PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
ALL IS FORGIVEN
The truth about carbs
SUN SMARTS FOR WHEN...
> You’re pregnant > Spending more time outdoors > Caring for kids
Love your whole life
Exercise your empathy Do good… feel great
UNDERSTAND YOUR BODY, RESPECT YOUR SPIRIT AND CHOOSE HAPPINESS
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PROUDLY SOUTH AFRICAN
A PUBLICATION BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP
LIFE IS… Wisdom is one of the most beautiful things you acquire as you get older. When you live consciously, you learn something new every moment. The threads of the past inform the present and leave you better prepared for the future. There’s also humility in admitting that you might not have figured everything out yet, but you’re willing to learn, which is why every issue of Life Healthcare magazine is focused on helping you gain wisdom and insight, so you can do better. There’s expert advice on how to protect your skin this summer (page 32) – and each time you are exposed to the sun. Our experts weigh in on what you should know about carbohydrates (page 20) and when to be concerned about the amount of alcohol you consume (page 23). Take our quiz and find out if you’re an introvert or an extrovert (page 28), and gain a better understanding of people who are living with disability on page 46. Living with intention gives life meaning and helps to chart a course that remains steady no matter the challenges you encounter. (You might want to read the excerpt from Gabi Lowe’s compelling, moving memoir on page 64.) As you say goodbye to this year and welcome a new one, celebrate all that is splendid about you and let go of the stress of making resolutions. While this is the last issue of our magazine in its printed format, you will still be able to access our content on www.lifehealthcare.co.za and via our social media platforms. You already have all you need to make positive health choices. All you have to do is open your heart to learning something new and then act on your wisdom.
SAMANTHA PAGE EDITOR
MUST-READ IN THIS ISSUE
EDITORIAL COMMITTEE Dr Sharon Vasuthevan, Janette Joubert, Dr Tony Booysen, Liesel van Oudenhove, Lucy Balona (CANSA)
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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 private-sector 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.
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FOR MORE INFORMATION 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...
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.
Contents SUMMER 2019/2020
12 RELIEF FOR HEADACHE SUFFERERS
Early in 2020, Life Knysna Private Hospital will open a specialised multidisciplinary headache clinic By Emily Pettit
A NORMAL LIFE 14 ‘ILIKECANMYLIVEFRIENDS’
Tidinyane Reitumetsi (14) explains what it’s like to live with epilepsy As told to Emily Pettit
16 DO YOU HAVE THE PREGNANCY GLOW?
These are some common skin conditions during pregnancy By Charlene Yared-West
18 THE HEALING POWER OF H O 2
Why water is the ideal medium for rehabilitating some serious conditions By Pippa Naudé
HOULD WE CHANGE OUR 20 SRELATIONSHIP WITH CARBS?
Celebrating the virtues of this important macronutrient By Sam Brighton
AM I DRINKING TOO MUCH? 23 42
01 04 OVER TO YOU 08 NEWS LIFE IS…
A note from the editor
WATER WORLDS 2
Letters from our readers
The latest medical innovations, health information and ideas for living well
While an occasional drink might not be a cause for concern, it’s important to know your limits and when to get help By Emily Pettit
24 HI! MY NAME’S … AND I HAVE OCD
What obsessive compulsive disorder is and how it is diagnosed, managed and treated By Gillian Warren-Brown
26 WATER WORLDS
South Africa is one of the best places in the world to explore aquatic energy By Ryan Scott
54 AN INTROVERT 28 AORREANYOUEXTROVERT?
Take our test and evaluate your tendency
PROTECT THE SKIN YOU’RE IN
These are important steps to take to stay safe in the summer sun By Glynis Horning
BEST FOOT FORWARD
Minimally invasive surgery for foot and ankle surgery has many benefits By Trevor Crighton
40 UNDERSTANDING CANCER TREATMENTS
Get to grips with the oftenbewildering world of the most common treatments for cancer By Mandy Collins
FIRST AID FOR SUMMER’S STING
Basic information to care for your baby during the hot season By Melanie Farrell
50 VERYBODY’S TALKING ABOUT… 44 ESNORING
If you’re losing sleep, this is why we snore and what can be done about it By Emily Pettit
B ETTER HEALTH FOR PEOPLE WITH DISABILITY
With more understanding comes greater tolerance, compassion and understanding By Samantha Page
AN APPOINTMENT WITH… DR YUSUF DASOO
A fertility specialist at Life Brenthurst Hospital in Johannesburg By Erin Coe
54 CTHEAPEWAYMEDITERRANEAN: WE LOVE TO EAT
Mediterranean-style cooking straight from the Western Cape coast
IGHTING THE WAY TOWARDS 61 LENVIRONMENTAL SUSTAINABILITY
Life Cosmos Hospital becomes the fifth in the Group to install a solar energy system By Samantha Page
62 MIND GAMES
Take a break with our puzzles and brain games
64 A RACE AGAINST TIME
An excerpt from Get Me to 21: The Jenna Lowe Story by Gabi Lowe
50 IT FEELS GOOD TO GIVE
The positive impact of volunteering your time By Jabulile S. Ngwenya
52 WHAT’S CAUSING MY CHEST PAIN?
It can range from harmless to serious, but how do you know the difference? By Julia Lamberti-Morreira
COVER IMAGE Gallo/Getty Images
AN INVALUABLE RESOURCE
LETTE In June 2019, I underwent triple R bypass surgery, as well as a mitral valve repair. Dr Tertius van Rooyen, the cardiothoracic surgeon at Life Bay View Private Hospital in Mossel Bay, performed both procedures. The heart surgery was a success and I was well on my way to recovery, eager to start training for my next Two Oceans half marathon, but this was not to be. Spontaneous bleeding developed around my lungs, and I had to have two emergency surgeries before the problem was addressed. This set me back and I spent 20 days in ICU. The staff in the ICU, whether they were nurses, kitchen staff, administrators or cleaners (day and night shift), were second to none. They not only ensured that my physical condition was taken care of, but they also always had time for a quick chat. Dr Van Rooyen was exceptional, checking up on me twice a day, every day – sometimes even more. His communication with my wife was greatly appreciated. As residents of the Garden Route, we are very fortunate to have a hospital of this quality on our doorstep, staffed by professional and caring medical personnel. Donald MacKenzie, Western Cape
Above and beyond
I spent some time in the ICU at Life Flora Hospital in Roodepoort to remove a cancerous lesion from my oesophagus. I received excellent care from these exceptional medical professionals, who look after patients with considerable attention. I know that without these competent people I would not have been able to recover as quickly as I have. This hospital provides some of the best treatment I’ve ever received. Thank you to each member of the staff, who go above and beyond to give hope to the sick. Pat Nielson, Johannesburg (translated from Afrikaans)
You never walk alone
I was recently admitted to Life Chatsmed Garden Hospital in Chatsworth. I arrived via ambulance – alone, without any family or friends. The trauma staff and doctor immediately started stabilising me while the reception staff worked on my admission authorisation. It was really amazing to see how these teams coordinate. Due to a weakened immune system, my pulmonologist requested that I be isolated in a private ward. This was swiftly arranged. Although I was weak, the nurses ensured that I ate something. Thank you for taking superb care of me. Vishnu Maharaj, Durban
In short… I was so impressed with the treatment my daughter received at Life Entabeni Hospital in Berea. The staff were warm and welcoming, and the nurses treated us with respect. Phindile Thusi, Durban We were recently at the Life Groenkloof Hospital in Pretoria and I can honestly tell you that I have never had such a wonderful experience at any other hospital in all my life. Elsabe Swiegers, Pretoria I truly had an excellent experience at Life Westville Hospital. From the warm welcome I received at reception to the sisters at the day clinic and theatre nurses – even security – everyone gave their best. Chris Naicker, Durban
4 February is
World Cancer Day Visit www.cansa.org.za for more information.
WIN A R1 200 LIFEGAIN® HAMPER Lifegain®, the nutritional supplement formulated to help people regain physical and emotional wellbeing, comes in four flavours and now contains 2.5g of glutamine. This amino acid provides extra immune and digestive health support during times of physical stress. The hamper contains two Lifegain® flavours and a blender. Visit www.lifegain.co.za for more information. Email email@example.com about how you experienced life, health and care at a Life Healthcare hospital or facility and you could win a hamper of two 1kg tins of Lifegain® and a blender. The prize is non-transferable and cannot be exchanged for cash.
I MAG ES FREEPIK, GALLO/GETTY IMAGES, SUPPLIED
OVER TO YOU
Touching the lives of every South African under the Sun. Today, Sun Pharma truly is a global phenomenon, employing over 30 000 people representing more than 50 cultures in five different continents. As the largest pharmaceutical company in India and fourth largest in America and in the world, with 2000 of the worldâ€™s best scientists committed to developing complex products, we additionally fulfill our core mandate of offering affordable generic medicines to all. Sun Pharma also offer generic anti-retroviral (ARV) medicines to needy patients in Southern Africa, supporting national governments in their effort to control the AIDS epidemic. Sun Pharma has a state-of-the-art production facility in Roodepoort, South Africa, that manufactures analgesics, ARVâ€™s, cold, cough & flu preparations, anti-histamines, antihypertensives, CNS drugs, vitamins & minerals, and a comprehensive range of over-the-counter (OTC) products.
Reaching People, Touching Lives.
I MAG E GALLO/GETTY IMAGES
Plain water is the best choice for staying hydrated, but some people find it a little hard to swallow. Fruit-infused water is a great alternative – especially in summer when there are so many great fruity options. A study published in the journal Physiology & Behavior found that ‘reluctant drinkers’ consumed 159% more water when flavour was added. Whether you use mint, cucumber, pomegranate seeds, lemon slices or strawberries, infused water helps control appetite, keeps the body hydrated, boosts immunity, helps prevent heartburn and regulates blood sugar. Go on, drink up!
LIFE NEWS HOME HEALTH
Most people associate flowers with special occasions, but flowers don’t need an event to bring joy. According to a Rutgers University study on the emotional impact of flowers, researchers concluded that a simple bouquet of blooms is a natural moderator of moods. Participants reported that they felt less agitated when they were consistently surrounded by fresh flowers. Urbanisation has removed city dwellers from nature, so it’s important to bring the outdoors inside. These are three key benefits: Flowers help to humidify the air, which assists in fighting infections.
Life Healthcare is a leading provider of private psychiatric services in South Africa, offering acute mental healthcare in nine dedicated facilities in four provinces.
TO FIND OUT MORE visit https://www.lifehealthcare.co.za/ patient-information/patient-services/ complementary-services/life-mental-health/
Bright blooms boost happiness and help to build positivity. They reduce stress and anxiety.
WHEN A SNAKE BITES… Do
Get medical help immediately.
Cut the bite site and try to suck out the venom.
Clean the wound and apply a pressure bandage to the bitten limb. Restrict movement. Transport quickly to the nearest hospital that can deliver emergency care, and anti-tetanus and anti-venom treatments.
Apply a tourniquet that can impede blood circulation. Elevate the wound above the heart or chest level. Administer aspirin, pain relievers or traditional remedies.
NB: Time is CRITICAL – 30 minutes 8
BYTE-SIZE WISDOM ASKED AND ANSWERED
3 apps for heart health
WHAT’S THE BEST WAY TO CUT DOWN ON SUGAR? A Human Sciences Research Council study has shown that South Africans consume, on average, 25kg of sugar annually. Our country seems to be part of a world trend in which sugar consumption has risen from 48g a day 30 years ago, to 70g daily today, according to a Credit Suisse Research Institute report. ‘Sugar is an empty kilojoule: it gives you energy, but no healthy nutrition, such as vitamins, minerals and fibre,’ says Kim Hofmann, a registered dietitian. If you add sugar to tea and coffee, reduce it gradually to help your taste buds adapt. Sweeten cereal with fresh fruits and add cinnamon for added flavour. While there are natural sugars in fruit, this sugar comes with vitamins, nutrients and fibre, so it’s good to eat a few portions a day as part of your five-a-day allocation.
FOOD FOR THOUGHT
Sweetly DOES IT
It looks like sugar. It tastes like sugar. It bakes like sugar, but it’s really a nutritious and delicious sugar substitute that’s low GI and low in kilojoules (kJ), which means it has almost no effect on blood glucose levels. The entirely plant-based Sweetly formulation has no bitter aftertaste and one stick or teaspoon contains only 5kJ compared to the 80kJ in one teaspoon of regular granulated sugar. With a thumbs up from Diabetes South Africa and The Glycemic Index Foundation of SA, it’s definitely worth a try. The range includes sticks, packs, a baking sugar substitute and protein shake powder in three delicious flavours: vanilla, chocolate and iced coffee.
Heart disease claims around 225 lives in SA each day – yet 80% of heart disease and strokes can be prevented, according to the Heart and Stroke Foundation South Africa. Here are three free apps that can help you understand cardiovascular disease better and reduce your risk. 1 My Cardiac Coach Developed by the American Heart Association, My Cardiac Coach is a mobile app that aims to help heart attack patients make a successful recovery. It’s a personalised app that gives you lessons on how to manage your lifestyle, progress trackers for monitoring blood pressure and weight, tools for logging physical activity and more. 2 SmartBP SmartBP is a simple, easy-to-use, blood pressure management tool. SmartBP allows you to record your blood pressure measurements, track and analyse your progress, and share reports with your doctor or members of your family. 3 CardioVisual Created by cardiologists, CardioVisual is a multimedia educational heart health app. Its comprehensive library of videos and interactive graphics provides clear explanations of all aspects of heart health, including risk factors, prevention, conditions and treatments of cardiovascular diseases and diabetes. Search for these on Google Play or on the Apple App Store
FOR MORE INFORMATION visit www.sweetly.co.za
YOU SHOULD KNOW ABOUT...
