviours become compulsive and very difficult to resist,’ she explains. These disordered eating patterns take on a destructive life of their own and sufferers may battle with other psychiatric illnesses, such as depression, anxiety, obsessive compulsive disorder and substance abuse. In fact, EDs are viewed as ‘addictive’ disorders, says Charlene van Rooyen, a senior social worker at Life Poortview in Roodepoort, Gauteng. ‘Like addicts, those struggling with EDs display adverse behaviour, such as reactivity, manipulation, impulsivity, peoplepleasing, avoidant behaviour, isolation and suicidal tendencies,’ she says.
As with addiction, anorexia nervosa (AN), bulimia nervosa (BN) and bingeeating disorder (BED) can devastate not only your physical and mental health, but your relationships, social life and career. At their extreme, they can lead to organ failure and, in the case of AN, even death.
UNTANGLING THE COMPLEX CAUSES OF EATING DISORDERS Anybody can suffer from one, particularly during adolescence and in their twenties, but EDs are more common in women than in men by a ratio of 10:1. They affect up to 5% of the population in Western countries, says Dr Bentley. ‘Unlike in the West, the prevalence of AN in Africa is
very low. However, there’s a relatively high proportion of African women with BED, and BN in African women has a prevalence of 0.87%. This is similar to Western countries, where the prevalence is 0.88% to 4.6%,’ says Dr Bentley. ‘A local study in 2001 showed that abnormal eating attitudes were equally prevalent in girls from different ethnic backgrounds.’ Despite extensive scientific research, EDs’ biological, behavioural and social underpinnings remain largely elusive. ‘What is known is that they run in families and that people with EDs tend to, for example, be more perfectionistic and obsessive, have more negative experiences, are less self-directed and less cooperative, and are less likely to enjoy close social contact,’ says Dr Bentley. Other factors include trauma or abuse, and family dynamics – for example, both overprotective and uninvolved parents. Disturbances of brain chemicals have been associated with EDs, too. Their destructive obsession with thinness is fuelled by the distorted body ideals depicted in the media, says Dr Bentley. ‘Greater internet and socialmedia use – especially image-based social media such as Facebook and Instagram – has been associated with triggering ED behaviour and worsening symptoms. Pro-ED websites and online groups provide a normalisation and sense of social connection detrimental to those with EDs,’ she says.
HIDDEN SIGNS AND SYMPTOMS
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It’s not always easy for family members to know that their loved one is in the grip of an ED, as sufferers can be highly secretive and manipulative. It often takes someone outside of the family to recognise the severity of the problem, says Dr Bentley. AN, which involves significant loss of weight or maintenance of it, is easier to spot. ‘Anorexics have an intense fear of
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HELPFUL RESOURCES •E ating Disorders Anonymous (EDA): http://www. eatingdisordersanonymous.org •R ecovery Space – eating disorder information and recovery resource: http://www. recoveryspace.org •E ating Disorder Hope: https:// www.eatingdisorderhope.com •S A Depression and Anxiety Group: http://www.sadag.org gaining weight or behave in a way that consistently interferes with them gaining weight, despite being very underweight,’ explains Dr Bentley. ‘The family may see less time spent at the dinner table and the avoidance of eating meals together, despite clear weight-loss or failure to gain weight.’ Other symptoms can include excessive exercising, bingeing and purging, brittle hair or nails, irregular menstruation, constipation and lethargy. BN involves recurrent episodes of bingeing – eating large amounts of food over a relatively short time period with an accompanying sense of lack of control. ‘They’ll use compensatory behaviours to try prevent weight gain, for instance self-induced vomiting, misuse of laxatives, diuretics or other medications, fasting or excessive exercise. Bingeing usually occurs in private and may be planned,’ says Dr Bentley. Other behaviour may include splurging on foods, frequent ‘diarrhoea’ (from laxative use), dental problems from vomiting, and a change in face shape, as recurrent vomiting can lead to a ‘chipmunk’ face.
Dr Judy Bentley is a general adult psychiatrist at Life St Vincent’s based at Life Vincent Pallotti Hospital. She also consults at treatment and counselling centres for people with addictions and eating disorders. Her interests include the mental health of those with autism spectrum disorders and intellectual disability.
‘BED involves compulsively overeating large amounts of food in a short period of time, either daily or infrequently,’ says Charlene. ‘It leads to serious weight gain, as the binges occur without compensatory behaviours to avoid weight gain.’ Most people have some bad habits, but these become a concern when daily activities are affected by those bad habits.
TREATMENTS OF CHOICE
Community education and awareness programmes have a part to play in addressing and destigmatising mental health disorders – which also helps with early detection. All mental health disorders have better outcomes the earlier they’re treated. For all EDs, psychotherapy is the preferred treatment. Group and family therapy is crucial, including getting support from Eating Disorders Anonymous (EDA), advises Dr Bentley. ‘Inpatient treatment is often necessary, especially during the early phases of refeeding. There are no specific medications for treating AN, but associated mental health conditions may be treated.’ For BN and BED, medication can be used, and a medical evaluation is needed to check for medical or psychiatric complications, Dr Bentley says. ‘Self-induced vomiting and using laxatives to control weight gain can cause medical complications that can be fatal. BEDs’ weight gain can also cause dangerous complications. Recovery can take months and relapses are common,’ she says. At Life Poortview, all patients admitted with an ED are assigned to the addiction programme, says Charlene. ‘Behaviour modification and ongoing intensive therapy forms an integral part of their treatment. Cognitive behavioural therapy (CBT) is offered to address the changes needed, as are sessions with a dietitian. Should a patient not gain the needed insight and motivation to address their behaviour, their prognosis will be poor.’
Charlene van Rooyen is a senior social worker at Life Poortview, a mental-health facility for the treatment of psychiatric disorders and dual-diagnosis disorders. She has a master’s in Forensic Social Work, specialising in sexual abuse, and is a Unisa e-tutor in sexual trauma. WWW.LIFEHEALTHCARE.CO.ZA
ARE YOU OBSESSED WITH PERFECTION?
Do you set your sights too high or expect too much from those around you? Even though we live in an imperfect world, we may still strive to make our lives absolutely perfect. The problem is that if we leave no room for error, then no matter what challenge we take on, the end result will almost always be disappointment. Find out if you have perfectionistic tendencies with this test Read every statement carefully and indicate which option applies best to you – your life, feelings, attitudes and behaviour. Then sum up your points using the scoring table and view the relevant results for you. 1. When I look back at my life, I see only my failures. A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 26
2. I have to excel at everything I do. A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 3. I spend a lot of time on getting things right at work. My colleagues will think less of me if they ever find a mistake in my work. A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree
4. If my children aren’t successful in school, I’ll be labelled a bad parent. A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 5. If I’m not perfect, my partner will think that I’m not good enough for him or her. A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree
6. I believe I have to be in perfect physical shape in order to be viewed as attractive. A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 7. I find myself getting impatient with my family when they mess up. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
8. When I assign tasks at work or home, I expect them to be done without any errors. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me 9. I worry about what others think of me. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
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10. I try to be everything to everyone. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
S C O R IN G YO U R S E LF QUESTION 1 2 3 4 5 6 7 8 9 10
A 10 10 10 10 10 10 10 10 10 10
B 8 8 8 8 8 8 8 8 8 8
C 5 5 5 5 5 5 5 5 5 5
D 2 2 2 2 2 2 2 2 2 2
E 0 0 0 0 0 0 0 0 0 0
Being perfect may be a goal for some, but it’s not something you aspire to – you have few, if any, perfectionistic tendencies. This is generally a healthy approach to life, but there’s still something you should keep in mind: although it is unfair to set unrealistic expectations for yourself (or others), it is still important to strive to do your best. Completely dismissing mistakes or ignoring failures won’t do anyone any favours. Setting the bar realistically high, however, will push you to attain your full potential. You’ll never know what you’re capable of achieving unless you keep raising the bar. Just don’t lose sight of the fact that you’re still human. Making mistakes is often the best way to learn.
You either set unrealistically high expectations in some areas of your life and none in others, or you display a moderate degree of perfectionism all around. Either way, some degree of perfectionism is healthy. You just need to make sure that when you do set the goal high, whether for yourself or for others, it is still within reach. By all means, strive to do that extra kilometre on your daily jog or help your child turn that C grade into a B. Even if you don’t accomplish everything you set out to do, the fact that you tried is something to be proud of. And be willing to give and accept compliments. By doing so, you create a sense of pride after a job well done.
‘Do or die trying’ is probably more in line with your life motto than ‘Live and let live’. Your perfectionistic tendencies can be quite extreme and inflexible. Unfortunately, you seem to be setting standards that will be difficult to meet. This can hurt your self-esteem and happiness (or someone else’s). Whether the source of your perfectionism comes from yourself or an outside influence, understand that perfection is one of those goals that isn’t attainable. If you only see an outcome as either a success or a failure, you’re already sabotaging yourself. Set the bar high but be realistic: you can and will make mistakes. As long as you learn from them, however, you automatically turn any outcome into a success.
Recent research has shown that there are three degrees of adaptiveness for perfectionism: adaptive, maladaptive and non-perfectionism. Adaptive perfectionists strive to be perfect but are open to the possibility of error and failure. They know and accept the fact that they’re not always going to be perfect. Maladaptive types are obsessed with perfection – in their eyes, error and failure are completely unacceptable. Non-perfectionists, however, don’t set high standards for themselves and do not expect perfection from others. Perfectionism has long had negative connotations. Studies have shown that an obsession with perfection can have serious repercussions, such as depression, poor self-esteem and, in some extreme cases, suicide. It can also lead to marital and interpersonal issues. However, the keyword here is ‘obsession’. Striving for excellence is a healthy approach to challenges. In moderation, it can lead to a fulfilling professional and personal life. But it’s when we want constant perfection, leaving no room for human error, that we risk scarring ourselves, as well as other people, emotionally.
THE BEST THINGS IN LIFE
If you blew your budget in summer, don’t stress. We’ve rounded up the best things to do in your city this winter that don’t come with a price tag. By Erin Coe
JOHANNESBURG ENJOY THE VIEW FROM NORTHCLIFF HILL If you need to take a breather from the hustle and bustle of Joburg, Northcliff Hill is the perfect place to gain some perspective. Enjoy the expansive views of the CBD on the one side and the leafy northern suburbs on the other. GO TO A NIGHT MARKET Wine? Tick. Nice crowd? Tick. Delicious meals? Tick. If this sounds like something that would interest you on a chilly evening, then head to the market at Arts on Main in Maboneng on the first Thursday of every month. NORTHCLIFF HILL
JAMES HALL MUSEUM OF TRANSPORT 28
PICNIC AT ZOO LAKE Zoo Lake, one of the oldest parks in Joburg, is perfect for lazy Sundays. The interesting part? The area was once owned by mining magnate Hermann Eckstein, who turned it into a forest that was a popular relaxation spot for the wealthy ‘Randlords’. After his death, his company gave the land to the Johannesburg Town Council in 1903 under provision that it be kept open to the public.
EMBRACE YOUR INNER PETROL HEAD The James Hall Museum of Transport, started in 1964, is the largest museum of land transport in South Africa. From Joburg’s first horse-drawn trams to double-decker buses, the museum covers years of transport history. BE A HISTORY BUFF Browse the shops, go to the open-air museum and check out the Freedom Charter Monument at Walter Sisulu Square in Kliptown. Try a shisanyama if you get hungry (trust us on this!).
JUST NUISANCE MONUMENT
RIDE ON THE PROMENADE Roller skates, bicycle, skateboard ... whatever you prefer, Durban’s promenade is a great place to get your daily dose of cardio. Start at the Blue Lagoon, detour past the Moses Mabhida Stadium, stop for a surf at North Beach and end with a sundowner at uShaka Marine World. ADMIRE THE GREENERY Feeling worn out? Take a breather in the Japanese Gardens, Durban North, surrounded by cobbled pathways, water features, gazebos and Japanese blossoms. After an hour or two, you’ll feel completely relaxed and rejuvenated.
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FEAST YOUR EYES From the red-bricked Emmanuel Cathedral and the colourful Victoria Street Market to the elaborate Juma Masjid Mosque and Art Deco apartments, Durban’s architecture is something special. Take a walk to enjoy the sights. STOP AND SMELL THE ROSES Jameson Park used to be a pineapple plantation, but these days it’s the 200 rose species that are the main attraction. Cross the road to Mitchell Park, a lush haven for animal-lovers, to admire tropical fish, exotic birds, reptiles and other small animals. GET SOME VITAMIN SEA Durban winters boast minimal rainfall and moderate weather, meaning the beach is an option all-year round. White sand, a warm ocean and plenty of waves – what more could you want? DURBAN PROMENADE
CAPE TOWN FEED THE SQUIRRELS AT THE COMPANY’S GARDEN Located in the CBD, the Company’s Garden was created in the 1650s by European settlers. It is home to sprawling lawns, historic statues, the oldest cultivated pear tree in South Africa, and lots of curious squirrels. So set aside a few hours and go for a walk – just don’t forget the peanuts. LEARN ABOUT A NAVAL DOG If you’re a dog-lover, you’ll love the story of Just Nuisance, the Great Dane. He grew up with sailors and ‘joined’ the Royal Navy in 1939. When he died in 1944, he was buried with full military honours. Now you can drive to Simon’s Town to see the bronze statue erected in his honour. APPRECIATE AFRICAN ART Zeitz MOCAA is home to the largest collection of contemporary African art in Africa. And it’s not just the art itself that’s
impressive, the building that houses it all is also something to behold – a converted grain silo built in 1921. At R180 a ticket, it might not seem accessible, but on Wednesdays between 10am and 1pm, entry is free for African citizens. Can’t make mornings? There are free Museum Nights on 28 June and 26 September 2018 from 5pm to 10pm. GO TO THE BAY HARBOUR MARKET Go window shopping at Hout Bay’s favourite market. There you’ll find delicious food stalls, handcrafted jewellery and second-hand clothing, among many other things. Trading times are Friday 5pm to 9pm; and Saturday and Sunday 9:30am to 4pm. ENJOY FREE BEER What better way to start the weekend than with free beer? Every Friday from 4pm to 5pm, Beerhouse on Long Street give away litres of free beer. Visit their Facebook page for the password, tell it to the barman and free beer is all yours. Cheers!
HEALTH CELEBRATING OUR NURSES / LISTERIOSIS 101 / TEENS AND DRUGS
‘NURTURING YOURSELF IS NOT SELFISH – IT’S ESSENTIAL TO YOUR SURVIVAL AND YOUR WELLBEING.’ RENEE PETERSON TRUDEAU
CELEBRATING 20 YEARS OF
LIFE COLLEGE OF LEARNING Nursing training has undergone radical changes in the past two decades, and nowhere is this more apparent than at the Life College of Learning, which celebrates its 20th anniversary this year. Established in 1998 with 10 bridging nursing students, today the college has seven learning centres countrywide. Last year, the college produced 1Â 100 graduates primed for the demands of hi-tech private hospital care. By Glynis Horning
or Shereen Choonara, Life College of Learning’s Regional Education and Training Manager (Eastern Cape), the revolution in nurse training is vividly summed up in the difference between how she taught first-year students to give injections in 1998, and how they are taught today. ‘Students are always afraid of hurting patients, so we’d train them by injecting oranges, which give a similar sensation to human muscle,’ she says. ‘But today they learn on partial mannequins – lifelike models of human body parts. They can be anatomical replicas, for instance of an arm or pelvis. But that’s not all: we also use high-fidelity robotic
If students don’t give the injection properly, the robotic patient yelps – or rather, I do, through the voice simulator. You should see them jump!
patient simulators that lie on a bed just like a real patient. And if students don’t give the injection properly, the robotic patient yelps – or rather, I do, through the voice simulator. You should see them jump! We can even make the “patient” breathe or have a heart attack. We hope to have a pregnant simulator soon, which midwifery nurses can palpate and assist with delivery or c-sections. Talk about progress...’ Other technological advances at the college include access to interactive multimedia modules that enable students to actually see things like the body’s blood circulatory system, and create 3D images and anatomical cross-sections in computer labs.
They also have access to academic databases and journals online, and to college policies and procedures through an internal college intranet. ‘All student documents are electronically scanned so that we can go paperless,’ says Shereen excitedly. ‘Healthcare is also about helping the environment.’ For Life College of Learning’s quality and development manager, Magda Cunze, and National Education Manager Peggy Naicker, the greatest achievement of the past 20 years has been the college’s registration with the Department of Higher Education and Training as a private highereducation institution. ‘The college has maintained registration as a nursing education institution over the past 20 years and our graduates are sought after for their clinical competence and expertise. The college also maintains a patriotic association with the Nelson Mandela University, which has played a significant role in our governance and growth during this period,’ says Magda. Peggy is also proud of developments in the college’s research: ‘We provide an opportunity for students to do their own research and then present it at annual research days held at each learning centre. This includes students who are employed by Life Healthcare who have completed formal graduate studies and projects for clinical practice,’ she says. The Life Healthcare Group has its own Research and Ethics Committee, provisionally accredited in 2016 by the Department of Health’s National Health Research Ethics Council (NHREC). But along with advances, the past 20 years have brought challenges, some of which continue to grow. One of the biggest is addressing the nationwide shortage of nurses. Shereen attributes this partly to young women exploring professions other than the traditional nursing, teaching and secretarial work – a trend that a rise in the college’s enrolments by young men (now about 10% of the college’s students) has not been able to counter. The quality of students’ basic education is another challenge. ‘Not all schools have a good standard, and literacy and numeracy is a problem, never mind computer literacy,’ says
MEMORABLE LIFE COLLEGE MOMENTS ‘My best moments in the past 20 years have been seeing how adaptable our students are, such as watching a mature student start her training after raising a family; finding her way around a computer and simulation labs to go on to excel. And seeing students get involved in our community involvement projects, showing the compassion so needed in nursing. Some work with children at a crèche, giving them health talks and toothbrushes. Students even raised funds and started a soup kitchen for the homeless.’ – Shereen Choonara ‘My most satisfying moments have been watching students triumph against the odds. A male nursing student with potential approached me, unable to continue his studies for financial reasons. I spoke to one of our Life Healthcare hospitals and they financed his studies, arranging that he work it back. He’s now an excellent registered nurse. Students are always so grateful for the experiences and opportunities the college provides.’ – Magda Cunze ‘I’m a student doing my first-year bridging course after obtaining a BA in psychology from Nelson Mandela University. My best moment has been nursing a long-stay patient five weeks after an infected post-valve replacement. His family live in Australia, so I organised a laptop and connected him via Skype. The minute he saw his daughters and grandchildren on the screen, he started crying. I did, too.’ – Olwethu Hlazo ‘The graduation ceremonies are a highlight. It’s a proud moment for me to see the impact we’re making in upskilling nurses. I’ve had countless testimonials from graduates saying the college has enriched their personal lives and their careers as nurses.’ – Dr Sharon Vasuthevan
LIFE COLLEGE MILESTONES
2005 The Lifecare School of Nursing is integrated with the college, so the name becomes the Life College of Learning. The college offers three training areas: the school of nursing, health sciences, and management development.