LIVING WELL WITH DIABETES Are you one of the 3.5 million people in South Africa living with diabetes or one of the 5 million more who are undiagnosed? TYPE 2 DIABETES The majority of people with diabetes have Type 2, where the body becomes resistant to insulin, resulting in very high blood-sugar levels. Lifestyle or genetic factors are the root cause of this condition Diabetes is the second most common cause of death in South Africa
The number of people who’ve already developed complications by the time they are diagnosed with Type 2 diabetes 10
COMMON SYMPTOMS • Extreme, unquenchable thirst • Urinating more often than usual • Weight loss • Hunger, despite regular eating • Disrupted or blurry vision ANAGING M THE DISEASE • Healthy diet • Regular exercise • Correct use of medication • Regular monitoring of blood-sugar levels Source: Statistics South Africa (2016)
ASK AN EXPERT Pregnancy Awareness Week is from 11–15 February. Life Healthcare magazine asked Dr Nadira Khamker, a psychiatrist practising at the Life Mental Health Unit at Life Riverfield Lodge and Life Fourways Hospital, about postpartum depression. Q: What is postpartum psychosis (depression)? A: It’s a rare mood disorder occurring three to five days after delivery and lasting between one week and several months in the absence of treatment. Q: What are the symptoms? A: The condition is a complex mix of physical, emotional and behavioural changes that occur after giving birth, including mood swings, weeping, withdrawal, inability to bond with the baby, irritability, sleep and appetite disorders, overwhelming fatigue, anxiety, feelings of inadequacy or despair, and even thoughts of harming yourself or your baby. Q: Who is susceptible? A: Anyone in any situation can be affected – however, you may be more at risk if you have bipolar disorder. Q: How is it treated? A: Treatment may involve anti-psychotic drugs, counselling, hospitalisation or electroconvulsive therapy. It’s best to seek immediate treatment if any of the above symptoms occur.
I M A G E S FR E E PI K, GALLO/G ET TY I MAG ES, SU PPLI E D. C O M P I L E D BY SAMANTHA PAG E
FOETAL ALCOHOL SPECTRUM DISORDER (FASD) ‘In South Africa, approximately 78% of pregnancies are unplanned. As a result of this, women often do not realise that they are pregnant and therefore continue to use alcohol, especially during the first trimester (three months of pregnancy). This is a very vulnerable time for the foetus as most of the organs develop during this period. Contrary to popular belief, FASD does not only affect lower-income groups. In fact, it is under-reported among higherincome groups and is often incorrectly diagnosed as something else. FASD is prevalent in all socio-economic and cultural groups.’ Dr Leana Olivier (PhD), CEO, FOR MORE INFORMATION visit www.farrsa.org.za Foundation for Alcohol Related Research
LOOSE OR FUNGAL DAMAGED NAILS? Oh dear... Look at my nails! WHAT’S WRONG?
My nails are WHAT?! Loose or fungus-damaged? SO WHAT NOW?
In a loose nail, the nail bed may begin to form a granular layer of abnormal cells on its surface. After six months of detachment, this layer is likely to prevent the adhesion of any new nail tissue, possibly leading to permanent deformity.* The cavity under a loose nail is often warm and humid - the perfect environment for fungal growth. *Richard K. Scherr (1 December1997)
Fix-4-Nails! Oh I see, VERY CLEVER!
It softens the nail bed AND inhibits the fungi!! This is exactly what my nails need to regrow NATURALLY!!
The Fix-4-Nails® formula has been:
• Dermatologically tested on sensitive skin • Proven effective as fungistatic in inhibiting T.Rhubrum, the fungus mainly responsible for nail-fungus infections • Formulated as a mild keratolitic to soften the nail bed • Effectively restoring loose and fungus-damaged nails for decades.
www.loosenails.co.za • firstname.lastname@example.org • Tel 0861 999 907 Available at Dis-Chem, Takealot and other participating pharmacies and Salons
HEADACHE SUFFERERS In March 2020, Life Knysna Private Hospital is set to open a multidisciplinary headache clinic that will treat both acute and chronic cases. Emily Pettit takes a look at this groundbreaking facility
Treatments offered at The Garden Route Headache Clinic In order to prescribe the correct treatment, it’s vital to establish an accurate diagnosis and determine the correct etiology of the pain. Research has shown that in most 12
headache sufferers, the pain doesn’t originate inside the head, but from structures outside the skull, such as the cervical spine and musculature. ‘Fortunately for headache and migraine sufferers, this means the painful structures can be accessed and physically treated,’ says Dr Rowan Venter, a neurologist at Life Knysna Private Hospital. ‘In the event of other factors contributing to the headache, such as psychological influences or medical conditions, it will be addressed by our relevant specialist health professionals. Our aim at the clinic is to achieve permanent pain relief with as few medical and interventional measures as possible.’ Staff and equipment The clinic will be run by three main team members: a physiotherapist, a neurologist and a registered nurse. The equipment will include everything required to perform an initial screening, and further investigation such as X-rays, CT scans, MRIs and blood tests will be done at the Life Knysna Private Hospital. ‘The treatment programme will commence during the patient’s hospital admission and may be continued on an outpatient basis if required,’ says Vlok. What makes this clinic different? ‘There is a big demand for a comprehensive diagnostic and therapeutic service for the treatment of headaches,’ explains Dr Venter. ‘The Garden Route Headache Clinic will offer a multidisciplinary approach to the diagnoses and treatment of headaches. Currently there is no other multidisciplinary headache clinic that incorporates all of the different techniques that we will be utilising.’
WHEN TO SEE A DOCTOR: You may need medical assistance if you experience the following symptoms: • extremely painful headaches that occur very suddenly • recurring headaches in children • headaches following a blow to the head • headaches that come with confusion, disturbed vision, imbalance or abnormal speech • headaches that cause numbness, weakness, fever, seizures or unconsciousness • headaches accompanied by a stiff neck, rash or persistent vomiting
LIFE PLUS WHERE TO FIND US
Life Knysna Private Hospital
044 302 5200 I MAG E GETTY/GALLO IMAGES
A need fulfilled We all experience headaches from time to time. A couple of paracetamols and some water can often sort it out, but for many, they are a recurring symptom that’s painful and debilitating. When headaches occur repeatedly, it’s known as a headache disorder. The most common are tension-type headaches. According to the World Health Organization (WHO), in developed countries these headaches affect over a third of men and more than one half of women, and recent studies show it’s the same in developing countries – up to one adult in 20 has a headache daily or nearly every day. ‘Headache disorders can cause personal suffering, impaired quality of life and can be a financial strain,’ says Nevil Vlok, Hospital Manager at Life Knysna Private Hospital. ‘Repeated headache attacks, and often the constant fear of the next one, can affect family life, social life and employment, but many – and this includes some healthcare professionals – tend to perceive headaches as a minor, trivial complaint. As a result, the physical, emotional, social and economic burdens are often poorly acknowledged.’ The headache clinic at Life Knysna Private Hospital therefore aims to treat a condition that is very common and potentially debilitating to a large segment of the community.
Pressure Relieving Mattress rentals is celebrating Pressure Relieving Mattress rentals is celebrating 21 years South AfricaAfrica 21 yearsinin South P.A.C. Rentals is the leading supplier of Mattress and seating pressure relieving systems in South Africa. rental concept was introduced into South Africa in 1998 by Neil McMillan who was the time P.A.C. Rentals isThe the leading supplier of pressure-relieving mattress and seating systems in at South Africa. working in South Africa representing an overseas supply company. In 1998, Neil McMillan, who, at the time, was working in South Africa as a representative of an overseas Neil and his wife – Catherine both have backgrounds in nursing and paramedics aswell as teaching supply company, introduced the rental concept to the South Africa market. and training nursing staff regarding pressure ulcer awareness and prevention. Neil and his wife Catherine the for fields of nursing andinparamedic care, ascare well as Together theyboth saw have there experience was a huge in need rental equipment the hospitals and teaching and training nursing staff in the areas of pressure-ulcer awareness and prevention. environments and decided to set up a company dedicated to supplying the needs for this They identifiedspecialised a pressingequipment need for nationally. rental equipment in hospitals and care environments in South Africa, and
established a company dedicated to supplying specialised on and a rental basis. P.A.C. Rentals has grown with the this increased demandequipment in the country now has a dedicated team of 40 staff members and is represented in all provinces in South Africa. P.A.C. Rentals has grown with the increased demand for pressure-relieving mattress rental in the country, and is now represented in all South Africa’s provinces, supported by a team of 40 committed staff members. The advantages of renting specialised equipment :
The advantages of •renting specialised equipment: The company – PAC Rentals – holds the responsibility for the maintenance of the mattresses and pumps. • P.A.C. Rentals is fully responsible for the maintenance of its mattresses and pumps. • decontamination The cleaning and decontamination thethe systems is the responsibility of P.A.C.Each Rentals. Eachis stripped, • The cleaning and of the systems isofalso responsibility of P.A.C. Rentals. system system is stripped – cleaned and decontaminated according to infection control guidelines cleaned and decontaminated according to infection-control guidelines. hospital is not needed as wedelivers deliver to hospitalon onorder, order and and collects collect the • Storage space •at aStorage hospitalspace is nottoathe requirement as the company to the hospitals, when the system is not needed anymore. equipment again when the system is no longer needed. • Financially if the hospitalis isrenting rentingand andmotivates motivatesto tothe the need medical – they are more • In terms of financial outlay, if–the hospital to aids the medical aids, the funders are willing to pay the daily rental fee. more willing to pay the daily rental fee. • not The make cost ofuse renting is mattress on a dailythey basishave and on usage. If the use the mattress • If a hospital does of the purchased, andhospital it sits indoes the not store room, it is not cost they have purchased then it sits in the store room and it is not cost effective. effective, therefore P.A.C. Rentals calculates the cost of equipment on a daily basis and on its usage. • Our rangesystems of systems varyfrom frompaediatric paediatric mattresses mattresses to • The range of P.A.C. Rentals varies to Bariatric bariatricmattresses mattresses.and all are available for rental. • A stock of seating is also available for rent, if required. • We also have a rental fleet of seating available if required. The key to preventing is to move body onbody a regular basis.basis. If you are unable to move yourself on The key atopressure preventingulcer a pressure ulcer isyour to move your on a regular a regular basis in bed,are your nurse carer may suggest thatbasis you are provided withora carer MATTRESS WITHthat ALTERNATING If you unable to or move yourself on a regular in bed, your nurse may suggest you are PRESSURE THERAPY. provided with a MATTRESS WITH ALTERNATING PRESSURE THERAPY.
Alternating pressure therapy have been developed and designed to completely relieve the body of pressure.
Alternating pressure therapy has been designed to completely relieve the body of pressure. Pressure-relieving are constructed from layers of air cells that inflate and deflate on a regular basis to mimic your body’s mattresses are They constructed from layers of air cells that inflate and deflate on a regular basis to mimic the body’s natural natural movements. movements. These movements help to maintain blood flow in the skin tissue and assist in the prevention and treatment These movements helps to maintain blood flow in your skin tissue helping to prevent a pressure ulcer from of pressure ulcers. developing or helppressure to treat one if you already a pressure ulcers. For more information, discuss ulcers with yourhave healthcare professional or carer. For further information please discuss pressure ulcers with your nurse or carer.
P.A.C. Rentals: 888 P.A.C. Rentals011 : 011 8885450 5450
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‘I CAN LIVE A NORMAL LIFE
LIKE MY FRIENDS’
10 February is INTERNATIONAL EPILEPSY DAY
experienced my first seizure when I was 12 years old. I didn’t know what was happening to me and I was scared. It came at night – suddenly I could hear and see things that other people couldn’t. My mother and father were shocked and had no idea what was causing this. It wasn’t anything that we knew or understood in our family and their first response was to take me to church and pray. We tended not to go to doctors. ʻThis was a hard time for me and my family. My mother would sleep in my room so she could wake up and help me during the seizures, making sure I didn’t fall off the bed or swallow my tongue. She learnt to recognise the sound of it coming on and would keep me safe. In the mornings she would tell me what happened because I had no idea and would wake up not knowing that I’d even had a seizure. ʻI had reached a point where I was having a seizure once a week and we all agreed I needed to see a doctor. We visited Dr Mukhethwa Tsikane, a neurologist at Life Roseacres Hospital in Primrose, Johannesburg. After describing the symptoms, he asked my mother to record one of the seizures to give him a better idea of what was happening during those times. He watched the video and then suggested a brain scan to confirm his diagnosis – after the scan, he told me that I had epilepsy. ʻMy first reaction was to think, why me of all people? I was scared and wondered how I could live the rest of my life with this condition. However, once I was diagnosed, Dr Tsikane gave me medication.
I MAG ES FREEPIK, GALLO/GETTY IMAGES
When 14-year-old Tidinyane Reitumetsi experienced her first seizure, she wasn’t sure what was happening, but now she understands her condition and is living a full, healthy life with epilepsy – as told to Emily Pettit
Living with epilepsy
AURA: a warning before a seizure; sometimes a patient smells, feels, hears or sees something that nobody else can see.
SEIZURE: a sudden, excessive discharge of nervous system electrical activity that usually causes a change in behaviour. SPELL: a period, bout or episode of illness or indisposition; refers to seizures or other disorders that produce brief episodes of behavioural change. STEADY STATE: a state in which equilibrium has been achieved. Steady state is reached when a constant daily dose of a drug produces consistent blood levels of the drug. Source: epilepsy.com
I started taking it every day – in the morning and in the evening and it worked. I haven’t had another seizure since I started taking the medication and now I know that I can live a normal life like my friends. My mother is able to sleep in her own room again and I feel safe knowing that I can go to bed without worrying about something bad happening to me while I am asleep.’
Epilepsy 101 Dr Tsikane of Life Roseacres Hospital says that there are not necessarily any initial signs that someone has epilepsy – however, on occasion, someone might experience an aura prior to their first attack. An aura is a feeling, experience or movement that just seems different. ‘There are people who are born with epilepsy, as it can be inherited from a parent, or it can result from injury during birth. It can also develop at any stage of life – for example, people who have experienced head injuries, brain infections or a tumour. At times, a cause may not be known or found. Some of the outcomes of epilepsy are that a patient cannot drive, work on high building sites or do any activity that might endanger their life – such as swimming alone – until the seizures are under control. ‘There are various medications that are available to treat epilepsy. It is important to consult a neurologist or general practitioner for treatment,’ says Dr Tsikane.
DO YOU HAVE THE
Stretch marks may be a common skin concern during pregnancy, but it’s not the only one. Charlene Yared-West investigates
n pregnancy, the skin can exude a truly healthy glow because of a combination of factors, such as greater blood volume, which can give the cheeks a flushed appearance, and more sebum, which can literally make the skin shine. While pregnant women experience hormonal changes differently, there are a host of common skin conditions that surface during this time. To find out more, Life Healthcare magazine chatted to Life Fourways Hospital gynaecologist Dr Abigail Lukhaimane, Life Mercantile Hospital dermatologist Dr Zinzi Limba, and maternity coach and spa owner at Genesis Maternity Clinic, Tsholo Bless.
‘Acne is very common in pregnancy, especially in the first and second trimester and, in some cases, can be quite severe. When the hormones settle by the third trimester, it can subside, but this is not always the case,’ says Dr Abigail Lukhaimane. ‘I do my best to reassure moms that acne is a natural, cosmetic condition and that it will get better when hormones stabilise.’ Primary cause: Dermatologist Dr Zinzi Limba explains that increased levels of androgen hormones, believed to be important for cervical ripening at full term, as well as for maintaining a healthy pregnancy, can cause acne. What can you do? ‘Managing acne in pregnancy can be tricky because many prescriptions and over-the-counter treatments are contraindicated for pregnancy and can cause birth defects,’ 16
says Dr Limba. She encourages moms to talk to their doctor to plot the best and safest way forward before undertaking any acne treatment. Genesis Maternity Clinic maternity coach Tsholo Bless recommends some drug-free options for managing outbreaks: • When washing your face, use an oil-free, alcohol-free cleanser, limiting washes to twice a day. Avoid over-cleansing, as this stimulates the oil (sebaceous) glands in the skin to produce more oil (sebum). • Change pillowcases often and opt for cotton, which helps to keep cool. • Try to keep your hands away from your face so that you do not spread bacteria from your fingers to your face. • Avoid the temptation to squeeze or pop your pimples, as this can cause reinfection and scarring.
Chloasma: the ‘mask’ of pregnancy
Dr Lukhaimane explains that chloasma, also known as melasma, is a common skin problem where the condition causes dark, discoloured patches (hyperpigmentation). It is most common on the forehead, nose, cheeks and chin. Primary cause: ‘Oestrogen and progesterone sensitivity often accompany this condition and can trigger it,’ says Dr Lukhaimane. ‘Usually it is self-limiting and will fade after pregnancy. Sun exposure can also predispose you to melasma. In addition, darker-skinned people are more at risk than those with fair skin.’ How do I know I have it? A visual examination of the area is often enough for your care provider to diagnose it, says Dr Limba. ‘However, dermatologists can
perform a bedside test using a Wood’s lamp – a special light that allows the doctor to check for any bacterial and fungal infections to determine how many layers of skin have been affected by melasma.’ Living with chloasma: Not all cases clear up with treatment, but there are behavioural changes that can help minimise chloasma. ‘Discuss safe prescription options with your doctor,’ says Bless. • If you are self-conscious, use paraben-free makeup to cover areas of discoloration. • Wear sunscreen containing titanium dioxide and zinc oxide – every day! • Wear a wide-brimmed hat and protective clothing when you are out and about in the sunshine. • Join a support group for your condition.
The pregnancy line
Also known as linea nigra, the pregnancy line is a natural part of child-bearing – a vertical line that runs down the middle of the abdomen, between the belly button and the pubis. It is brown and darker than the skin tone of the woman, explains Dr Lukhaimane. Primary cause: ‘It is understood that the linea nigra and darkening around the nipples is caused by oestrogen and progesterone,’ explains Dr Limba. Does it fade? After pregnancy and birth, it goes away and requires no treatment.
Stretch marks? You’ve earned your stripes, Mama!
‘Stretch marks are common in pregnancy and do not cause harm to the mother or baby, but some women experience itching around the areas where they occur,’ says Dr Lukhaimane.
Primary cause: Dr Limba explains that skin is highly adaptable and can stretch and contract, but during pregnancy, the skin does not have enough time to adjust. This causes the skin to tear, which results in a scar and this is known as a stretch mark. Who gets stretch marks? ‘Lighter-skinned women often get pink stretch marks, while darker-skinned women will have lighter stretch marks than the surrounding area. They can occur anywhere; on the hips, thighs, belly, breasts, lower back and buttocks,’ says Dr Limba. Treatment: Bless says that there is no absolute treatment for stretch marks, but it’s comforting to know that they will fade into paler scars and sometimes become less noticeable. ‘The best advice would be to make sure that you keep the skin well nourished, and a cream or oil made from plant oils rich in omega-3, -6, and -9 can be very useful,’ she adds.
MEET OUR EXPERTS Dr Abigail Lukhaimane is a gynaecologist at Life Fourways Hospital. She cares for women from preconception to postpartum, and also focuses on premenopausal and postmenopausal screening and management, as well as fibroid care and endometriosis management with fertility preservation.
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Dr Zinzi Limba is a dermatologist at Life Mercantile Hospital. She also holds an MSc (Med) in Dermatology with a background in dermatology research, and has acquired a fellowship at the College of Dermatologists at The Colleges of Medicine of South Africa. Tsholo Bless is a maternity wellness coach at Genesis Maternity Clinic in Johannesburg, and owner of the clinic’s spa. She has a BSc degree in Biomedicine, is a doula – certified by WOMBS (Women Offering Mothers Birth Support) – and is passionate about empowering parents-to-be.
LIFE PLUS 3 TOP TIPS • If you’re going to be in the sun, use a pregnancy-friendly sunscreen or wear a wide-brimmed hat of tightly woven fabric. •W hen you’re pregnant, all medication should be cleared by your physician or gynaecologist. • Increase your water intake to ensure you are adequately hydrated. Your skin will thank you.
FIT FOR LIFE
THE HEALING POWER If you’ve ever had a relaxing soak in a hot bath, then you know all about the healing properties of warm water. But did you know that warm water can also be an ideal medium for rehabilitating some serious conditions? Pippa Naudé explores the benefits of aquatic physiotherapy
OF H2O arina Basset, a physiotherapist at the Life Rehabilitation Unit at Life St Dominic’s Hospital in East London, explains that aquatic physiotherapy, also known as hydrotherapy, is a rehabilitation tool that essentially requires two things: a registered physiotherapist with formal training, and thermoneutral water (water that is maintained at 34–35°C) ‘The physiotherapist’s role is to get the patient used to the water (especially if they are wary of it), guide them through exercises that will help their recovery, and end off with stretches,’ says Basset. She adds that props and equipment, such as floating devices and weights, can be used, but are not essential. As simple as this sounds, the outcomes of aquatic physiotherapy can be extensive, and include improved: • balance • circulation • coordination • emotional wellbeing • flexibility
Aquatic physiotherapy in progress at Life St Dominic’s Hospital
FIT FOR LIFE
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• mobility • muscle power • pain management, and • proprioception (body awareness) This makes it a powerful rehabilitation technique to help patients achieve a better quality of life. HOW DOES IT WORK? For some people, moving in water can be easier and safer than on land. Christine De Greef, a physiotherapist who has specialised in aquatic physiotherapy and who acts as a locum at the Life Rehabilitation Unit at Life St Dominic’s Hospital, explains: ‘Your body weight in water is much less than on land. This makes it easier for patients to move and exercise. The temperature of the water is therapeutic and relaxing, and therefore movements are less painful and can be performed slowly. Patients also experience less fear of falling, as the water supports them even if they lose their balance.’ However, while aquatic physiotherapy can make exercising easier, it doesn’t mean the exercises are easy, adds De Greef. Patients must continuously use their core muscles to control their buoyant movements, while the pressure of water creates resistance on inhalations and lengthens exhalations, which increases their cardiovascular workout. Small adjustments can also make exercises much harder. For example, water assists with slow movements, but quick movements create drag and are therefore more strenuous. WHO CAN DO IT? Aquatic physiotherapy can benefit patients with a range of conditions, such as multiple fractures, amputations, hip and knee replacements, arthritis, chronic pain, difficulty balancing, strokes, brain
ADVANTAGES OF AQUATIC PHYSIOTHERAPY Warm water (34–35°C) = less pain
Lowered blood pressure
Lowered heart rate
Buoyancy = less strain on joints and easier movement (30% body weight when water is at chest height) Water pressure = supportive, reduces risk of bad falls Water resistance = improved balance and coordination
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MEET OUR EXPERT 2.5cm
Carina Basset has 12 years’ experience as a physiotherapist. She has done advanced and basic neurodevelopmental therapy (NDT/Bobath) training, and is currently based at the Life Rehabilitation Unit at Life St Dominic’s Hospital.
injuries, post-neurological surgeries, neurological conditions and spinal cord injuries. Another advantage is that it is suited to all ages and abilities – including those who cannot swim. However, there are risks that need to be considered, says Basset: ‘Patients with cardiac conditions must be cleared by their doctor, and extra precautions need to be taken by the physiotherapist. And we need to be careful that the water temperature does not exceed 35°C for pregnant women.’ Aquatic physiotherapy is not advised for conditions where being in the water might pose unnecessary risks. Unstable diabetes and hypertension, resting angina, uncontrolled cardiac failure, acute vomiting or diarrhoea, and open, infected wounds are a few examples.
LIFE PLUS LIFE REHABILITATION UNITS THAT OFFER AQUATIC PHYSIOTHERAPY: • Life Vincent Pallotti Hospital, 021 506 5111 • Life Entabeni Hospital, 031 204 1300 • Life St Dominic’s Hospital, 043 707 9000 This kind of rehabilitation should be recommended and approved by your physician.
THE WAY WE EAT
S H CARB
T A I 0 L N E SH R
E W C H D A L N U GE O
â€˜Carbohydrateâ€™ is often considered a dirty word in polite diet conversation. But the time has come to celebrate the virtues of this important macronutrient rather than vilify it, says Sam Brighton 20
THE WAY WE EAT
e’ve been waging war on carbohydrates for centuries. The term ‘Banting’, a verb used to describe being on a low-carb, high-fat (LCHF) diet, takes its name from a 19th-century undertaker who adopted and promoted this way of eating, particularly the restriction of starches and sugars. But carbs are much more than the sugary, starchy scapegoats for weight gain. ‘Carbohydrates are sugars, starches, fibres and cellulose found in plant foods, fruit, vegetables and dairy; they provide the body with the energy it needs to function,’ says Denise Caron, a clinical dietitian at Life Vincent Pallotti Hospital. They are part of the three macronutrients found in food: carbohydrates, proteins and fats.
Do we need carbs?
‘Yes, we need carbohydrates for their energy, bran, fibre, vitamins, minerals and phytochemicals,’ says Caron. ‘They also play a role in digestion, gut health, immunity, and protection from cancer.’ The body breaks carbohydrates down into glucose, the body’s fuel of choice. Caron elaborates: ‘Any diet that restricts or cuts a food group or macronutrient is not sustainable for health, as each food group contains nutrients specific to that group that is essential for health.’
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Do carbs make you fat?
‘No, carbohydrates do not make you fat in isolation,’ Caron says emphatically. It’s quite simple, really: we gain weight when we eat more kilojoules than our body needs. According to a Harvard School of Public Health study, people who increased their intake of whole grains, whole fruits (not fruit juice), and vegetables (which are all carbohydrates) over the course of a 20-year study gained less weight [than those who did not].
Quantity and quality
So, we’ve established that carbs are not the enemy. But there are parameters of which to be mindful. ‘Firstly, it is best to eat carbohydrates in their most natural form because then they still contain all their nutrients and fibre,’ Caron explains. White flour is an example of a product that has been processed, leaving it stripped of some of its natural goodness.
Carbohydrates should make up 45–65% of your total energy intake. For the average healthy, active person consuming around 8 400 kilojoules per day, this equates to between 225g and 325g from carbohydrates. Remember – this doesn’t mean you should eat 250g of potatoes or bread! This quantity will be made up from all the dairy, fruit, vegetables, cereals, breads, starches and sugars you eat that day. There are three types of carbohydrates: •S imple carbs – sugars Sweet, short chains of glucose molecules. Examples include xylitol, cane sugar and honey. •C omplex carbs – starches Long chains of glucose molecules. Examples include starchy vegetables, grains and legumes. • Fibre Although we can’t digest fibre, it is essential for building healthy bacteria in your gut, aids digestion and keeps you fuller for longer.
‘I educate on the glycaemic index (GI) of carbohydrates. The GI ranks foods [on a scale of 1–100, with pure glucose being 100] based on their direct and immediate effect on our blood glucose levels. High blood glucose levels can have a harmful effect on our health, which may lead to insulin resistance,’ says Caron. What the GI values mean: •5 5 or less = low •5 6–69 = medium •7 0 or higher = high
FAST FACTS ON CARBS The body converts carbohydrates into glucose, the first form of energy our bodies use. The brain only uses glucose for energy and it is the primary source of fuel for red blood cells, foetuses and exercise. On average, one gram of carbohydrate contains about 17 kilojoules (subject to cooking methods).
MEET OUR EXPERT Denise Caron is a specialist intensive care and clinical dietitian at Life Vincent Pallotti Hospital. With a BSc (Hons) in Dietetics from the University of the Western Cape, as well as accreditation with the Diabetes Education Society of South Africa, she adopts a practical, patient-centred approach to diet therapy.
The GI value of some common carbs FOOD
White wheat bread
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AM I DRINKING
Whether it’s wine at a braai, cheering on your team with a beer or after-work libations, alcohol is a big part of the social scene. But when is ‘enjoying a drink’ actually something more serious, asks Emily Pettit Alcohol in South Africa According to a 2018 study by the journal BMC Medicine, South Africa is among the highest-ranking in the world when it comes to alcohol consumption. One in 10 deaths in the country can be attributed to alcohol abuse in some way, with men in low-income groups most at risk. It’s easy to think that you don’t fit the stereotype of an alcoholic – you have a job and a family, you’ve never been homeless or stolen money to buy alcohol – but the reality is that alcoholism takes many forms. So, when do a few drinks around the braai become a problem?
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Warning signs ‘There are a number of signs that should ring alarm bells,’ says Anneline Reetley, counselling psychologist at the Life Mental Health Unit at Life Glynnview. ‘For example, when you drink and cannot stop until the alcohol is finished; you need alcohol to relax, feel confident and enjoy yourself; and you try to cut back, but can’t.’ Other signs include lying and feeling guilty about how much you are drinking and drinking in the morning or when alone. ‘When family and friends express concern about alcohol use or it gets you into trouble with the law or work, you have blackouts or can’t remember anything from when you were drunk – these are all concerning signs.’ How to recognise a problem These warning flashes provide you with a good idea that you, or someone you know, is abusing alcohol. But you may also notice a change in behaviour that seems out of character: the person may neglect things that they once valued, lose track of goals and start to remove themselves from family and friends, especially when confronted about how much they are drinking. ‘Addiction causes major changes in wellbeing. When alcohol use progresses to the disease of addiction, there are
permanent changes that may occur to the brain structure and function,’ says Reetley. ‘Addiction can cause extensive pain in multiple areas of your life. Identifying the problem early on and taking preventive measures can save a lot of pain and heartache.’ Responsible alcohol use There are a number of checks and balances that you can put in place to ensure you are responsible when it comes to your alcohol use, especially over the summer holidays and festive season, when the amount people drink generally increases. Reetley’s advice is to implement the following measures: • determine what the cut off is, i.e. when you’ve had enough; • communicate the plan to exercise control with family and friends; • permit trusted people to speak to you when you exceed the limits that you have set; • remove yourself from situations where you know you will be tempted to lose control; • limit contact with people who abuse alcohol; and • have a good support system around you. Where to turn Get help from Alcoholics Anonymous, which can be contacted on 0861 435 722, or visit www. aasouthafrica.org.za for online support. For more about Life Mental Health’s service offerings, contact us on 011 219 9620 or email mentalhealth.headoffice@ lifehealthcare.co.za. Life Healthcare has nine mental health facilities spread across four provinces.