The college is fully registered as a highereducation institution. The Diploma in Operating Department Assistance is accredited with CHE.
2016 Life Healthcare Group’s Research and Ethics Committee receives provisional accreditation from the National Health Research Ethics Council (NHREC) – another first for a private healthcare institution. For more information, visit the college’s website: www. lifehealthcare.co.za/careers/ life-college-of-learning
Magda. ‘We get many applications from rural areas where schools don’t have computer labs, and there is understandably a lack of even basic computer knowledge.’ This is one of the issues the college plans to address as it moves into the next 20 years. ‘From 2020, the college intends to offer a foundation programme to assist potential applicants who don’t make the entrance requirements of the college’s primary learning programmes,’ says Peggy. ‘Two new programmes will be offered – a one-year higher certificate in auxiliary nursing, and a three-year diploma in nursing – and we’ll forge ahead with e-learning.’ Dr Sharon Vasuthevan, the national nursing and quality executive at Life Healthcare, is 36
115 students enrol at the college, mostly after basic training.
The name is changed to the Afrox Healthcare College of Learning.
Dr Sharon Vasuthevan joined Life Healthcare in 2001 and is currently the nursing and quality executive.
The college is provisionally registered as a higher-education institution. The postgraduate diploma – Medical and Surgical Nursing Science – is accredited with the Council on Higher Education (CHE).
On its 15th anniversary, the college celebrates ‘exceptional growth and operational excellence’, with learning centres and classrooms countrywide. In total, 10 000 qualified nurses pass through its doors.
Peggy Naicker joined Life College of Learning in 2007 as a nurse educator and is now the national education manager. Peggy has a master’s in Health Sciences.
On its 20th anniversary, the college reaffirms its focus on being ‘a world-class provider of quality healthcare for all’ by investing in hi-tech equipment and expanding partnerships with other education institutions. It has produced 10 762 nursing graduates.
passionate about the Life College of Learning and the opportunities it offers students. ‘Our vision is to create a skilled workforce for Life Healthcare and the healthcare industry, in order to provide cost-effective, quality and competent patient care,’ she says. Added to that, it’s imperative that the college prepares students for new medical and nursing challenges linked to advances in technology, and dealing with more knowledgeable patients with higher expectations. ‘Through all we have achieved over the past 20 years, we are committed to providing students with opportunities to upskill and ensure they are practising best-quality care using state-ofthe art technologies,’ Dr Vasuthevan concludes.
Magda Cunze, the College’s quality and development manager, has a master’s degree in Health Sciences. She joined the College in 1996.
Shereen Choonara began at Life College of Learning as a nurse educator in 1998. She is currently the regional education and training manager (Eastern Cape).
The Afrox College of Learning is started in association with the University of Port Elizabeth, through the amalgamation of the Afrox School of Nursing, started in 1998 at Brenthurst Clinic’s nursing residence with 10 bridging students, with nursing schools attached to Afrox hospitals.
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5 reasons to visit our new website We’ve launched our new website and we’d like to introduce you to some of its features www.lifehealthcare.co.za has been designed with you, the patient, in mind. It’s fast, easy to navigate and offers an enhanced experience on your mobile device. You can:
#2 Download a pre-admission form
#4 Search for a hospital and their specialists and services
#1 Get a list of what to pack for your hospital stay
#3 Read Life Healthcare magazine
#5 Learn more about patients rights and responsibilities
If you know you are going to be in hospital overnight – or a little longer – it is helpful to have all you need to make your stay as comfortable as possible.
Pre-admission ensures that you are as prepared as possible for your hospital stay. Make sure all relevant documentation has been completed on the day of your admission.
The latest issue of our quarterly publication is available online. You can also access all previous issues so you can catch up on health news and lifestyle advice.
Life Healthcare has 64 facilities from which to choose, as well as physicians and staff who are committed to caring for your health and wellbeing.
Our patient rights and responsibilities informs our patients and their families of their basic rights with regard to care in our facilities.
Making life better starts by clicking on www.lifehealthcare.co.za You can also ﬁnd us on Facebook (@lifehealthcare) and Twitter (@LifeHealthcare_)
TO THE FUTURE
Life Carstenhof Hospitalâ€™s new radiology and imaging unit offers patients top-class facilities and cutting-edge technology. By Melanie Farrell 38
I N N O VA T I O N
V I M A G E S G ET TY/GALLO I MAG ES, SU PPLI E D. P H OTO G R A P H E R @CH E R RYMASH4TOG R APHYAN DVI DEO
hen your doctor sends you for X-rays, you want the best care, slick service and a quick turnaround. The last thing you need is equipment that’s out of date, delays or lack of clarity. Until the end of 2016 – when the hospital had a total revamp – the old radiology unit at Life Carstenhof Hospital in Midrand, Gauteng, was still using analogue technology. The switch from analogue to digital has improved the overall patient experience. Faster, more accurate equipment ensures that patients receive the best care possible, whether they need a routine X-ray or an MRI scan. The hospital revamp has equipped the radiology unit with everything a modern radiology department could need. ‘The new department is a state-of-theart, cutting-edge radiology practice,’ explains Dr Aobakwe Segwe, a specialist radiologist and co-founder of the unit. ‘It is fully equipped with various imaging modalities, including X-rays, mammogram and an MRI suite.’ ‘We also offer CT scans, ultrasound (including ICU and neonatal unit portable ultrasound) and fluoroscopy facilities for videos of the internal organs,’ says Dr Segwe. ‘We would use fluoroscopy in the workup for infertility, as well as bladder and bowel disorders,’ she explains. Dr Segwe co-founded the unit with Interventional Radiologist Dr Nhlanhla Sithole, who explains the benefits of the newly kitted-out centre. ‘The newer equipment allows us to offer a reduced radiation dose to our patients with fewer repeat exams because all images are stored electronically on our picture archiving and communication system (PACS),’ says Dr Sithole. ‘We strive to have shorter waiting times when booking as well as after the radiology exam and we have improved our efficiency with our new radiology information system (RIS),’ he adds.
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Prior to the overhaul of the unit, a patient who needed an MRI had to be sent elsewhere. Now that the centre boasts its own high-tech MRI, this is no longer necessary. Dr Segwe explains that the digital technology has benefited patients because it enables doctors to offer a more accurate diagnosis than before. ‘For example, we have improved breast-cancer detection with our mammography software,’ she says, and gives an account of how this has helped specific patients. ‘We detected early-stage breast cancer in a 47-year-old patient who came to us for a mammogram. Due to the
early detection, she was able to undergo conservative surgery and is doing well.’ ‘Another patient presented with weakness of the right side. Further imaging revealed a benign left brain tumour that required surgery,’ Dr Segwe says. ‘Our resident neurosurgeon used images from our MRI navigation software to assist him during the operation and the surgery was a success.’ The patient has since gone back to work and is regaining neurological function of her right side. The new unit’s doors are open 24 hours a day, every day of the year, ensuring round-the-clock access for patients when they need it most.
OUT WITH THE OLD, IN WITH THE NEW The old X-ray unit had outdated analogue equipment that has now been completely replaced by digital technology. ‘The new equipment is worlds apart from the analogue,’ says Dr Sithole proudly. ANALOGUE
How are images obtained?
Images are obtained using wet processing and the use of a darkroom.
Images are obtained via wireless detectors. These are sent electronically to the doctor’s room for reporting.
How are images stored?