FOR MORE INFORMATION visit https://www.lifehealthcare.co.za/ patient-information/patient-services/ complementary-services/life-mental-health
MEET OUR EXPERT Anneline Reetley is a counselling psychologist who is a part of the multidisciplinary team at Life Glynnview, where she sees patients with multiple stressors. She also conducts groups such as the Dual Diagnosis programme that deals with psychoeducation on addiction or dependency, co-morbid psychiatric disorder and relapse prevention.
HI! MY NAME IS…
AND I HAVE Wanting everything to be ‘just so’ is one thing, but having constant, intrusive thoughts and fears that drive you to repeat timeconsuming rituals can interfere with your ability to function at home, work and socially. By Gillian Warren-Brown
ow many times have you flippantly said you’re OCD about your kitchen, desk, books or clothes? In a world full of acronyms, OCD has become code for perfectionism. But not everyone who likes things to be ‘just so’ has obsessivecompulsive disorder (OCD). On the contrary, OCD is a distressing and serious psychiatric illness. Dr John Torline, a specialist psychiatrist based at Life St Vincent’s at Life Vincent Pallotti Hospital in Cape Town, says the obsessions that a person with OCD experiences are ‘unwanted and stressful thoughts, images or urges that continually enter their mind’. Compulsions are time-consuming behaviours or acts that they feel compelled to perform repeatedly as a result of the obsessions, even though
they recognise them as senseless. ‘To resist is difficult and causes anxiety, which doesn’t improve until the behaviour is completed,’ says Dr Torline. For example, an obsession might be a fear of picking up germs from sitting in certain chairs, from shaking hands, or touching door handles. The corresponding compulsion could be washing your hands countless times a day until they become red and raw after you’ve touched, or thought you’ve touched, a contaminated object.
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WHO GETS OCD? We don’t know exactly how common OCD is in South Africa, but Professor Christine Lochner, co-director at the SAMRC Unit on Risk and Resilience in Mental Disorders at the University of Stellenbosch believes local rates are similar to the global figure of 2–3% of the population. She acknowledges, though, that in addition to those diagnosed with OCD, there are many people who have some symptoms, but these are not intrusive enough to interfere with their ability to function at work, home and socially. Dr Pauline Mawson, a clinical psychologist based in Benoni and consulting for the Life Mental Health Unit at Life Glynnview says OCD can be diagnosed by a psychiatrist or psychologist via a background history and clinical observations. She adds that people who exhibit traits of OCD but don’t fulfil the criteria for a full OCD diagnosis could still benefit from treatment. Dr Torline says most people who are diagnosed with the disorder start developing symptoms in their late teens, although in boys, who are more often affected in childhood, it could be as early as the age of 10. In adulthood, the balance shifts to women, who are affected slightly more commonly than men. WHAT CAUSES OCD? A history of anxiety and depression may be a predisposing factor, says Dr Mawson, as well as other things such as early childhood trauma and/or abuse (especially sexual). Those who internalise their thoughts and feelings are more at risk. Dr Torline adds that genetic factors also play a role. ‘People with a parent or siblings with OCD have a higher risk of developing the disorder. It’s likely that many genes are involved and that certain environmental
Typical OCD obsessions and compulsions vs behaviour easily mistaken for OCD The information that follows is not intended to simplify OCD, which is a complex condition with a range of behaviours that intrude on an individual’s ability to function. It is a condition that has to be diagnosed by a trained mental health professional. OCD
A teen buries his cutlery and crockery in the garden after every meal because he worries about infecting his family with a disease.
A student washes her cup after drinking coffee and washes up after every meal.
A young woman silently and constantly repeats a prayer for fear that if she doesn’t something bad will happen.
A person prays daily in accordance with his religion.
A man worries that his car will be stolen so he goes to look every five minutes and triple check that it’s locked.
After locking his car, a man checks and re-checks that it is, indeed, locked.
Living with OCD
For those diagnosed with OCD, psychologist Dr Pauline Mawson suggests some ways of managing the disorder: • Talk about it: tell your family and friends. • Join a support group. • Use mindfulness and techniques for relaxation. • Learn how to cope with stressful situations (regulating your emotions, conflict management and assertiveness). • Develop hobbies. • Exercise – it’s a helpful outlet for anxiety. factors, such as birth complications and stressful or traumatic events, may influence the expression of these genes,’ he says. The sudden onset of symptoms in children is believed to be linked to streptococcal infections, such as a strep throat. HOW OCD IS TREATED Medication, cognitive-behavioural therapy (CBT) or a combination of both is effective in reducing the symptoms of OCD, says Dr Torline. Medications, such as selective serotonin re-uptake inhibitors (SSRIs), usually show some effect after four to six
weeks, although eight to 12 weeks are usually needed for maximum benefit. Dr Mawson says CBT is especially successful at helping patients to deal with intrusive thoughts and learn how to resist compulsive behaviours. With appropriate treatment and the help of support groups, including online groups, it is possible to manage OCD.
MEET OUR EXPERTS Dr John Torline is a specialist psychiatrist based at Life St Vincent’s at Life Vincent Pallotti Hospital. He is trained to practise evidence-based psychiatry, working within the biopsychosocial model. As part of providing patients with a comprehensive assessment, he looks at the social and cultural context and takes physical and mental symptoms into account. Dr Pauline Mawson is a clinical psychologist and consults at the Life Mental Health Unit at Life Glynnview, where she works with individual inpatients and runs groups. Her interests lie in children and adolescents, anxiety disorders, personality disorders, trauma and forensic evaluations (family and criminal).
Life-giving and energising, water is undeniably essential for health and wellbeing, and South Africa is one of the best places in the world to channel that aquatic energy. By Ryan Scott
To keep out of harm’s way when exploring these water worlds, take the following precautions: • Never dive into unfamiliar water. There may be unseen objects below the surface. • Be aware of others in the area. Many people can’t swim and can easily misjudge depths. • A barefoot grip is better than that of shoes when it comes to slippery rock surfaces in rivers and at the seaside. • Always keep your eye on the sea’s horizon. Waves can surprise you.
GOLDEN MILE – DURBAN
LONG STREET SWIMMING BATHS
Best for surfing and its weather in winter Feature: Year-round surfing, fishing and promenade cruising Description: Even in winter, the temperature of the ocean can be 20℃. No wetsuits required and the waves are of a high enough quality to have nurtured the likes of arguably South Africa’s most famous surfer ever, Jordy Smith. There are great beginners’ waves and activities alongside, too: cycling, running or simply strolling are options for the whole family to get the most out of this beautiful stretch of Durban coastline. Plus the KwaZuluNatal Sharks Board has created some of the safest beaches in the country here, with extensive shark-net coverage.
Best for public swimming Feature: Old-school charm with a choice of warm pools Description: South Africa has good public swimming-pool facilities and possibly the most interesting of them all are the Long Street Baths, which consists of pools as well as Turkish baths. This unique swimming destination in the Cape Town CBD is beautifully adorned with murals and bathed in soft light, and it encompasses the look and feel of a bygone era of socialising around public baths. There are two pools available from 7am until 7pm, Monday to Saturday – a warm-water 25m pool with lanes for laps and a children’s 12m pool for some less structured fun in the water.
Best for getting close to a large waterfall Feature: Cascading falls and canyon in a national park Description: In the middle of the dry Northern Cape, a not-so-little miracle thunders surreally through a 240m gorge. The mighty waters and immense power of the 56m Augrabies Falls will stir your soul as you witness them from up close. The original Khoi name is ‘Aukoerebis’ – Place of Great Noise – and you will hear it before you see it. Its location inside a national park of the same name means this special place is well managed and available to all at reasonable rates, along with various other activities, accommodation options and safari drives.
>> https://www.westerncape.gov.za/ facility/long-street-baths
>> https://www.sanparks.org/parks/ augrabies
THE ORANGE RIVER
Best for inland water sports Feature: 800km of tranquil shoreline with easy access Description: Bordering the Free State, Mpumalanga and Gauteng provinces, the Vaal Dam has become entrenched in South African culture as a great place for water enthusiasts to sail, paddle, waterski, windsurf, swim, kiteboard and generally enjoy the magnitude of opportunities that such a large, clean and accessible water mass provides. There are also three yacht clubs and two marinas, as well as birdwatching and fishing to enjoy year-round.
Best for rafting Feature: Unspoiled landscapes Description: At 2 200m, the Orange River is South Africa’s major watercourse. Not only does it provide hydroelectric power and irrigation for vast tracts of arable land, but in the Richtersveld area, the water flows fast enough for river rafting, too. Travelling down this life-giving force during the day and sleeping on its banks at night is the best way to experience its natural beauty. The river’s variable pace – from serenely sedate stretches, to rushing white-water rapids – is what makes rafting here so much fun.
Best for natural hot springs Feature: Healing waters in a natural mountain setting Description: A jewel on the Western Cape’s entertaining Route 62 is the natural spring of the Goudini Spa in the Boland. Towering mountains present a scenic backdrop while you immerse yourself in warm, mineral-rich water bubbling up from deep within the earth. The spa is located in a resort that offers a range of self-catering holiday accommodation, entertainment and recreational options for all ages, and includes wedding and corporate facilities.
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>> https://en.wikipedia.org/wiki/ Golden_Mile,_Durban or www.durban.gov.za
ARE YOU AN
INTROVERT OR AN EXTROVERT? Are you orientated more towards the outer world or your inner world? Are you most comfortable in throngs of people, or do you prefer the company of few? This test is designed to evaluate your individual tendency towards extroversion or introversion.
Read each statement carefully and indicate which option best applies to you or accurately describes your behaviour. After finishing the test, you can sum up your points using the scoring table and view the relevant results for you. 1. Itâ€™s important to me to have an active social life. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 2. I am very talkative. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 3. I make friends easily. a. Completely true b. Mostly true c. Somewhat true/false
d. Mostly false e. Completely false 4. I love being the centre of attention. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 5. I eagerly share my thoughts and feelings with other people. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 6. Others would say that Iâ€™m easy to get to know. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false
7. After being with a large group of people, I need some time to myself. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 8. I tend to think ‘out loud’. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false
9. I enjoy meeting new people. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 10. When I have free time, I: a. Almost always prefer to do something with other people. b. Sometimes like to do things with other people, but also enjoy spending time by myself. c. Almost always prefer to spend time alone.
A little insight into social orientations
Imagine yourself at a huge tropical resort on a one-week vacation. Do you see yourself sticking to the poolside, taking the occasional stroll alone on the beach, maybe making one or two friendly acquaintances? Or are you chatting it up wherever you go, quickly forming a group of friends and seeking out all the good parties? If you picked the first one, you just may be an introvert – and if you picked the second, you just may be an extrovert. The keyword in the sentence, however, is ‘may’. Extroversion and introversion are not ‘either-or’ characteristics. Moreover, despite what some people might think, whether you’re an extrovert or an introvert is typically not a matter of choice. While introverts are drawn to, and seek solace in, the inner world of thoughts and emotions, extroverts turn to the outer world of people and social activities.
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0–40 You display many of the characteristics of an introvert. This doesn’t mean that you don’t enjoy making friends or being around people. Introverts typically prefer to focus on quality rather than quantity when it comes to friendships, and often prefer a small number of close, trusted companions. Like most introverts, you probably also enjoy time alone. Being around people too much drains you, compelling you to seek time to yourself. As an introvert, you probably go over a lot of life’s events in your mind, mulling over issues until you can find a suitable solution. You are also not the type of person who will spill your guts and talk about yourself with just anyone. So while some people may dismiss your silent demeanour by assuming that you’re standoffish, bored, sad or lonely, the truth is that you’re very much aware of everything that goes on around you. You are always listening, observing, taking everything in and processing it in your own way.
Scoring yourself Add up all your points according to this chart: QUESTION
The beauty of being an ambivert is that you share characteristics of both introverts and extroverts. Like an ambidextrous person who can use their left and right hand, you can adapt to pretty much any social situation you find yourself in. If you’re in an environment where you’re required to socialise and network, you will have little trouble doing so. If you’re in a situation where you need to work on your own, you can adjust quite easily. Among a group of extroverts, you can turn on the charm and hold up a conversation. Among a group of introverts, you can listen attentively and sit in silence. You have the best of both worlds. However, even though you don’t mind being around big crowds, that doesn’t mean you’ll want to crash every party you’re invited to. In addition, although you enjoy reflecting on and sharing life’s experiences with those around you, there are simply some moments when you’d prefer to analyse and absorb things on a more internal and personal level. What you desire, more than anything else, is balance.
It’s not that you hate spending time alone, but why would you wile away the hours alone when you can do it with a huge group of friends doing something fun? As an extrovert, you enjoy interacting with a variety of people. You are very peopleorientated, and may often be described as the ‘life of the party’. You probably enjoy bouncing ideas off of others, thinking out loud, and if you’re upset or feeling down, you’d much rather turn to others for support and guidance than go through it on your own. Too much alone time isn’t just boring for you, it’s suffocating. You need to socialise in order to feel happy, and to feel alive. People who don’t understand you may think you’re talkative, or that all you care about is partying, but what they don’t see is your amazing ability to navigate different social worlds – whether at a resort or a conference, among friends or strangers. You easily make connections and friendships wherever you go.
HEALTH ADJUST YOUR (EXERCISE) ATTITUDE
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The brain is the most powerful exercise tool, which is why changing the way you think about physical activity could have a direct effect on weight loss. In a recent study, participants all walked the same course, but half were told it was exercise and the others were merely told to enjoy listening to the music. Researchers concluded that the ‘exercisers’ did not enjoy the experience. They were tired and grumpy and ate more sugary treats afterwards. The non-exercisers focused on the enjoyment of the activity, which had a direct health benefit in that they felt happier, healthier and less inclined to snack on sweets.