One film is printed and kept by the patient. You are unable to reprint the film for comparison, so if it is lost you can’t compare old and new.
Images are stored on a picture archiving and communication system (PACS). These images and reports can be reviewed by the team of specialists treating the patient.
How does digital save time?
(Analogue mobile machine in casualty and ICU) It takes time to acquire an image, then proceed to the darkroom to process via wet processing and return with the image.
(Digital mobile unit in ICU and casualty) A digital screen on the mobile machine shows the image immediately at a patient’s bedside, saving considerable time.
Dr Aobakwe Segwe is a specialist radiologist skilled in interpreting imaging from various modalities. Dr Segwe has been practising at Life Carstenhof Hospital since 2016.
Dr Nhanhla Sithole is an interventional radiologist performing both vascular and non-vascular work. Dr Sithole has been practising at Life Carstenhof Hospital since 2016. WWW.LIFEHEALTHCARE.CO.ZA
Teens and drugs:
WHAT YOU NEED TO KNOW Drug addiction is the terror that lurks in the dark for many a parent. Mandy Collins finds out how you can protect your teenager
lobally, substance abuse is on the rise. And in South Africa, we’re not immune to this trend – the problem is worse than most of us realise. So says Dr Suntheren Pillay, a specialist psychiatrist at Life St Joseph’s, based at Life Entabeni Hospital in Durban, which specialises in acute mental healthcare treatment. ‘There are no exact statistics, but it’s far worse than people think it is,’ says Dr Pillay. ‘It’s common – the youngest patient I’ve seen was 8. Generally, however, it starts at about age 11 or 12, and goes upwards from there.’ WHY DRUG ABUSE IS ON THE RISE Dr Pillay says there are various reasons for this increase in substance abuse; the causes are complex. ‘Access to the media and social media means that people are more aware of drugs – which is both a good and bad thing,’ he says. ‘They’re also more readily available. It used to be much harder to score drugs, and now they are available on the corner of any street.’ He says substance abuse has also become more socially acceptable – much more so than in the older, more conservative society many of today’s parents grew up in. ‘Traditional family structures have collapsed,’ he adds. ‘We have far more single-parent families, grandparent-led households, and child-headed households.’ Of course, there’s also a self-medication aspect – teenagers are quite susceptible to depression and mood disorders, says Dr Pillay, adding that in the US, suicide is the second most common cause of death 40
in teens, after accidents. ‘Drugs and alcohol are the quickest ways for them to numb what they’re feeling,’ he says. The South African Depression and Anxiety Group (SADAG) point to local stats suggesting that 19% of SA teens had considered suicide, with numbers rising. Drugs today are not only easier to access, they’re also more popular – and more affordable. In the 1970s, ketamine was the big thing. But it was never as big as ecstasy is in today’s party culture, says
Dr Pillay. They also cost much the same in actual rands now (R30, R40 or R50) as they did 20 years ago, so they’re affordable. ‘Teenagers are more susceptible to drug abuse because they’re at a natural stage of rebellion. They’re likely to experiment and are more impulsive – it’s part of their normal development,’ says Dr Pillay. *Children with Attention Deficit Hyperactivity Disorder (ADHD) are at even higher risk because they’re far more impulsive. Up to 70% of children with
Glossary: common drugs > Flakka: a synthetic psychoactive drug that comes as a white or pink crystal that you can snort, eat, inject or even vape. > Blow, coke, charlie: cocaine, usually snorted or rubbed on the gums. > Rocks, freebase: crack, a cheap and deadly form of cocaine that is turned into smokeable ‘rocks’ with the use of additives. > XTC, e, Adam, MDMA, Molly: Ecstasy – a rave or party drug that enables users to dance all night. > Whites, buttons: Mandrax or methaqualone. Tablets are usually powdered and smoked with a mixture of marijuana or tobacco in a bottleneck pipe. > Acid, blotter acid, microdot, white lightning: LSD – an odourless and colourless drug available in two forms: paper stamps impregnated with the LSD or micro-tablets (‘microdots’) containing LSD in low concentrations. > Whoonga, nyaope, wunga: a concoction of various substances, such as rat poison, soap powder and the main ingredient, anti-retrovirals (ARVs). It’s distributed as a fine white powder, which is added to marijuana and/or tobacco and then smoked, producing one of the most lethal drugs in the world. > Mercedes, Mitsubishi, Lacoste: a white ecstasy-based pill, with a piece of metal wire hidden inside.
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ADHD will abuse substances, which reduces to under 20% on treatment, he says. Ritalin (methylphenidate in all preparations) and other medication for ADHD decrease addiction by over 50%. But when these children become teenagers they stop their meds and are therefore more vulnerable. HOW TO PROTECT YOUR CHILD Parents need to establish a good, loving relationship with their children so that they can pick up when things have changed, says Dr Pillay. ‘You can’t stop them experimenting,’ he cautions, but you can keep those channels of communication open. ‘And if they’re in trouble, you want them to feel they can turn to you for help. ‘Spend time with your children, so you can talk about these topics when they arise,’ he urges. ‘It’s also important to expose your own humanity to your child. Tell them about the stupid things you did when you were their age – there’s no point in holding the moral high ground.’ Parents need to be on the lookout for changed behaviour, he says, and a decline in academic performance. These may signal a drug-abuse problem. ‘Usually, there are mood changes. They become irritable and socially withdrawn. Also look for changes in weight, concentration, sleep patterns and friends,’ he says. And if you suspect a problem, seek professional help immediately. Life has nine mental health facilities in four provinces (Gauteng, Eastern Cape, KwaZulu-Natal, Western Cape) where your child can get help. ‘We facilitate rehab as part of an integrated psychiatric offering,’ says Dr Pillay. ‘Most patients have a dual diagnosis: they have abused drugs or alcohol because of an underlying psychiatric condition or psychological issue. So we treat both problems.’ He concludes, ‘This is a universal problem – it happens to the best of families and people. Modern drugs are formulated in a way that all it takes is one experiment, and you’re hooked. It’s vital that parents approach substance abuse in a non-judgemental, loving way.’ *Source: Pharmacotherapy for attention deficit hyperactivity disorder (ADHD) decreases the risk for substance abuse: findings from a longitudinal follow-up of youths with and without ADHD Biederman J. J Clin Psychiatry: 2003
Dr Suntheren Pillay is a specialist psychiatrist at Life St Joseph’s in Durban. His interests are ADHD, bipolar mood disorder, treatment-resistant mood and anxiety disorders, and dual-diagnosis patients. In his time off, he enjoys yoga and being with friends and family.
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WHEN ANTIBIOTICS AREN’T THE ANSWER
We all want what’s best for our children – but that doesn’t always mean antibiotics. Bridget McNulty asks a clinical pharmacist how to know when antibiotics are essential and when to avoid them
THE BABY FILES
bacteria have been exposed to numerous antibiotics and, as a result, they’ve become resistant to them. ‘The more we learn about bacteria, the more we realise how advanced they actually are,’ says Michelle. ‘They develop mechanisms of resistance to protect themselves against the effects of antibiotics and can even “communicate” through a process called quorum sensing. This lets them pass resistance between different types of bacteria.’ When resistant bacteria cause infection, there are limited antibiotic options available. And in the case of superbugs, there aren’t any. ‘The discovery of antibiotics remains one of the biggest scientific miracles,’ says Michelle, ‘but it’s essential that we preserve this miracle for future generations by using antibiotics only when truly necessary.’
WARNING SIGNS THAT IT MIGHT BE TIME FOR ANTIBIOTICS
If your child has a bad cold or flu, there are over-the-counter products that can help relieve the symptoms. But an initial viral infection (such as a cold) may lead to a secondary bacterial infection (such as a chest infection), in which case it might be time for antibiotics. If you feel unsure, contact your doctor or pharmacist.
WHEN TO SEEK MEDICAL ATTENTION
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he first thing to understand is the difference between a viral infection and a bacterial one. ‘Many common infections seen in children – such as colds, flu and bronchiolitis – are caused by viruses,’ explains Michelle Gijzelaar, a clinical pharmacist at Life Healthcare’s Johannesburg head office. ‘Antibiotics treat bacterial infections and are ineffective in treating viral infections.’ In fact, using antibiotics unnecessarily contributes to antibiotic resistance – one of the biggest threats to public health today, according to the World Health Organisation (WHO).
ANTIBIOTIC RESISTANCE 101
Antibiotics have been overprescribed and overused for decades. This means that
• If your child has a fever or is lethargic and is younger than three months • If symptoms are severe or unusual and you are concerned • If symptoms last more than 10 days without improvement • If fever persists for more than two days despite using over-the-counter medicines • If your child has a number of these symptoms: a fever, no appetite, shortness of breath, vomiting, crying inconsolably, difficulty waking, a stiff neck, a rash or bruised-looking purple spots.
When used correctly, antibiotics are incredible – truly miracle drugs. That’s why it’s so important that we all understand how to take them – and give them to our children – the right way.