PROTECT THE Fun in the summer sun can leave you with more than great holiday snaps â€“ ultraviolet rays can result in premature wrinkles, liver spots and potentially deadly skin cancer. December is Skin Cancer Awareness Month, and a reminder to take steps to stay safe, says Glynis Horning
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he skin is our biggest organ, transmitting sensations from our surroundings, regulating our body temperature and protecting us from the elements – and one of the most dangerous of these is the sun. UVA rays can damage the elastin in skin and cause wrinkles, liver spots and skin cancer, while UVB rays cause sunburn and are even more strongly linked to skin cancer. South Africa now has the second highest incidence of skin cancer after Australia, reports the Cancer Association of South Africa (CANSA). Every year at least 20 000 people are diagnosed with non-melanoma skin cancers – mainly basal cell carcinoma and squamous cell carcinoma, which can be disfiguring if left untreated. And about 1 500 are diagnosed with malignant melanoma, which can be deadly, says CANSA health specialist Professor Michael Herbst. What’s more, the World Health Organization (WHO) has warned that the incidence of skin cancer is rising with global warming. In the UK alone, over the past decade diagnoses have increased by almost half. ‘As ozone levels are depleted, the atmosphere loses more and more of its protective filter function and more solar UV radiation reaches the Earth’s surface,’ the WHO reports (www.who. int/uv). ‘It is estimated that a 10% decrease in ozone levels will result in an additional 300 000 non-melanoma and 4 500 melanoma skin cancer cases (a year).’ ‘Anyone can get skin cancer,’ says Dr Memory Bvochora-Nsingo, a clinical oncologist at the Life Oncology Unit at Life Gaborone Private Hospital. ‘When caught early, it’s highly treatable – usually surgical removal is adequate. Melanoma presents the greatest treatment challenge, and if it spreads to other organs, the patient may require many treatment methods, including surgery, radiation therapy, chemotherapy or immunotherapy.’
SKIN CANCER AWARENESS MONTH 1–31 December Be sun smart!
PEELING AWAY SKIN CANCER MYTHS
The sun is a danger only on hot, sunny days. Your skin can burn even on cloudy days – while clouds block the sun’s light, they don’t block its harmful UV rays: ‘Eighty percent of ultraviolet radiation may still penetrate the cloud cover,’ says Dr Bvochora-Nsingo. I’m rarely outdoors, so I won’t get skin cancer. Even brief sun exposures, such as walking to a car or driving, can add up. Cumulative exposure is associated with squamous cell cancer, and though not as dangerous as melanoma, this causes up to 20% of skin cancer deaths, according to the American Society for Dermatologic Surgery, and the same is true in South Africa, says Professor Herbst. So apply sunscreen each day and, if possible, have UV-blocking film applied to your car windows. I tan easily, so I needn’t worry about skin cancer. There’s no such thing as a healthy tan – a tan is the result of your skin producing more melanin in an attempt to protect itself from damage by UV radiation. Any change in your natural skin tone signals skin damage, say Professor Herbst and Dr Bvochora-Nsingo.
SPOT SKIN CANCER
Be alert to the ABCDE of warning signs for moles:
I’m dark-skinned, so I can’t get skin cancer. If you’re of African or Indian descent, you have more protective melanin in your skin, but you can still suffer UV damage and develop skin cancer. ‘I’d never heard of a black person with skin cancer,’ says actress, model and presenter Naniki ‘Nikki’ Seboni, 29. She was diagnosed with malignant melanoma at 24 and is now a CANSA Survivor motivational speaker.
Asymmetry: one half is unlike the other.
Border: this is irregular or poorly defined.
Colour changes: it’s not just brown or black like common moles, but a mix of brown, black, tan, red, white and even blue.
Sunbeds, sunlamps and sunless tanning products are safe ways to tan. Sunbeds and sunlamps still deliver UV radiation. The American Academy of Dermatology reports that using indoor tanning beds before the age of 35 can increase your risk of melanoma by 59%, and the risk increases with each use. In 2009, sunbeds and tanning booths were officially classified as cancer-causing agents, says Professor Herbst. And CANSA warns that sunless tanning products are not safe either. Sprays and mousses may contain Melanotan 11, which is reported to have serious side effects and could possibly cause melanoma.
iameter: it’s more than 6mm across D (the size of a pencil rubber).
Evolution: it’s becoming bigger and more prominent. Source: CANSA (www.cansa.org.za)
hours, or after sweating, swimming or towelling yourself down, even if it’s marked ‘water-resistant’. Go for a baseline skin check with a dermatologist, or at a CANSA Care Centre with a FotoFinder dermoscope machine, and ask about mole-mapping. This is especially important if you have more than 50 moles, a previous personal or family history of melanoma, or have ever been severely sunburnt, says Dr BvochoraNsingo. Then go every two or three years for a check-up if you’re dark-skinned, and yearly if fair-skinned. ‘It’s only smart to protect the skin you’re in.’
‘Sun avoidance is the most desirable form of sun protection,’ says Dr Bvochora-Nsingo. Stay out of the sun between 10am and 3pm. If you must venture out into the sun, wear long sleeves and pants of closely woven fabric, a hat or cap with a generous brim (at least 10cm) and sunglasses that block 95–100% of UVA and UVB rays. According to research this year at King’s College London, men are more likely to develop melanoma on the head, neck and trunk, and women on the legs.
Apply sunscreen every morning to your face and all other exposed parts of your body. Be generous – use about 2 tablespoons – and don’t forget the tops of your ears and feet. ‘Sunscreen is not as effective if not applied properly,’ says Dr BvochoraNsingo. Choose a brand that gives protection against UVA and UVB rays (look for the CANSA Seal of Recognition logo). And see that it has a sun protection factor (SPF) of 30 to 50: the higher the number, the greater the protection, but the higher you go, the smaller the difference becomes, says Professor Herbst. (SPF 15 filters out about 93% of UVB rays; SPF 30, 97%; SPF 50, 98%.) Don’t use a product that’s been open for more than a year: it will have lost its effectiveness. If you’re spending time outdoors, reapply sunscreen 20 minutes before going out, and at least every two
‘IF YOU MUST VENTURE OUT INTO THE SUN, WEAR LONG SLEEVES AND PANTS OF CLOSELY WOVEN FABRIC, A HAT OR A CAP WITH A GENEROUS BRIM (AT LEAST 10CM) AND SUNGLASSES THAT BLOCK 95–100% OF UVA AND UVB RAYS’ 36
SUN-PROOF YOUR CHILDREN Just one or two blistering sunburns in childhood or adolescence doubles the risk of melanoma later in life, reports CANSA. Babies are most at risk as their skins are less mature – but they have a higher ratio of surface area to body weight, so their exposure to the chemicals in sunscreen is greater. Don’t use sunscreen on them before the age of six months – keep them out of direct sunlight entirely. Use a pushchair or buggy with a canopy or parasol and when driving, attach their seat in the middle of the back seat, away from side windows, or secure sunscreens to these and the back window, if they don’t have UV film. If outdoors, a pop-up cabana can provide useful moveable shade. Babies are also more at risk of dehydration and heat exhaustion through excessive sweating, which can result in potentially deadly heatstroke.
MEET OUR EXPERT Dr Memory BvochoraNsingo is a clinical oncologist at Life Gaborone Private Hospital. She lives in the lovely sunny country of Botswana where daily sunscreen should be a given.
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Take steps to protect your precious skin:
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FORWARD Minimally invasive surgery has huge benefits when performed correctly by a highly skilled surgeon. Trevor Crighton sat down with one of them to learn more
or more than a decade, a quiet revolution has been happening in every speciality of surgical medicine, encouraging surgeons to rethink conventional surgical approaches to improve clinical outcomes and reduce hospital stays and recovery times. MIS – minimally invasive surgery – requires less exposure because the incisions are small, and the repair is done with a small burr (cutting tool). Besides these, there are also aesthetic advantages, as there is less scarring. MIS is also sometimes referred to as arthroscopy, but the term encompasses more than just minimally invasive surgery.
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MIS vs osteotomy
Orthopaedic surgeon Dr Ziyaad Mayet has added MIS for foot and ankle surgery at Life Roseacres Hospital in Johannesburg, and he says that while there are many benefits to employing this technique, the most important is that the surgery still needs to achieve the aims required of it. ‘Operating using smaller incisions has meant the development of new equipment and techniques, including the notable advent of robotic surgery for urology and for knee replacements,’ he says. ‘In foot and ankle surgery, there have been similar significant developments in the instruments being used, as well as the techniques with which we use them.’ The ‘keyhole’ technique can now be applied to ligament repairs, correction of deformities and fusions, most notably the correction of bunion deformity and lesser toes, lessening the chances of wound breakdown and healing problems associated with traditional ‘open’ surgery. ‘I use MIS a lot for arthrodesis surgery (the surgical immobilisation of a joint by fusing the bones), and the indications in sports medicine for surgeries on cartilage are good – it just depends on the scale of the repairs required,’ he says. Dr Mayet emphasises the distinction between the indications for MIS vs surgeries such as open osteotomies, which most definitely
THE ‘KEYHOLE’ TECHNIQUE CAN NOW BE APPLIED TO LIGAMENT REPAIRS, CORRECTION OF DEFORMITIES AND FUSIONS, MOST NOTABLY THE CORRECTION OF BUNION DEFORMITY AND LESSER TOES still have a purpose. ‘MIS can effectively correct things like flatfoot deformities and bunions, but it doesn’t always replace open osteotomy,’ he explains.
The way of the future
MIS for the foot and ankle area requires the use of two basic instruments: the burr (to shape the bones) and the endoscope, a camera that allows the surgeon to see inside the joint. While the technology was first employed in the 1990s, it has been significantly boosted by the establishment of GRECMIP (Groupe de Recherche et d’Etude en Chirurgie Mini-Invasive du Pied – Group of Research and Study in Minimally Invasive Surgery of the Foot) by a group of French surgeons in 2002. Dr Mayet has attended both the Basic and Advanced courses offered by GRECMIP and is confident that the refinement brought to the technique by decades of research means that most foot and ankle surgeries will be carried out with MIS in the future. ‘It’s a great technique for the correction of a number of forefoot deformities, but not all pathologies and problems are amenable to this type of surgery, and a thorough initial assessment is indicated. A lot of the benefits are dependent on the skill of the surgeon performing the operation – there are potential complications, like the risk
of developing burns from the burrs,’ explains Dr Mayet. It’s also not ideal for revision surgeries, with the size of the ‘orthopaedic hardware’ in place often meaning that open surgery is a more viable option.
Patients should be aware that, even though the recovery periods are shorter, there is still a need for a significant amount of rest. Dr Mayet says that while current GRECMIP guidelines quote six-week recovery periods from MIS surgery, his experience is that patients are fully recovered within two to three months – still a substantial reduction in the recovery period, compared to that incurred by traditional methods. CAS E S T
Dr Mayet’s most satisfying case so far is that of a young woman who had a congenital deformity in her fourth and fifth toes, and a bunionette in her fifth toe. These were in constant conflict with footwear and she had difficulty wearing closed shoes. After undergoing MIS, she was back at work after about two weeks, in open shoes with straps. By four weeks, the osteotomies (bone cuts) had united. As of her last visit, she was satisfied with the preliminary result, and was about to move on to wearing closed shoes.
MEET OUR EXPERT Dr Ziyaad Mayet finished his postgraduate studies in Orthopaedic Surgery at Wits university before completing fellowships in foot, ankle and limb reconstruction. He heads the Foot and Ankle and Adult Deformity Unit at Chris Hani Baragwanath Hospital and also performs surgeries at Life Roseacres Hospital. He has attended several GRECMIP courses in minimally invasive surgery.
A cancer diagnosis can be devastating, and once it’s been made, you may enter a bewildering world of treatments. Mandy Collins gets to grips with the most common ones
ancer. It’s a word that fills most of our hearts with dread, and conjures up all kinds of misconceptions, but not all cancers are a death sentence. Having been diagnosed, however, you’ll need treatment, and treatments such as chemotherapy can seem scary, particularly if you’ve experienced a loved one going through a particularly harrowing course. Dr Louis Kathan – Business Lead at Life Healthcare, and an oncologist at the Life Oncology Unit at Life Vincent Pallotti Hospital – explains that most tumour diagnoses start with a biopsy. ‘This is performed by the surgeon, physician, radiologist or GP. Surgery is the mainstay of most tumours, either to establish a histological diagnosis [looking at the cancer cells under a microscope] or to try to remove the tumour. Whether surgery is performed depends on the stage of disease – if a patient has advanced metastatic disease [there are secondary tumours] – surgery will only be in the form of a biopsy, to establish the diagnosis,’ says Dr Kathan. ‘For example, early stage breast disease can mean surgery upfront, followed by
either chemotherapy or radiotherapy, or both,’ he says. ‘But in some breast cancer patients we do chemotherapy, followed by surgery. These complex decisions are made in a multidisciplinary clinic.’ Myths and misconceptions A common misconception is that cancer is one thing. But all cancers are not created equal, and each one behaves differently. ‘Each person and their cancer are different,’ says Dr Kathan. ‘Not only do patients vary in age, sex and comorbidities [the other medical conditions they might have] but tumours are also at different stages and histology. We look at the molecular nature of the tumours to further differentiate them and can therefore target them with specific treatments. ‘Solid tumours differ from leukaemias and lymphoma and melanoma, and breast cancer that has spread to the bone is different to a primary bone tumour like an osteosarcoma. So, the treatment and prognosis for each are completely different.’ In addition, he says, patients often think all chemotherapy is the same. ‘I always tell patients that the chemotherapy is
CATCHING CANCER EARLY ‘Patients need to see their doctors for annual medicals and cancer screening,’ says Dr Kathan. ‘Men need a rectal and PSA prostate cancer screening, women need Pap smears and mammograms to screen for cervical and breast cancer. And all adults aged 50 and above, even without a significant family history, need regular colonoscopy for colon cancer screening. These interventions can detect early stage disease, which is more easily treated and cured, and can even detect pre-malignant lesions.’
tailored to their specific cancer, weight and height. If an aunt had breast chemotherapy, you are not going to get the same dose. Everyone experiences chemotherapy differently. There are common side effects, but you will not necessarily get them. Also, not all chemotherapy causes hair loss and diarrhoea.’
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At the Life Oncology Unit at Life Vincent Pallotti Hospital, oncology pharmacist Miempie Truter is responsible for all aspects of administering patients’ chemotherapy treatments. ‘Chemotherapy can be used as single agents or in combinations, depending on the stage and type of cancer,’ she explains. ‘Chemotherapy drugs can also be given via various methods. Most commonly, they are given intravenously in an outpatient unit or in a hospital. But they can also be given orally in the form of tablets or capsules.’ The frequency and length of time that chemotherapy is given varies among patients, depending on the type of
cancer, the regimen followed, their response to the treatment and tolerance of side effects, she says – so treatments may be given daily, weekly or monthly. ‘Chemotherapy kills the cancer cells, but in the process can also cause harm to the body’s healthy cells and this causes the side effects,’ she explains. ‘Supportive medication is prescribed to alleviate and protect against side effects. Nausea and vomiting are the most common, for which there is an extensive range of medication available.’ Radiotherapy Radiation therapy (also called radiotherapy) uses high doses of (ionising) radiation to kill cancer cells and shrink tumours, says Kulthum Ismail, lead radiotherapist at the Life Oncology Unit at Life Vincent Pallotti Hospital. ‘The ionising radiation damages or destroys cells in the area being treated, making it difficult for the cancer cells to grow and multiply.’ There are three types of radiotherapy: • External radiation uses high-energy rays, delivered to the tumour by a machine. • Internal radiation or brachytherapy uses a radioactive ‘pellet’ placed inside the body, in or near the tumour, which releases energised particles that target and kill the tumour cells. • Systemic radiation, involves radioactive chemicals, which are introduced into the body, either orally or intravenously.‘Radiation not only kills or slows the growth of cancer cells, but it can also affect nearby healthy cells,’ says Ismail. ‘However, the healthy cells are able to repair themselves and almost always recover after treatment.’
TARGETED AND IMMUNOTHERAPY ONCOLOGISTS ALSO USE TARGETED AND IMMUNOTHERAPY TO TREAT SOME CANCERS. TARGETED THERAPY DRUGS TARGET SOMETHING IN OR AROUND A CANCER CELL THAT IS HELPING IT TO GROW AND SURVIVE, WHILE IMMUNOTHERAPY TREATMENTS USE THE IMMUNE SYSTEM TO FIND AND ATTACK CANCER CELLS. SOURCE: WWW.MACMILLAN.ORG.UK She adds that every patient is different, but side effects will not be experienced immediately. ‘Acute side effects will occur in weeks two to three, and may include red and itchy skin and fatigue.’ Most radiation therapy patients will need continued follow-up care, and it is imperative that patients attend their check-ups.
MEET OUR EXPERTS Dr Louis Kathan is a clinical oncologist at the Life Oncology Unit at Life Vincent Pallotti Hospital. He is also responsible for pioneering work in stereotactic body therapy. Miempie Truter studied BPharm at Potchefstroom University, and has been the oncology pharmacist in the Life Oncology Unit at Life Vincent Pallotti Hospital since 2013. Kulthum Ismail has a degree in Radiography (Therapy) and a postgraduate diploma in Healthcare Management from Stellenbosch University. She has 17+ years of radiotherapy experience in the private and public sectors.
FIRST AID FOR SUMMERâ€™S STING Babyâ€™s first bee sting or sunburn can be traumatic, but it helps if you know some basic baby first aid. By Melanie Farrell
ummer means spending more time outdoors and, although we all enjoy having fun in the sun, this can be a hazardous time for babies, who risk getting sunburn or stung by a flying insect. Most infants will also get a rash or a sore tummy at some stage and, in most cases, common sense and a cool head will be enough to care for your ailing infant. However, in some cases, you will need to call the doctor. Paediatrician Dr Natasha PadayacheeGovender, from Life Fourways Hospital in Johannesburg, has some expert advice about what to do when your baby needs first aid.
THE BABY FILES
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WHEN A RASH APPEARS ‘Most children experience a rash at one time or another, and many rashes disappear without treatment. Others may be accompanied by fever, itchiness and a range of symptoms that depend on the kind of rash,’ says Dr Padayachee-Govender. ‘Heat rash or prickly heat might appear if your baby gets hot in a humid environment,’ she says. ‘The rash shows as tiny red bumps or blisters on the skin, which can be very itchy. Cooling your baby down and avoiding humidity is the best way to counteract heat rash, which usually clears within two to three days without treatment.’ ‘Another rash to look out for is urticaria, also known as hives. This is an outbreak of swollen, pale red bumps or plaques (weals) on the skin that appear suddenly, either as a result of the body’s reaction to certain allergens, or for unknown reasons. Hives usually cause itching, but may also burn or sting,’ says Dr Padayachee-Govender. ‘A rash that may crop up in summer with increased skin-to-skin contact or by sharing swimming-pool water or towels is Molluscum contagiosum,’ explains Dr Padayachee-Govender. ‘Molluscum contagiosum spots look like pimples and grow into round pearly white lumps, usually 2 to 5mm in size. They can be itchy. Usually they heal without treatment within six months, but it might take longer.’ ‘Most rashes are harmless and go away on their own,’ says Dr PadayacheeGovender. ‘Whatever their age, you should take your child to the doctor if they have a rash and are unwell with a persistent high temperature, cold or cough symptoms, or swollen neck glands.’
WHEN THE BODY DEHYDRATES ‘Dehydration remains a major cause of morbidity and mortality in infants and young children worldwide,’ says Dr Padayachee-Govender. ‘Dehydration is a symptom or sign of another disorder, most commonly diarrhoea. Infants are particularly susceptible to the ill effects
of dehydration because of their greater baseline fluid requirements (owing to a higher metabolic rate), higher evaporative losses (due to a higher ratio of surface area to volume), and inability to communicate thirst or seek fluid. Dehydration in infants or children results as a loss of fluid volume (due to diarrhoea or vomiting) or because of decreases in fluid.’ Signs of mild dehydration include a slightly dry mouth and thirst. ‘Children who are mildly dehydrated do not need immediate medical attention, but should be given extra fluids and monitored for signs of worsening dehydration,’ continues Dr Padayachee-Govender. ‘Signs of moderate or severe dehydration include: decreased urination (not going to the bathroom or no wet nappy in six hours), a lack of tears when crying, a dry mouth, sunken eyes, cool or clammy hands and feet, and listlessness. ‘A child who is moderately or severely dehydrated should be evaluated by a doctor or nurse as soon as possible.’
WHEN A BEE STINGS ‘Being stung by a bee, wasp, hornet or yellow jacket can be both painful and scary,’ says Dr Padayachee-Govender. ‘Some children may have serious or even life-threatening reactions to stings, which requires quick treatment. ‘After being stung, you should remove the stinger from your child’s skin as soon as possible to prevent any more venom from being released into the skin. ‘Most children who are stung by an insect will develop a local reaction (an area of swelling and redness). Some children may also develop a severe allergic reaction called anaphylaxis. To soothe baby’s immediate discomfort, wrap ice in a cloth and apply to the site of the sting to reduce swelling. Then apply calamine lotion to relieve itching, advises the Little Life guide, Your Baby. ‘Symptoms of an allergic reaction usually develop quickly and include skin symptoms, such as hives, redness or swelling of skin away from the area that was stung, belly cramps, nausea, vomiting,
or diarrhoea, hoarse voice, shortness of breath and difficulty breathing,’ says Dr Padayachee-Govender. Severe allergic reactions are a medical emergency that can be fatal if not treated quickly. If your baby develops any symptoms of anaphylaxis, you need to get them to emergency care as soon as possible.
WHEN THE SUN BURNS ‘There are a number of effective ways to prevent sunburn, including staying out of the sun during peak hours, using sunscreen, and wearing protective clothing,’ advises Dr Padayachee-Govender. ‘While these measures are important for everyone, they are especially important for children and people with fair skin, who burn easily and tan poorly.’ If your baby’s skin is red and swollen and they’re crying after spending a day out in the sun, the chances are they have a case of sunburn. The Little Life guide, Your Baby, recommends that you lower the temperature of the skin in a cool bath, apply cool water compresses and use a water-based moisturiser or an aloe-based skin gel. ‘Give your child paracetamol or ibuprofen for discomfort and fever. Be sure to follow the directions on the container and never use aspirin in children,’ says Dr Padayachee-Govender. ‘Apply a topical moisturiser, aloe gel, hydrocortisone cream or a topical pain reliever to sunburned skin. If blisters are present, don’t break them open, as infection can occur. ‘Keep your child out of the sun until the burn is healed and give them extra fluid for several days to prevent dehydration.’
MEET OUR EXPERT Dr Natasha PadayacheeGovender is a specialist paediatrician in private practice at Life Fourways Hospital. She is passionate about caring for Life Healthcare’s littlest patients as well as their parents.
Did you know that while snoring is common, it’s not normal. Here are the reasons why we snore and what can be done about it. By Emily Pettit hile snoring is commonly thought of as an annoying habit that can just be laughed off, it could actually be a sign of one or more health hazards – not just those received when your exhausted partner unleashes their frustration in the middle of the night, but also unhealthy lifestyle choices or underlying disease.
Why do some people snore?
‘Snoring is caused by a blockage in the airway,’ explains Dr Ridwaan Essa, an ear, nose and throat (ENT) specialist at Life Roseacres Hospital. ‘The airway includes the mouth, nose, back of the mouth, back of the nose and voice box. The blockage narrows the airway, resulting in air turbulence, which produces the snoring sound.’ In children, large adenoids and tonsils are a common cause; in adults, physical causes are poor tone or fat mass in the neck that cause a collapse in the airway. Lifestyle factors that increase the chance of snoring, explains Dr Mark Richardson, ENT specialist at Life St James Hospital, include a lack of exercise that results in
weight gain, smoking and drinking alcohol before sleeping – which decreases upper airway muscular tone. ‘The effects of a poor lifestyle will have their own impact on the cardiovascular system, which can aggravate snoring.’
What is sleep apnoea?
The World Health Organization (WHO) defines sleep apnoea as a clinical disorder that causes frequent pauses in breathing during sleep, usually accompanied by loud snoring. The pauses cut off the oxygen supply for a few seconds, which jolts the brain awake and reopens the airways. It can occur multiple times a night. ‘Someone suffering from sleep apnoea will recurrently have blood-pressure and heart-rate spikes at night. After many years, this can lead to high blood pressure and diabetes and could progress to strokes and heart disease,’ says Dr Essa. All patients with sleep apnoea snore, but not everyone who snores has sleep apnoea. ‘Sleep apnoea is a medical condition that needs treatment, but snoring can just be monitored,’ he adds.
Treatments and management
Should someone be concerned about their snoring, an ENT specialist will suggest a nasopharyngolaryngoscopy – a long word for a medical procedure that uses a flexible fibre-optic endoscope to view any possible obstructions in the nasal passages. This can be done in the consulting room or under general anaesthetic. ‘Once the patient is examined thoroughly, we can provide a definitive diagnosis and management,’ says Dr Richardson. ‘A number of patients benefit from upper and lower gum guard equivalents, which advance the lower jaw and tongue forward during sleep to decrease obstruction and increase airflow – however, lifestyle changes are the most important management tool for snoring,’ he advises. So, more exercise, less alcohol and quitting smoking are all part of the recipe for a quiet night. Sleep tight!
HOW TO RECOGNISE SLEEP APNOEA:
• Waking up more sleepy than usual or with a headache • Daytime sleepiness – dozes off easily • Poor memory or concentration • Irritability or moodiness • Partner mentions choking while the person is sleeping
MEET OUR EXPERTS Dr Mark Richardson is an ear, nose and throat (ENT) specialist who operates mainly from Life St James Hospital. He performs all surgeries there, from tonsillectomies and grommet to navigation sinus surgery and coblation surgery. Dr Ridwaan Essa is an otorhinolaryngologist at Life Roseacres Hospital, where he helps patients with ear, nose and throat problems. He is also a head and neck surgeon, operating on growths in the neck.
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EVERYBODY’S TALKING ABOUT...
DO YOU CONSTANTLY FEEL OVERWHELMED BY YOUR EMOTIONS? Does it feel like you cannot switch off the bad thoughts running through your mind? You could be one of 300 million people globally affected by mental illnesses such as depression1
HELP IS AVAILABLE! Life Mental Health is a leading provider of mental healthcare services in South Africa at nine dedicated facilities across four provinces. The mental healthcare services offered at these facilities include general psychiatry, treatment of substance dependence and other addictions related to psychiatric disorders. 1
To find out more, contact 011 219 9626 or email email@example.com
POWER OF FIVE
THINGS YOU SHOULD KNOW ABOUT LIVING WITH DISABILITY
People living with disability have the same healthcare needs as others. By Samantha Page
The World Health Organization (WHO) defines disability as a term referring to physical or emotional impairments as well as other participating and activity limitations. Disability also involves how a person with a health condition interacts with the factors in their environment. The South African government states that a disability can be physical, mental, cognitive, sensory, emotional or developmental, or a combination of these.
People living with disability across the world largely remain marginalised because of stereotyping, traditional beliefs and ignorance. The WHO estimates that 10% of the world’s population consists of people with disabilities, with the majority of these in developing countries. Some common challenges are: •L ack of employment opportunities •L ack of proper health facilities • Stereotyping and discrimination •L ack of access to essential services • Expensive support equipment
he following divisions T have been made from a population figure in South Africa of 40 583 573
Visually impaired: 1 091 022 Hearing impaired: 383 408 Physically impaired: 55 774 Mentally impaired: 192 554 (Source: Statistics SA)
Living with disability Take a moment to think about life from the viewpoint of a person with disability. The world is full of challenges – even for people without disabilities. Here are some small changes that can make a big difference: Do • As an employer, create working environments that include, accept and develop people living with disabilities. • Reach out to a person with disability so that you understand their challenges. • Use the appropriate language: person with disability. Don’t • Park in a bay reserved for a person with disability. • Feel sorry for a person with disability; it can lead to patronising behaviour. • Assume you need to help a person with disability perform their tasks because you think they might not get them done on their own.
ssistive devices can enable A people with disabilities to be independent.
• 70 million people worldwide need a wheelchair. • Only 5–15% have access to one. • 360 million people globally have moderate to profound hearing loss. Production of hearing aids only meets: • 10% of global need •3 % of developing countries’ needs (Source: World Health Organization World Report on Disability)
I M A G E S F R E E P I K . S O U R C E S M AY O C L I N I C , H E A LT H X C H A N G E . S G , H E L P G U I D E , B U S I N E S S L E A D E R , F O R B E S
The national disability prevalence rate is 7.5% in South Africa, with disability more prevalent among females (8.3%) than males (6.5%).