Find out more about antibiotic resistance and take the quiz: http://www.who.int/mediacentre/ factsheets/antibiotic-resistance/en
FAST FACTS ABOUT ANTIBIOTICS
1 Colds and flu are viral infections that your immune system will fight. No antibiotics should be given for colds and flu. 2 Antibiotics can take up to two to three days to start working. 3 It’s essential to give the antibiotics to your child exactly as prescribed by your doctor and directed by your pharmacist. Never give leftover antibiotics to your child. 4 While antibiotics are killing the harmful bacteria causing the infection, they also kill beneficial gut bacteria. Probiotics may be beneficial to replenish the good bacteria and reduce the chance of nasty side effects. 5 Common side effects of antibiotics include rash, diarrhoea and thrush. Call your healthcare provider if your child has severe side effects, such as breathing difficulty, skin hives, severe diarrhoea, or a severe vaginal or oral yeast infection.
Michelle Gijzelaar is a pharmacist with a master’s degree in Clinical Pharmacy. She has been working for Life Healthcare for seven years, and is passionate about antimicrobial stewardship and clinical pharmacy in South Africa.
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‘Usually the pregnant woman does not become ill or develops mild disease. However, infection of the foetus is often severe and can lead to miscarriage, stillbirth, premature labour or neonatal listeriosis (when the baby is born with disease),’ she adds.
TRACED TO ENTERPRISE FOODS PRODUCTS
South Africans may never look at polony the same way, after the popular sandwich meat’s starring role in the listeriosis outbreak, says Pippa Naudé
tarting in 2017 and continuing into 2018, South Africa had the world’s largest known outbreak of listeriosis – a food-borne illness caused by the bacteria Listeria monocytogenes. The Mayo Clinic lists the symptoms as fever, muscle aches, nausea and diarrhoea, with potential complications such as blood infections (septicaemia) or inflammation of the brain and fluid around the brain (meningitis).
LISTERIA IS EVERYWHERE
‘Listeria monocytogenes is widespread in the environment; it can be found in soil, water, vegetation and the faeces of some animals,’ says Dr Juno Thomas, who heads the Centre for Enteric Diseases at the National Institute for Communicable Diseases (NICD). ‘It’s not possible to eradicate this bacteria from the environment.’ Established hygiene standards normally prevent its spread in food production, but outbreaks can occur. Ready-to-eat processed cold meats and unpasteurised dairy products are often culprits, as listeria can survive refrigeration or freezing, but high temperatures and pasteurisation destroy it. 44
IT CAN BE DEADLY
Surprisingly, most healthy adults aren’t affected by listeria, while those considered ‘at risk’ could find it deadly. It has a 20–30% mortality rate, despite available antibiotic treatment. Vulnerable groups have immature or weakened immune systems and include: newborn babies, pregnant women and their unborn babies, people over 65, people with a compromised immune system (such as those with HIV, undergoing chemotherapy or taking immune-suppressing drugs), and people with diabetes, cancer, or chronic liver or kidney disease. In the case of pregnant women, it is thought pregnancy-related changes in their immune system make them more susceptible to the bacteria, explains Dr Thomas.
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Although the outbreak is being managed, Dr Thomas says all at-risk groups should remain vigilant about food safety. ‘Reasonable advice includes avoiding unpasteurised milk, dairy products and soft cheeses, which are inherently at higher risk of being contaminated, and avoiding ready-to-eat processed meat or poultry products,’ she says, adding that everyone should practise the World Health Organisation’s five keys to safer food: • Wash hands and surfaces before, and regularly during, food preparation. • Separate raw and cooked food, and don’t mix utensils and surfaces when preparing food. • Cook food thoroughly – all bacteria are killed above 70°. • Keep food at safe temperatures – either simmering hot or in the fridge. • Use safe water and safe ingredients to prepare food.
Dr Juno Thomas is a medical doctor who specialised as a pathologist in clinical microbiology and infectious diseases. She currently heads the Centre for Enteric Diseases at the National Institute for Communicable Diseases (NICD).
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EVERYBODY’S TALKING ABOUT…
On 4 March 2018, Health Minister Aaron Motsoaledi announced the cause of the outbreak had been traced to polony products from an Enterprise Foods facility in Polokwane. The National Consumer Commission subsequently issued a recall to remove all potentially contaminated products (including other cold meats that could have come into contact with the polony) from supermarket shelves and consumers’ homes for safe disposal. As of 13 April 2018, the NICD confirmed 1 011 confirmed cases of listeriosis, including 193 mortalities. Despite the product recall, these numbers are likely to increase as the bacteria has an incubation period of six hours to 70 days.
POWER OF FIVE
5 GOOD REASONS
If you can donate blood, you should because it’s a life-saving gift that can make a real difference to people’s lives. Consider the following, says Samantha Page
YOU SHOULD CONSIDER BLOOD DONATION
The need for blood is unpredictable. The South African National Blood Service (SANBS) believes they’re always one day away from running out. While 75% of the population are potential recipients, less than 1.2% of the population are donors, and approximately 16 000 donors give blood more than four times a year.
LIFE PLUS 46
YOU CAN BE THE DIFFERENCE:
Donated blood is separated into its three main components – red blood cells, plasma and platelets. By donating one unit (±474ml), you can save three different lives. Blood is so unique in its composition that there is no known substitute and it cannot be replicated due to its complexity. Only the real thing will do.
ONE DAY YOU COULD BE IN NEED: More than
26% of donated blood is used for cancer patients and cancer can affect anyone at any time. Other patients most in need are women haemorrhaging due to pregnancy or gynaecological complications, premature babies, children with severe anaemia, accident trauma patients and surgical patients.
IT’S GOOD FOR YOUR BODY:
Donating blood regularly reduces your risk of heart disease. According to a study published in the American Journal of Epidemiology, blood donors who donated blood bi-annually were 88% less likely to suffer a heart attack due to the lowering of iron levels in the body, and 33% less likely to suffer from a cardiovascular disease.
THE PROCESS IS SAFE AND QUICK: The SANBS,
and their mobile units, use sterile, disposable equipment, so there’s no risk of infection. The entire process takes just 20 minutes, after which you can resume your daily activities – most people are back at work an hour later. Your body won’t even miss the unit of blood because it’s quickly replaced.
WORLD BLOOD DONOR DAY: 14 JUNE 2018 Be there for someone else. Give blood. Share life. Every year on 14 June, countries around the world celebrate World Blood Donor Day. The event serves to thank voluntary, unpaid blood donors for their life-saving gifts of blood, and to raise awareness of the need for regular blood donations to ensure the quality, safety and availability of blood and blood products for patients in need. For more information on how you can make a difference through donation, visit https://sanbs.org.za
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BLOOD IS IN SHORT SUPPLY:
WHAT IS A UROLOGIST?
Meet Dr Heinrich Voigt, a urologist at Life Cosmos Hospital in Mpumalanga. He spoke with Life Healthcare magazine about the rewards of the job, his motto at work and one of his most memorable patients. By Erin Coe What is urology?
What does your average day look like?
What did you study?
Do you have a specific recollection about a patient that you won’t forget?
From its Greek roots, urology literally means the ‘study of urine’. It’s a branch of medicine that focuses on the surgical and medical diseases of both the urinary tract and the male reproductive organs. Conditions like prostate and bladder cancer, bladder prolapse, blood in the urine, erectile dysfunction, swelling of the prostate, painful bladder syndrome and urinary incontinence are all treated by a urologist. I completed my medical degree at the University of the Free State in 1996. After that I did my internship before moving to the UK and working there for six months. When I returned to South Africa in 1998, I decided to specialise in urology. I completed my studies in 2003 and then went into private practice in Bloemfontein until December 2017. After that, I moved to Mpumalanga to join Dr Wikus Vermeulen and Dr Nico van Greunen in a urology partnership.
What is the most rewarding part of your job?
It gives me great satisfaction treating patients and truly relieving their problems – sometimes even instantly. For example, patients with kidney stones will present with agonising side pain and blood in their urine. But once the diagnosis has been confirmed by X-ray, removal of the stone can be done straight away, and they can leave the hospital symptom-free within a few hours.
What is the worst part of your day?
As with the rest of medicine, the burden of paperwork has increased and I don’t enjoy these admin tasks. I’d much rather be treating patients than sitting at my desk with paperwork, motivating for procedures and medication authorisation.
Most days, after feeding my two cats and three dachshunds, I go for an early morning run. Then it’s off to the hospital for ward rounds. I’m a morning person and like to start early – sometimes to the frustration of the nursing staff and my colleagues. The rest of the day is taken up by theatre cases and consultations.
Urological patients are special and usually have a good – and naughty – sense of humour. I once had a patient who placed a sign inside his theatre underwear reading: ‘Please take good care of me’. The theatre staff responded with: ‘Do not use until further notice’. Both the staff and the patient enjoyed this interaction tremendously.
What is your work motto?
I have two; one serious and one not-so-serious. The serious one is: ‘Treat each and every patient as if they’re a member of your own family’. The not-so-serious one is: ‘In urology there are no big problems; only wee ones.’
What character traits should urologists have?
There was actually a study published in the Canadian Journal of Urology that compared the personalities of urologists to those of professionals in other surgical disciplines and non-surgical disciplines. The study found that urologists tended to be more extroverted – more sociable, assertive and active. They liked excitement and stimulation, and tended to be upbeat, energetic and optimistic. That is definitely true of me and my colleagues.
HEART MARK TAKES THE GUESSWORK OUT OF CHOOSING HEALTHY FOOD Consumers are faced with so many options when they walk into a grocery store. So how do you make the best food choices for your family and you? Heart and Stroke Foundation South Africa suggests you look for the Heart Mark
WHAT IS HEART MARK? The National Department of Health has approved the Heart Mark programme. The Heart Mark is a guaranteed way to buy food lower in salt, sugar and saturated fats, and higher in ﬁbre. This makes it the smartest way to maintain a healthy, balanced diet, which goes hand in hand with physical activity and other positive lifestyle choices. While price, quality and taste will always inﬂuence what you buy, you can rest assured that products bearing the Heart Mark logo are healthier. The Heart Mark endorsement programme is part of ongoing efforts by HSFSA to reduce the number of deaths in South Africa from preventable heart disease and stroke. With over 450 different Heart Mark endorsed products, you will ﬁnd Heart Mark choices for most of the foods you usually buy. HEART AND STROKE FOUNDATION’S GUARANTEE Foods have to earn the Heart Mark. If the product does not meet certain criteria (e.g. the sodium level is too high), products may be reformulated or otherwise declined for endorsement. Keep in mind that while products may have the Heart Mark logo, no product should be eaten in excessive amounts or too frequently and you should always discuss with your doctor what’s right for you. DO FOOD COMPANIES BUY THE HEART MARK? The endorsement is awarded on the product’s merit, and foods are independently tested. Food manufacturers cannot buy the endorsement, but they do have to pay a licence fee once they are approved. The Heart and Stroke Foundation SA is a registered Non-Proﬁt Organisation (NPO), and the licence fees are used to ensure the quality and sustainability of the various programmes offered at the Foundation. LIST OF HEART MARK PRODUCTS Print a handy shopping list with Heart Mark approved products from www.heartfoundation.co.za, and take it with you when you next visit your local supermarket.
MORE INFORMATION ON PRODUCT ENDORSEMENT Rubeshan Nayager EMAIL:
Rubeshan.Nayager@ heartfoundation.co.za WEBSITE:
021 422 1586 074 304 9129
CARE PREVENTABLE HEART DISEASE / THE TRUTH ABOUT ACNE / HEALTHY MEALS
‘WITHOUT A SENSE OF CARING, THERE CAN BE NO SENSE OF COMMUNITY.’ ANTHONY J. D’ANGELO
DON’T IGNORE A SORE THROAT Rheumatic heart disease, in which there’s permanent damage to the heart, is the after-effect of an untreated, common throat infection. Gillian Warren-Brown looks at how it can be prevented
sore throat, especially without the usual cold or flu symptoms, is a red flag that should not be ignored. It might be what’s commonly referred to as a strep throat, which, if untreated, can eventually lead to rheumatic heart disease. This is one of the few cardiac diseases that is 100% preventable, says Associate Professor Liesl Zühlke, a paediatric cardiologist at the Red Cross War Memorial Children’s Hospital in Cape Town. All it takes is a penicillin injection to treat a throat infection caused by the group A Streptococcus bacteria, which, if left unchecked, can develop into acute rheumatic fever, causing the irreversible damage associated with rheumatic heart disease. Professor Zühlke says if your child has a sore throat, symptoms to look out for are: • The infection doesn’t clear up within a day or two • Swollen glands in the neck • Tonsils show pus ‘To be on the safe side, take your child to a clinic or doctor to be treated,’ she adds. ACUTE RHEUMATIC FEVER If a strep throat isn’t treated and the bacteria are still present, the body’s fight-back mechanism kicks in. This autoimmune reaction may occur two to four weeks after the throat infection. Professor Antoinette Cilliers, the head of paediatric cardiology at Chris Hani Baragwanath Hospital in Johannesburg, explains that antibodies produced to protect your body from the bacteria also attack tissues that have a molecular resemblance to the bacteria – such as the heart, joints and skin and the central nervous system.
This causes symptoms that may include a fever, rapid heartbeat, painful joints, a skin rash that lasts a short time and jerky movements of the limbs. These are the signs of acute rheumatic fever. Professor Cilliers says children between the ages of 5 and 15 are most at risk – although adults and younger children can sometimes be affected. She adds, ‘It is particularly prevalent in overcrowded, economically deprived communities with poor access to healthcare.’
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As rheumatic heart disease is most often found in disadvantaged communities, surgery isn’t always available to everyone who needs it RHEUMATIC HEART DISEASE Professor Zühlke says once rheumatic fever is diagnosed, long-acting penicillin injections given monthly for 5 to 10 years – perhaps even lifelong – may be prescribed to control the symptoms and prevent further episodes. Flare-ups tend to occur and the recurring inflammation causes more damage to the heart, which explains why rheumatic heart disease can sometimes surface 10 to 20 years after the initial infection. Professor Karen Sliwa, director of the Hatter Institute for Cardiovascular Research in Africa and president-elect of the World Heart Federation, says the only national estimates we have for South Africa come from the ‘Heart of Soweto Study’: 17/100 000 new presentations of rheumatic heart disease a year in the 20- to 30-year age group. Professor Zühlke explains that a figure of over 3/100 000 is deemed an epidemic. ‘Young people, especially women, are profoundly affected by the disease. One complication, a disturbance of the heart rhythm, is a common cause of stroke in this age group,’ she adds.
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Associate Professor Liesl Zühlke is a paediatric cardiologist at Red Cross Children’s Hospital and the president of the South African Heart Association.
Professor Antoinette Cilliers is head of paediatric cardiology at Chris Hani Baragwanath Hospital. Her work focuses on children with congenital and acquired heart disease.
Professor Karen Sliwa is the director of the Hatter Institute for Cardiovascular Research in Africa. One of her main areas of research is cardiovascular disease in pregnancy and postpartum.
Dr Johan Jordaan, a cardiothoracic surgeon based at Life Rosepark Hospital, is involved in advanced tissue engineering for cardiac applications.
• If you have rheumatic heart disease, go for regular medical check-ups and inform your dentist – bacteria from your mouth or teeth can get into your blood stream and infect damaged heart valves. • If you’re a woman, ask about your risks around pregnancy as the extra strain on your heart may be life-threatening. She says if rheumatic heart disease is suspected, the diagnosis is made via an ultrasound of the heart (echocardiogram), which can show heart-valve damage. If there is only mild damage, a healthcare worker may, by chance, detect a heart murmur (symptomatic of rheumatic heart disease) during an examination for another medical problem, says Professor Cilliers. And if the damage is severe, a patient could have signs of heart failure and may need surgery. WHEN TO OPERATE Dr Johan Jordaan, a cardiothoracic surgeon based at Life Rosepark Hospital in Bloemfontein, says damage to the valve between the two left chambers of the heart (mitral valve) is most common, but the other heart valves can be affected. Surgery is usually needed if: • There’s a leak in the mitral valve, which allows blood to flow the wrong way. • The valve has become narrowed, decreasing blood flow. Surgery involves repairing or replacing the damaged valve or valves. Dr Jordaan says the inflammation that occurs in rheumatic fever may also weaken the heart muscle itself, affecting its ability to pump and thereby raising the risk of heart failure. Unfortunately, as rheumatic heart disease is most often found in disadvantaged communities, surgery isn’t always available to everyone who needs it. ‘The danger is that if you wait too long, the extent of damage to the heart may mean that it can’t cope with surgery,’ says Dr Jordaan. The best thing is prevention, which can be achieved with a higher level of awareness about the disease and its cause – and taking action to treat a strep throat instead of thinking it’ll simply go away.
SEPARATING FACT FROM FICTION Acne, or acne vulgaris, is a common and often chronic skin condition that can lead to depression, anxiety and frustration in its sufferers, and surprisingly, many people who get acne arenâ€™t teenagers. Ruth Rehbock asked dermatologist Dr Thinus Jacobs to answer some of the most commonly asked questions
here are many misconceptions and beliefs about what causes acne, how to prevent it and the best way to treat it. Life Healthcare magazine asked an expert and this is what he wants you to know.
What causes the skin problem we know as acne? Acne is a chronic skin condition caused by blocked and/or inflamed hair follicles and their accompanying sebaceous (oil) glands in the skin. The most significant cause of acne is the effect of hormonal changes that occur in teenagers. The two main categories of acne are noninflammatory acne, which includes blackheads and whiteheads, and inflammatory acne, which causes pimples that are red and swollen. Is acne in the genes? Yes, many studies have found that acne runs in families. We inherit the number, size and activity of sebaceous glands.