AN APPOINTMENT WITH...
DR YUSUF DASOO
A fertility specialist at Life Brenthurst Hospital spoke to Erin Coe about the struggles of infertility and how important early treatment is, and his favourite ways to relax
What is a fertility specialist?
A fertility specialist is a doctor who specialises in treating couples that have difficulty falling pregnant or are unable to fall pregnant. My speciality is often confused with gynaecology, but the two are very different, as the latter is more concerned with medical issues related to the female reproductive system and breasts. A gynaecologist would refer a patient to a fertility specialist if they suspect infertility.
Are there other specialists with whom you consult?
We always have an in-house psychologist, as both the condition of infertility and the treatment of it are often an emotional roller coaster, and patients benefit from some psychological counsel.
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How common is infertility in SA?
It’s very common in South Africa and throughout the world. The quoted incidence is that it occurs in 15% of couples in the reproductive age group (age 15–45). In sub-Saharan Africa, that percentage can increase to around 20–25%. The problem with getting proper statistics is that very often patients who suffer from infertility find it difficult to seek help and are not diagnosed at all. This is due to a lack of access. There are only three facilities in South Africa in the public sector that can assist couples with infertility problems. Even if you include private fertility clinics, there are simply not enough to serve the number of patients that have fertility problems.
How important is early treatment of infertility?
Your peak fertility potential is between 20 and 30 years of age. Once you reach 35, there is a distinct decrease in your natural ability to fall pregnant. Even with fertility treatment, the success rate is highly dependent on age. The earlier you seek assistance, the better the outcome.
What success story sticks in your mind the most?
A couple who had been trying to fall pregnant for more than 15 years had undergone many treatment cycles and, despite going to several clinics in South Africa and travelling to the UK and the USA, they were still unsuccessful. Their issue was that the husband had no sperm. Even after a testis biopsy, they were unable to get sperm and, owing to their religious beliefs, they were not willing to accept donor sperm. I told them that it was unlikely that I would be able to help since they seemed to have exhausted all the options.
SCHEDULING IN SOME DOWNTIME >> My favourite way to relax is going away on a beach holiday – away from crowds and noise. >> I feel restored by spending quality time with family and friends. >> My three components for relaxation are television (boring, but therapeutic), a good meal and time at home. However, we tried a new approach – using immature sperm. These were injected into the eggs, and to all our surprise we got fertilisation and an embryo developed. Even at this stage we were not too optimistic, but they fell pregnant! They now have a lovely six-year-old child and every year we get a thank you card from them with a picture. These success stories, against all odds, keep me motivated to continue helping infertile couples in their journey to have a baby.
MEET OUR EXPERT Dr Yusuf Dasoo is a fertility specialist at Life Brenthurst Hospital practising at the BioART Fertility Centre. He has a special interest in endoscopic surgery and treating endometriosis and infertility.
YOUR TIME IS THE MOST VALUABLE THING YOU HAVE Thinking about volunteering to make an impact in your community? SAYes is recruiting mentors for our 2020 Programmes. At SAYes we train and support you to use your life experience in an invaluable one-to-one mentorship programme. Visit sayesmentoring.org to learn more and to register.
www.sayesmentoring.org Inspiring leaders of social change
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WHAT DOESN’T KILL YOU…
Everyone experiences hardship and challenges at some point, but adversity is not necessarily a bad thing – in fact, some researchers believe that the tough times can make you more resilient. ‘There’s a difference between coping and being resilient,’ says Patrick Dolan, professor of sociology at the National University of Ireland in Galway, who researches resilience. ‘Coping is what we do in everyday life. Resilience is going a step further.’ Professor Dolan cites a study in which men who had experienced stressful events during adolescence had developed coping skills that made them more resilient adults. Those who encountered few or no difficulties at all were more vulnerable to depression, anxiety and mental health issues. If you find yourself going through a particularly difficult time, instead of lamenting the reality, see the experience as an important life lesson with far-reaching benefits.
IT FEELS GOOD
INTERNATIONAL VOLUNTEER DAY IS 5 DECEMBER. Giving of your time is good for your health!
Practising philanthropy has countless benefits for both the recipient and the benefactor. Jabulile S. Ngwenya finds out more about the positive impact of giving
rom improving cardiovascular health and lowering stress to boosting self-confidence and dealing with depression, ‘this little prescription has the side effect of benefiting the helper,’ says Stephen G. Post in his book The Hidden Gifts of Helping: How the Power of Giving, Compassion, and Hope Can Get Us Through Hard Times. ‘Research in the field of health psychology, and all the great spiritual traditions, tells us that one of the best ways to get rid of anger or grief is to actively contribute to those around us. Science supports this assertion: giving help to others measurably reduces the giver’s stress; improves health and wellbeing in surprising and powerful ways; renews our optimism about what is possible; helps us connect to family, friends and lots of amazing people; allows the deep, profound joy of our humanity to flow through us and out into the world; and improves our sense of self-worth.’
Acts of love
People around the globe feel called to extend themselves to others. In fact, according to the Charities Aid Foundation (CAF) World Giving Index 2018, it’s possible the world is becoming a more generous and caring place. The survey was performed with more than 150 000 people in 146 countries over a five-year period (2013–2017), and the results were inspiring and uplifting. In developing countries, there is a growing trend towards volunteering help towards strangers in lieu of donating money – while the latter practice has increased in developed countries. Volunteering time, however, had similar participation levels across both developed and developing countries.
Healing while helping
Pre-admission clinical assessor and Community Improvement Programme chairperson at Life Vincent Pallotti
Johanna Benzant is energised by volunteering
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Life Healthcare’s employee-involvement programme Life Sizanani has existed for over 15 years, with more than 78 ongoing projects and a high level of employee engagement. Life Healthcare magazine spoke to a few employees about their volunteering experience.
Hospital Johanna Benzant can speak first-hand about the impact such giving has had on her life. ‘Volunteering changes your life because there is no greater feeling than doing something good for someone who needs and deserves it. You see opportunities that you might have missed and your eyes open to the world and its needs.’ As someone who survived breast cancer, Johanna believes that there is healing in pushing past your own reality.
something for someone without getting paid. Choosing issues to champion helps you feel a deeper sense of connection to the world and to yourself. • I t helps you build relationships: in the 21st century, one of society’s most urgent needs is real connection. Technology can make people feel lonely at times, which is why working alongside people and establishing bonds in person, keeps depression and anxiety in check.
Three immediate benefits
Find the right volunteering opportunity for you:
You don’t need to be rich to volunteer. Simply start with what you have – your personality, your time and your skills. • I t’s good for your health: according to Psychology Today magazine, those who volunteer are happier and healthier than non-volunteers, especially people who volunteer later in life. • I t gives you a sense of purpose: the essence of volunteering is to do
• Know what skills and talents you bring to the table. • Identify the opportunity you want. • Find out if there is a real need and ensure the organisation has been vetted. • Determine how much time you are able to commit. • Start small, then build on your achievements.
Jolandi de Villiers, social worker and volunteer at the Life Rehabilitation Unit at Life Vincent Pallotti Hospital ‘It is great to be able to inspire my family and my colleagues to also play a part in improving the lives of others around them with small acts of kindness. It is not about what you give, but the attitude with which you give.’ Danielle Mengo, ward clerk at the Life Rehabilitation Unit at Life Vincent Pallotti Hospital ‘It’s better to give than to receive. If you think that your life is difficult and you’re drowning in problems, and you get to see what others are going through, you realise that yours is actually a molehill against that person’s mountain.’ Cathy de Gruchy, trauma admissions clerk at the Life Rehabilitation Unit at Life Vincent Pallotti Hospital ‘I enjoy helping the less privileged and making a difference in their lives. You don’t realise how many underprivileged people there are until you get involved.’
Cholesterol-laden plaque (called atherosclerosis) causes narrowing of coronary arteries and heart attacks occur when one or more plaques rupture, leading to blood clot formation and sudden artery blockage. Age, sex, genetics, high blood pressure, high blood cholesterol, diabetes, smoking, obesity and a sedentary lifestyle are all risk factors for atherosclerosis.
Stable angina (the most common form of angina) is caused by atherosclerosis, leading to insufficient blood getting to the heart muscle when there is an increased need, but resolves with rest.
An unexpected squeezing or burning pain in the middle of the chest, which can spread up to the neck and/or arms and is often accompanied by a feeling of impending doom, nausea and sweating. There can be variations to this pain, particularly in women and diabetics.
A dull, squeezing or burning pain in the middle of the chest that may spread up to the neck and/or arm, usually precipitated by physical effort or emotion and subsiding with rest.
Requires immediate medical attention whereby electrical tracings of the heart rhythm, blood tests and an angiogram will be performed, after which a coronary stent (small tube) can be implanted, if necessary. Modifiable risk factors (such as blood pressure, cholesterol, diabetes and lifestyle choices) must also be monitored and treated with medication (such as aspirin and statins) and lifestyle interventions (such as weight loss and quitting smoking).
Medication, and possible implantation of coronary stents or coronary bypass surgery. Modifiable risk factors must also be monitored regularly and treated with medication and lifestyle interventions.
Leading a healthy lifestyle and treating risk factors for atherosclerosis, which includes maintaining a healthy weight, avoiding smoking, following a healthy diet (such as the Mediterranean diet), getting quality sleep, reducing stress and regular blood pressure, and cholesterol and diabetes screenings and treatment.
Leading a healthy lifestyle and treating risk factors for atherosclerosis.
MEET OUR EXPERT Dr Brad Griffiths is an award-winning cardiologist, offering a comprehensive cardiology service at Life Vincent Pallotti Hospital. He has worked extensively in South Africa and Australia, regularly presents at cardiology congresses worldwide and has had work published in a number of local and international journals. 52
While causes of chest pain can differ, it is always advisable to seek medical help when doctor for a proper assessment,â€™ advises Dr Brad Griffiths, cardiologist at Life Vincent
MY CHEST PAIN?
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Causes of chest pain can range from serious to harmless, but how can you tell the difference? Julia Lamberti-Morreira consults our expert on the most common types of chest pain
Stretching or tearing of chest muscle fibres as a result of sports injuries, poor posture, falling, a severe cough or overuse of muscles.
A result of viral, bacterial or occasionally fungal infections, which affect the lung’s larger airways (bronchitis) or the smaller air sacs lower down in the lungs (pneumonia).
Ulcers, acid reflux, stomach infections, irritable bowel syndrome, pancreatitis (an inflamed pancreas), pregnancy hormones, certain diseases or medications and lifestyle choices such as eating too much or too quickly, drinking excessive alcohol, smoking, stress and fatigue.
Depending on the severity, injured chest wall muscles may lead to sharp pain or dull pain, swelling, muscle spasms, difficulty moving the area, bruising and pain while breathing.
A chesty cough (with green or brown phlegm), breathing difficulties, chest pain or tightness, high temperature, headache, muscle aches and pains, fatigue and rapid heartbeat.
Heartburn, an acidic taste, bloating, fullness during or after a meal, stomach growling, belly pain, burning in the stomach or upper belly, belching, gas, nausea or vomiting.
Rest from physical activity, applying ice, anti-inflammatory drugs, stronger analgesics or muscle relaxants. Physical therapy or even surgery to repair torn muscle may also be recommended.
Bacterial chest infections are treated with antibiotics, but viral infections clear on their own. Hospital admission may be required for severe infection, but taking medications as directed, drinking fluids, rest, using a humidifier or steaming, elevating the head while sleeping and avoiding smoking generally ease symptoms.
Antacid medications or other treatment options may be prescribed, such as proton pump inhibitors, prokinetics, antibiotics, antidepressants or anti-anxiety medications.
Frequent hand washing, disposing of used tissues, avoiding smoking and getting flu and pneumococcal vaccines.
Avoiding trigger foods, regularly eating smaller meals, reducing or eliminating alcohol and caffeine consumption, avoiding certain pain relievers (such as aspirin and ibuprofen) and controlling stress and anxiety.
Warming up and cooling down before and after exercise, proper posture, strengthening core muscles, avoiding excessive exercise and using correct training techniques.
in doubt. ‘I would definitely recommend that any person suffering from recurrent or persistent troubling chest pain visit their Pallotti Hospital in Cape Town. ‘And especially in the case of a heart attack, as time is muscle…’
pâté noek pe s jam a C ked cot Smo with apri
th wi tĂŠ m Ă˘ p a ut cre tro our d s e ok nd Sm dill a
an: ranee love to eat
M e e p d a ith ter C e
Mediterranean cooking developed naturally within the Western Cape due to the climate of the region and the abundance of classic Mediterranean-style local produce. Ilse van der Merwe shares a few recipes from her latest book
Smoked Cape snoek pâté with apricot jam When I make snoek pâté, it is often with leftover braaied snoek, which already contains that little bit of sweetness. The best snoek pâté, however, is made with hot-smoked snoek, which you can buy in most supermarkets almost year-round. INGREDIENTS • 2 cups (500ml) flaked smoked snoek (boneless, skinless) • 1 tub (230g) plain cream cheese • 1–2 tbsps (15–30ml) freshly squeezed lemon juice • A generous handful fresh Italian parsley, finely chopped • 2 tsps (10ml) smooth apricot jam (or more, to taste) • Salt and freshly ground black pepper, to taste METHOD 1. Place the snoek, cream cheese, lemon juice, parsley and jam in a medium-sized mixing bowl and mix well (use a food processor or electric beater). Taste and season accordingly – sometimes snoek can be quite salty already, so be careful with the salt. 2. Spoon into a ramekin or pâté bowl and smooth the surface with a spatula. I use kitchen paper to clean and neaten the edges, then cover the bowl with plastic wrap and refrigerate until ready to serve. 3. This pâté should keep in the fridge as long as the ‘best before’ date on the smoked snoek packet. If you’ve made your own smoked snoek using fresh fish, the pâté should last at least a week in the fridge.