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Do only teenagers get acne? Although anyone may be affected by milder or more severe forms of acne, it’s primarily a condition of adolescence. Around 85% of young people between the ages of 12 and 24 get acne. A study looking at how common acne is among adults over 20 found that 35% of women and 20% of men reported having acne in their thirties. It also showed that 26% of women and 12% of men were still affected in their forties. ‘Adult’ acne affects the face, chest and back and is severe in nature. It manifests as nodules (firm lumps) and cysts (fluid-filled sacs) beneath the skin. Does diet have an effect on severe acne? It can. One study by the National Center for Biotechnology Information in the USA, published in the online journal Advances in Dermatology and Allergology in 2016, highlighted the potential link between a diet high in carbohydrates and raised blood sugar levels, and severe acne. Over the past decade, research has shown a link between drinking skim milk and acne. One such study, published in 2015 the Journal of the American Academy of Dermatology, revealed that although skim milk is a problem, full-fat milk is not. Are sunshine and washing the face beneficial? Exposure to UVB rays (short-wave ultraviolet light) usually improves acne, but excessive exposure, combined with high humidity, can cause so-called tropical acne. Too much exposure to sunlight is, of course, not recommended as it can cause other skin problems like skin cancer.
Treating acne with ointments or oral medication both dry out the skin, so it’s critical to use a good moisturiser to keep the skin healthy. Washing the face regularly can help, but it won’t cure acne, so again, look after the skin by using a good, non-greasy (non-comedogenic) moisturiser.
Research has shown a link between drinking skim milk and acne. One such study revealed that although skim milk is a problem, full-fat milk is not
Can sunscreen make acne worse? Sticky, heavy sunscreens can block pores and aggravate acne. However, there are non-greasy, non-comedogenic sunscreens available that do not block the pores and won’t be a problem. How does stress affect acne? Stress can aggravate acne as it raises testosterone levels, and testosterone can increase the production of sebum or oil in the skin. What is the most effective treatment for acne? The two types of treatment for acne both contain an ingredient called isotretinoin, which is a form of Vitamin A. This chemical is the most effective cure, since it reduces the amount of oil released by oil glands in the skin. For less severe acne, doctors suggest a topical treatment. For more serious cases, they usually first prescribe a dose of antibiotics. If that proves ineffective, they will give patients isotretinoin medication, which is taken orally. This treatment is normally used for severe acne, acne on the body, as well as for patients who are prone to scarring.
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IT’S ALL ABOUT BALANCE Instead of focusing on the oil glands as the culprit in acne, one team of researchers from the David Geffen School of Medicine at the University of California looked at the link between bacteria that live on the face and acne. They found that that the bacteria associated with acne are also found in the skin of those who don’t have acne. They reason that it’s the overall balance of bacteria on the skin that plays a role in the condition.
Dr Thinus Jacobs qualified as a dermatologist in 1995. He currently works in private practice at Life Rosepark Hospital in Bloemfontein WWW.LIFEHEALTHCARE.CO.ZA
Good, healthy food
Author Lisa Clark shares her favourite recipes and tips on how to provide healthy, balanced and quick recipes for the mom (or dad) on the move
Creamy tomato and basil soup Serves: 6 (makes ±1.2 litres) Preparation time: 5 minutes Cooking time: 10 minutes Difficulty: easy
My girls love this recipe and in winter it is our go-to soup. We normally sit around the table for meal times, but when it’s soup night they’re allowed to sit in front of the television … maybe this is why they love it so much! • 1 litre basic tomato sauce • 45ml olive oil • 250ml fresh cream • 250ml good-quality chicken stock • 10ml sugar
• Salt and freshly ground black pepper to taste • 10ml finely chopped fresh basil • Crumbled feta, for garnishing • Crusty bread, for serving 1. Place all the ingredients, except the basil and feta, into a large saucepan. 2. Slowly bring to a boil; add the basil. 3. Adjust seasoning to taste and pour into serving bowls. Sprinkle with crumbled feta and serve with warm crusty bread.
Basic bread dough Makes: 1 large loaf, or 2 small loaves or 24 mini rolls Preparation time: 20 minutes, plus 2 hours for rising Baking time: 30–35 minutes for loaves and 10–15 minutes for rolls Difficulty: easy The dough freezes well, so if you are using a half quantity, you can either freeze the remaining half for baking off later or simply use it right away to bake a single loaf or a dozen mini rolls. • 500g white bread flour • 15ml salt • 30ml sugar • 10g (1 sachet) instant yeast • 45ml olive, sunflower or coconut oil • ±300ml warm water
Veggie burgers Makes: 8 patties Preparation time: 10 minutes Cooking time: ±8 minutes Difficulty: easy • 500 g basic roasted vegetables • 2.5ml paprika • 2.5ml ground cumin • Pinch of chilli powder • 15ml finely chopped fresh parsley • 60ml dried breadcrumbs • 1 egg • Olive oil, for sautéing
1. Using a potato masher, roughly mash the roasted vegetables. 2. Add the remaining ingredients, except the oil, and mix thoroughly. 3. Shape into eight patties and place in the fridge for at least 20 minutes before cooking so that they can firm up. 4. Heat a little olive oil in a sauté pan over medium heat and cook each patty for 2–3 minutes on each side. 5. Serve with your choice of sides, such as pickled beetroot, mashed avocado, roasted vegetable hummus, and grilled mushrooms, all topped onto a wholewheat bun, or have it bun-less, if you prefer.
1. Mix the flour, salt, sugar and yeast in a large bowl or into the bowl of a stand mixer. Make a well in the centre and add the oil and water. Mix well to form a soft dough. If the dough seems a little stiff, add another 15–30ml water. Tip the dough onto a lightly floured work surface and knead for 10–12 minutes until the dough is silky smooth (knead for the same length of time if using a stand mixer with a dough hook attachment). 2. Place the dough in a lightly oiled bowl and leave to rise for 1 hour until doubled in size. 3. Knock back the dough and shape into either two loaf pans or 24 mini rolls on a baking tray. Allow to rise again until doubled in size. 4. Preheat the oven to 220°C and, once the loaves or rolls have doubled in size, place into the oven. 5. Bake the loaves for 30–35 minutes, or until golden brown and hollowsounding when tapped. Bake the rolls for 10–15 minutes, or until golden brown and cooked through. 6. Remove from the oven and cool on a wire rack.
Easy seed loaf Makes: 1 loaf Preparation time: 10 minutes, plus 30 minutes for rising Baking time: 30–40 minutes Difficulty: easy This bread becomes stale quickly as, unlike store-bought bread, it has no preservatives. But it is delicious, especially sliced and toasted with butter and honey. 58
• Flour, for rolling • ½ quantity Basic Bread Dough (recipe on previous page) • 1 egg, whisked • 65g sunflower seeds • 50g sesame seeds • 50g poppy seeds • 5ml salt 1. Sprinkle the work surface with flour and roll the dough into a rough rectangular shape. 2. Brush with the whisked egg and generously sprinkle with some of the
seeds. Roll up the dough and tuck the ends underneath. 3. Place the dough into a greased loaf pan and allow to rise until doubled in size. 4. Preheat the oven to 200°C. 5. Brush the top of the loaf generously with the remaining whisked egg. 6. Mix all the remaining seeds and the salt together and sprinkle on top of the loaf. 7. Bake for 30–40 minutes or until golden brown and hollow-sounding if tapped. 8. Remove from the oven and allow to cool on a wire rack or serve hot with butter.
Basic sponge cake Makes: 1 (18cm) layered cake Preparation time: 15 minutes Baking time: 15–20 minutes Difficulty: easy • 250g butter, at room temperature • 250g castor sugar • 5ml vanilla essence • 4 large eggs • 250g cake flour
• 7ml baking powder • Pinch of salt • Water, for mixing • Jam, for serving • Icing sugar, for dusting 1. Preheat the oven to 180°C. Line two 18cm cake tins. 2. Cream the butter and castor sugar together until softened. Add the vanilla essence and gradually beat in the eggs, one at a time. Don’t worry if the mixture looks split as the flour will bring it all together again.
3. Sift the flour, baking powder and salt together. 4. Fold the flour mixture into the creamed mixture, spoon by spoon, adding a little water each time to form a batter with a soft, dropping consistency. 5. Divide the mixture between the prepared cake tins and bake for 15–20 minutes or until an inserted skewer comes out clean. 6. Remove from the oven, turn out of the tins and allow to cool on racks. 7. Sandwich together with jam of your choice and dust with icing sugar.
Life Healthcare magazine is giving away two copies of Everyday by Lisa Clark. Email lifehealthcarecomp@ johnbrownmedia.com with ‘Everyday’ in the subject line by 31 July 2018 and stand a chance to win. This is an extract from Everyday by Lisa Clark, published by Penguin Random House. RRP R350
Commitment Our smile is our welcome Thoughtful care is our commitment How we leave you feeling after your hospital experience is our legacy In our commitment to providing high quality care and personal attention we promise to: Greet you courteously â€“ with a smile Treat you with dignity, respect and without prejudice Provide you with a safe, clean and organised facility Be sensitive to your physical, emotional and psychological needs Listen and address, to the best of our ability, any concerns that you may have We appreciate your feedback Speak to us: You are welcome to discuss any requests or concerns with members of the hospital management team Respond to our survey: As a valued patient you will receive an email or sms survey after you are discharged from our hospital Email us: Customer.email@example.com Use the web: www.lifehealthcare.co.za â€“ follow the prompts from contact us Call us: 011 219 9111
External Governing Bodies Hospital Complaints: Department of Health Office of Health Standards Compliance
This sometimes shy, always motivated pharmacist goes the extra mile for patients and makes tough decisions when necessary. By Melanie Farrell
ur hero, pharmacist Teresa Ponte from Life Bedford Gardens Hospital in Johannesburg, ensures that patients’ needs come first, whether it’s finding an alternative medication, helping the nursing team balance scheduled medications, or offering professional support. ‘I am quite shy, but when I am passionate about something, it’s easy for me to become confident and find my voice,’ says Teresa, who has worked at the hospital for two years. The pharmacist, who received the Jakes Gerwel Service Hero Award for Personal Care at Life Healthcare’s 2018 awards event, knew that she wanted to be a pharmacist from the age of 14. ‘I was good at all the science subjects at school and I wanted to be a healthcare professional. I had a burning desire to make a difference in the field. Pharmacy seemed the obvious choice because it is a well-rounded career, blending science and healthcare,’ she explains. Teresa’s caring nature ensures that patients at Life Bedford Gardens Hospital receive the best pharmaceutical care possible and she is on first-name terms with many of the regular patients who visit the pharmacy. ‘One day I came across an elderly couple who had lost their way in the corridors of the hospital. I escorted them to the ward they were looking for and the gentleman was admitted. ‘The next day I met him again on a ward round and he said he was feeling terrible. I thought that it could be due to the medication he’d been prescribed and found another drug that would do the same thing, but with fewer side effects,’
she explains. She discussed her findings with the patient’s attending physician and they decided to switch to a different medication and see if there’d be an improvement in the patient’s condition. ‘I’m the frontline of safe medication use and I advocate for the patient’s wellbeing. I take that role very seriously,’ she says. The following day the patient called her to say that he was feeling ‘on top of the world’. This patient is now one of many who ask for Teresa by name when they visit the pharmacy at Life Bedford Gardens Hospital. ‘It is a great feeling to be asked for by name, or sometimes a patient will request the pharmacist “with the long brown hair”. It means that the service I provided was helpful,’ says Teresa. Being a pharmacist also means making some tough decisions in the best interests
of patients, such as refusing to dispense medicine to someone who is addicted to opioids. ‘It is not uncommon to know someone who has been, or will become, addicted to opioids,’ she explains. ‘I have seen friends become addicted to them and it leads to destructive behaviour, in both your personal and work life. I believe pharmacists need to get involved in addressing this growing problem,’ she says firmly. At Life Bedford Gardens, Teresa has gained the respect and recognition of her peers through the professional, practical support she has offered to both the surgical ward and theatre. For instance, after two weeks of working closely with nursing staff in order to balance scheduled drugs better, Teresa compiled a study identifying possible reasons for stock not balancing. These findings helped staff correct the codes, billing and preference cards of scheduled drugs. Teresa has also motivated nurses at the hospital to adopt her ‘Be Medicine Smart’ campaign to raise awareness about the side effects of certain medicines. She held training sessions with nursing staff to teach them about different categories of medication and created creative study tools to make it easier for them to retain the information they had learnt. It’s hard to imagine Teresa doing any more than she already does at the hospital, but she finds time to help pharmacist assistants with their coursework, and encourages and identifies staff keen to get ahead. ‘I am all for self-improvement and empowerment,’ says the caring, passionate pharmacist.
PUZZLE THIS... Test your mental agility with our brain-teasers
1 CROSSWORD PUZZLE 2 SUDOKU
Difficulty level *** ACROSS
1 I love (Lat.) 4 Recede 7 Detest 11 Overextended 13 Hair-salon item 14 First victim 15 Afrikaner 16 ‘___ whiz!’ 17 57-Across site 18 Confused 20 On pension (Abbr.) 22 Commotion 24 Snapshots 28 Automobile framework 62
32 Bring forth 33 Sharpen 34 Alicia Florrick’s ‘field’ 36 A Great Lake 37 Enola Gay payload 39 Units of measure 41 Pay 43 Dict. entry 44 Furtive call 46 Teeny-tiny 50 Dog bane 53 Pick a target 55 Counterfeit 56 Prison compartment 57 Floral adornment
58 Polynesian carving 59 Serene 60 ‘___ Winterbourne’ 61 Favourite DOWN
1 Actress Jessica 2 Academic 3 Individuals 4 Omelette necessity 5 ‘Cheers’ order 6 Censor’s sound 7 Quickly and in large amounts 8 Homer Simpson’s dad
9 Sleuth 10 Wapiti 12 Request for a bribe 19 Billboards 21 Definite article 23 Lubricate 25 Ripped 26 ‘Grapes of Wrath’ type 27 Gets a glimpse of 28 Bloke 29 Vagrant 30 Unsigned (Abbr.) 31 Despondent 35 Marry 38 Clear the tables
40 Prized possession 42 Song of praise 45 Layer 47 Ante, maybe 48 Autumn tool 49 Leave out 50 US media watchdog org. 51 Meadow 52 Right-angled bend 54 Wrong (Pref.)
3 WORD SLEUTH
Find the hidden words in the diagram. They run in all directions
Curtin DeGeneres Diller Goldberg
Kudrow Latifah Louis-Dreyfus Nancherla
Poehler Rivers Schumer
Arthur Ball Burnett Buzzi
User the 15 tiles in this bunch to fill in each of the four grids below. To get started, a few tiles from the bunch have been placed. Reuse the tiles for each grid
I M A G E I S T O C K P U Z Z L E S P R E S S / M A G A Z I N E F E AT U R E S ( P T Y ) LT D
MAKE A FRIEND. BE A FRIEND. World Friendship Day is on 30 July 2018
In 12 Rules for life, author Jordan B. Petersen, a renowned clinical psychologist, aims to provide clarity in a world of chaos. Read his thoughts on friendship
consider: if you have a friend whose friendship you wouldn’t recommend to your sister, or your father or your son, why would you have such a friend for yourself? You might say: out of loyalty. Well, loyalty is not identical to stupidity. Loyalty must be negotiated, fairly and honestly. Friendship is a reciprocal arrangement. You are not morally obliged to support someone who is making the world a worse place. Quite the opposite. You should choose people who want things to be better, not worse. It’s a good thing, not a selfish thing, to choose people who are good for you. It’s appropriate and praiseworthy to associate with people whose lives would be improved if they saw your life improve. If you surround yourself with people who support your upward aim, they will not tolerate your cynicism and destructiveness. They will instead encourage you when you do good for yourself and others, and punish you carefully when you do not. This will help bolster your resolve to do what you should do, in the most appropriate and careful manner. People who are not aiming up will do the opposite. They will offer a former smoker a cigarette and a former alcoholic a beer. They will become jealous when you succeed or do something pristine. They will withdraw their presence or support, or actively punish you for it. They will override your accomplishment with a past action, real or imaginary, of their own. Maybe they are 64
You should choose people who want things to be better, not worse. It’s a good thing, not a selfish thing, to choose people who are good for you.
trying to test you, to see if your resolve is real, to see if you are genuine. But mostly they are dragging you down because your new improvements cast their faults in an even dimmer light. It is for this reason that every good example is a fateful challenge, and every hero, a judge. Michelangelo’s great perfect marble David cries out to its observer: ‘You could be more than you are.’ When you dare aspire upward, you reveal the inadequacy of the present and the promise of the future. Then you disturb others, in the depths of their souls, where they understand that their cynicism and immobility are unjustifiable. You play Abel to their Cain. You remind them that they ceased caring not because of life’s horrors, which are undeniable, but because they do not want to lift the world up onto their shoulders, where it belongs. Don’t think that it is easier to surround yourself with good healthy people than with bad unhealthy people. It’s not. A good, healthy person is an ideal. It requires strength and daring to stand up near such a person. Have some humility. Have some courage. Use your judgment, and protect yourself from too-uncritical compassion and pity. Make friends with people who want the best for you. This is an excerpt from 12 Rules for life: an antidote to chaos by Jordan B. Petersen, published by Penguin Random House. Available at all good bookstores.
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A short description of the June/Winter 2018 issue: In this issue of Life Healthcare magazine, the content focuses on finding the right balan...
Published on May 30, 2018
A short description of the June/Winter 2018 issue: In this issue of Life Healthcare magazine, the content focuses on finding the right balan...