Smoked trout pâté with dill and sour cream This easy recipe gets rave reviews every time. Hot-smoked trout keeps fresh in the refrigerator for up to 10 days, so it’s a great make-ahead snack for when you’re entertaining a crowd or when you’re planning a more extensive festive menu. INGREDIENTS • 2 cups (500ml) flaked hot-smoked trout (skinless, boneless) • 1 tub (250g) thick sour cream • 2 tbsps (30ml) mayonnaise • 1 tbsp (15ml) freshly squeezed lemon juice • A small handful fresh dill, finely chopped • Salt and freshly ground black pepper, to taste METHOD Place all the ingredients in a medium-sized mixing bowl and, using a fork, mix by hand to the desired consistency – I like mine quite chunky. Taste and adjust the seasoning, if necessary. Transfer to a clean ramekin and refrigerate until needed.
MAKES 2 LARGE
MAKES 4 MEDIUM
MAKES 8 SMALL
When the flatbread is rolled out and placed on a lined baking tray, you can add the following toppings before baking to create a more exotic flatbread.
Bread may have gained a bad reputation in an era of Banting, but if you’re not officially allergic or intolerant, I urge you to buy a packet of stoneground, unbleached, locally produced flour and try baking your own.
ZA’ATAR • 1 tsp (5ml) dried origanum • 1 tsp (5ml) dried thyme • 1 tsp (5ml) ground cumin • 2 tsps (10ml) fennel seeds • 1 tsp (5ml) ground coriander • 1 tsp (5ml) ground sumac • 2 tsps (10ml) sesame seeds • 1 tsp (5ml) salt flakes • 1 tbsp (15ml) olive oil
INGREDIENTS • 2 cups (300g) stoneground white bread flour • 2 tsps (10ml) instant dry yeast • 1 tsp (5ml) sugar • ½ tsp (2.5ml) fine salt • ¾ cup (200ml) lukewarm water • 1 tbsp (15ml) extra-virgin olive oil, plus more for oiling the bowl
Mix all the dry ingredients. Use a pastry brush to brush olive oil over the rolled-out dough, then sprinkle the za’atar spice blend generously over it and bake until golden. ONION AND ROSEMARY • Rounds of red onion (or white onion), thinly sliced • Fresh rosemary, finely chopped • Salt flakes and freshly ground black pepper, to taste Arrange the sliced onions in strands all over, sprinkle with rosemary, season with salt and pepper, then bake until golden. GARLIC AND FETA • 3 cloves garlic, finely grated • 1 tbsp (15ml) olive oil • 1 round (50g) feta cheese Mix the grated garlic with the oil in a small bowl. Use the back of a spoon to spread it onto the rolled-out dough to cover the whole surface, then crumble the feta all over. Bake until golden.
METHOD 1. Using a spoon, mix the flour, yeast, sugar and salt in a large bowl. 2. Add the water and oil and mix with the spoon until it starts to clump together, then mix with clean hands to form a dough. 3. Knead the dough for 5–7 minutes until it is very smooth (I turn it out onto a clean working surface for better access to kneading space). Shape into a ball and then place in an oiled bowl, cover with a plastic bag and leave to rise in a warm place until doubled in size (about 30 minutes). Preheat the oven to 230°C. 4. Turn out the dough onto a floured surface, then divide into two balls. Roll out each ball into a circular or oval shape, about the size of a large dinner plate (or bigger, depending on your desired thinness). 5. Place the flatbread circle on a large baking tray lined with nonstick baking paper (it’s not necessary to dust it with flour), drizzle with some olive oil and sprinkle with salt flakes. Bake for 7–9 minutes or until golden brown and puffy in places. 6. Serve immediately (break off pieces or slice with a knife).
Pavlova with lemon curd and passion fruit A pavlova is such a wonderful way to end a festive lunch or dinner and the toppings can be changed seasonally. And because you’re using six egg whites for the meringue, you might as well make a silky lemon curd with the yolks. INGREDIENTS • 6 extra-large egg whites (save the yolks and make lemon curd*) • 400g castor sugar • 2 tsps (10ml) white vinegar or lemon juice • 1 tbsp (15ml) cornflour • 1 tsp (5ml) vanilla extract (or scraped seeds of 1 vanilla pod) • 1 cup (250ml) fresh cream, whipped • 1 cup (250ml) lemon curd, for topping • Pulp of about 4 fresh passion fruits (granadillas)
Cook’s note: Pavlova must be assembled just before serving as it becomes soggy on standing. Store the unassembled baked meringue on the baking tray, covered with a sealed large plastic bag. It can be baked a day ahead if stored in an airtight container.
MAKES 2 CUPS
INGREDIENTS • Peeled rind and juice of 3 medium-sized lemons • 1 cup (250ml) white sugar • 180g soft butter • 4 extra-large eggs (or 6 extra-large egg yolks) • A pinch of salt METHOD 1. Place the peeled rind and sugar in a food processor and process until it becomes a very fine, yellow, grainy mixture. Add the butter and blend until light and creamy. Add the eggs and salt and mix well, scraping the sides of the
bowl. Add the lemon juice and mix until smooth. 2. Transfer to a small saucepan over very low heat. Stir continuously while it heats up (take care, it burns easily). The mixture will at first become runnier as the butter starts to melt, and then it will thicken again as the eggs form a glossy custard. 3. Never allow it to reach boiling point. If at any stage it looks like it’s burning, remove from the heat at once and strain to remove any brown bits. 4. Remove from the heat and transfer to a glass jar with a lid. Cool and refrigerate until ready to use. (Note: For an ultrasilky result, strain the hot mixture before cooling.) Best served at room temperature – spread it on cakes or cookies, or serve with meringues (Eaton mess-style) and on pavlova (with whipped cream and toasted almonds).
I M A G E S TASHA SECCOM B E
METHOD 1. Preheat the oven to 150°C. 2. Whisk the egg whites in a large bowl (using an electric whisk or stand mixer with whisk attachment) until soft peaks form. Gradually add the castor sugar to the egg whites, small amounts at a time, whisking constantly until the mixture is stiff and glossy. Add the vinegar or lemon juice, cornflour and vanilla and mix well. 3. Dot a large roasting tray with some of the mixture, then place a sheet of baking paper on top (so that it sticks like glue). Pour the pavlova mixture onto the tray and shape with a spoon or spatula into a circle with a diameter of about 23cm (draw a circle on the back of your baking paper, if necessary). The mixture will rise a bit around the sides, so leave enough space. 4. Place in the oven and immediately turn down the temperature to 120°C. Bake for 1¼ hours, then switch the oven off and allow to cool in the oven for about 2½ hours without opening the oven door. 5. To serve: carefully remove the baking paper from the bottom of the pavlova and transfer to a serving dish (it will have a few cracks, but that’s fine). Top with whipped cream and lemon curd, swirling the cream and curd together softly. Top with lashings of passion fruit pulp and serve at once, sliced.
Pan-fried calamari tentacles with chorizo, olive oil, lemon and herbs The flavour of this dish is quite dependent on the quality of the chorizo, so buy the best you can afford and you’re pretty much there already.
• 1–2 tsps (5–10ml) smoked paprika • 1 tsp (5ml) dried chilli flakes (optional) • juice of 1 lemon (or more) • A large handful fresh parsley and/or coriander, roughly chopped • Salt and freshly ground black pepper, to taste • A loaf of fresh rustic bread, for serving
INGREDIENTS • 2 tbsps (30ml) extra-virgin olive oil (plus 3 tbsps (45ml) more for drizzling at the end) • 200g good-quality chorizo, skin removed, sliced into thin half circles • 500g frozen baby calamari tentacles, cleaned and thawed
METHOD 1. Heat a large, heavy-based pan or iron skillet until very hot. Add the oil and fry the chorizo, stirring quickly until it starts to brown. Add the calamari, paprika and chilli flakes and fry over high heat, stirring, for 1–2 minutes until just cooked. 2. Remove from the heat, add the lemon
juice, more olive oil and parsley and/or coriander. Stir, loosening any sticky bits on the bottom of the pan, if any. Test for seasoning, then add salt and pepper to taste. You’re looking for a result that is not soupy, but instead ‘wet’ with punchy, red, herbacious, lemony oil and liquid around the calamari to enjoy with your bread. 3. If your pan is not hot enough, the calamari will release a lot of moisture and it will just simmer instead of fry. If this is the case, drain some of the liquid and continue over very high heat to reduce it before adding the lemon juice and other ingredients. Be careful, though, not to overcook the calamari while trying to reduce the liquid – it can become rubbery.
GIVEAWAY! Life Healthcare is giving away two copies of Cape Mediterranean. To stand a chance to win, email firstname.lastname@example.org with ‘Cape Mediterranean’ in the subject line by 31 January 2020. This is an extract from Cape Mediterranean (Penguin Random House, RRP R360). Our recipes are printed with the understanding that readers will make their own determination, including seeking advice from their doctor or dietitian, as to the suitability of the recipes, ingredients, quantities or portion sizes, especially if they have a pre-existing medical condition or are on a strict eating plan recommended by a qualified medical professional.
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LIGHTING THE WAY TO
ENVIRONMENTAL SUSTAINABILITY Life Healthcare recently expanded its solar installation to include Life Cosmos and Life Springs Parkland Hospitals. By Samantha Page olar power converts energy from the sun into usable energy either directly, using photovoltaics (PV), or indirectly using concentrated solar power, or a combination of the two. As part of its environmental sustainability initiatives, Life Healthcare continues to harness sunlight to cut carbon emissions and supply its hospitals with power without relying too heavily on the national energy grid. ‘Sustainability is an integral part of how we do business,’ says Bhekisisa Ngobese, Group Engineering Manager for the Life Healthcare Group. ‘Life Healthcare’s sustainability programme was established in 2013 in response to increasing energy costs, as well as the business commitment to responsible citizenship. Our strategy now also aligns with the United Nations Sustainable Development Goals,’ adds Ngobese.
I MAG ES GALLO/GETTY IMAGES, SUPPLIED
New energy solutions Life Anncron Hospital, in Klerksdorp, was the first Life Healthcare hospital to use solar power and, following the success of the project, three other hospitals also received installations: Life Fourways Hospital in Johannesburg, Life Eugene Marais Hospital in Pretoria and Life Wilgers Hospital, also in Pretoria. Life Cosmos Hospital in Witbank/Emalahleni, and Life Springs Parkland Hospital in
Springs, Johannesburg, are the most recent hospitals in the Group to have solar panels installed. A positive contribution The project at Life Cosmos Hospital consisted of 473 roof-mounted panels at a total power production of 519.03 kilowatt peak (kWp), yielding approximately 63 500 kilowatt hour (kWh) of energy per month. This is equivalent to 16% of the total energy consumption of Life Cosmos Hospital. In addition, this system saves 759 tons of CO2 and 1.1 million litres of water, and conserves 3 200 trees. Life Healthcare has identified several additional energy efficiencies, and the Group continues to investigate other sustainability opportunities. ‘A 10% energy-reduction target has been set over a five-year period, but we intend to
LIFE PLUS LIFE FOURWAYS HOSPITAL EXPANSION PROJECT The 580 kilowatt peak (kWp) Life Fourways Hospital solar (PV) project was commissioned in October 2016, and in 2019 the existing system was upgraded from a capacity of 581.50 kWp to 1 019 kWp (i.e. 1 MWp), making the installation at Life Fourways Hospital the biggest in the Group. The system yields a total energy of 135 000 kWh, which is equivalent to 32% of the total energy used by Life Fourways Hospital. entrench a culture of environmental awareness and continually strive for further efficiencies,’ says Ngobese.
SOLAR POWER COMES TO LIFE SPRINGS PARKLAND HOSPITAL
kWp The total power production of the entire solar system
Panels for the parking lot shade system Equivalent to
The amount of energy the system is set to yield every month
tons of CO2 saved
of Life Springs Parkland Hospital’s total energy consumption
1 397 000 litres of water saved
PUZZLE THIS... Test your mental agility with our brain-teasers
How well do you know your Christmas movies? Test your knowledge here
1. Which movie features Bruce Willis as John McClane, taking on a gang of criminals in a Los Angeles skyscraper on Christmas Eve? a. Die Hard b. Hostage c. Pulp Fiction 2. Who starred as Kevin McCallister in Home Alone? a. Jacob Tremblay b. Iain Armitage c. Macaulay Culkin 3. In which Christmas movie does Jim Carreyâ€™s character try to ruin Christmas for the people of Whoville? a. The Grinch
b. The Ghosts of Christmas Past c. Last Christmas 4. In which 2003 Christmas romantic comedy does the character Natalie fall in love with the British prime minister, played by Hugh Grant? a. Falling in Love b. Love Actually c. When a Man Loves a Woman 5. Which Hollywood actor played six roles in the Christmas movie The Polar Express, including Santa Claus, the conductor and the narrator? a. Tom Hanks b. Jim Carrey c. Robin Williams
Difficulty level ***
TRIVIA SOLUTIONS 1 (a) 2 (c) 3 (a) 4 (b) 5 (a)
Use the 15 tiles in this bunch to create words that fit into the grids below. To get you started, a few tiles from the bunch have been placed. The BANANA BITES provide hints. Reuse the tiles for each grid.
BRAIN GAMES SPOT THE DIFFERENCE
WORD FUN SOLUTIONS
Can you find six differences between panel A and B?
SPOT THE DIFFERENCE SOLUTIONS bubble boy’s hair dog’s teeth brush handle mouse and tap handle
(FOR KIDS) WORD FUN
I M A G E S F R E E P I K , G A L LO / G E T T Y I M A G E S 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
Almond Apple Apricot Chocolate
Cola Cranberry Cream soda Ginger ale
Grapefruit Guava Lemon Lime
Litchi Melon Pear
DRAWING STEP BY STEP
Pulmonary arterial hypertension is a rare, progressive degenerative lung disease that causes the arteries and blood vessels in the lungs to narrow. This forces the heart to work harder to properly oxygenate the lungs, weakening it over time.
A RACE AGAINST TIME
When Jenna Lowe was diagnosed with pulmonary arterial hypertension in January 2012, it became a matter of life or death to find healthy lungs. Her mother Gabi Lowe recounts their family’s journey in her book Get Me to 21: The Jenna Lowe Story
I am in a restless, dream-filled sleep when my befuddled brain hears the distant sound of my cellphone ringing. It’s unusual for me to sleep this late. Sleep-induced fog turns to high alert, nerve endings flash hot and my heart starts thumping. I grab for the phone before I’ve even remembered where I am. For seven months I’ve been hot-wired to this phone, every cell in my body waiting for it to ring. I take it with me to the toilet, the kitchen, to do the grocery shopping ... or simply to walk down the passage to check in on Jenna, my 20-year-old daughter. I listen for it constantly, awake or asleep, and I jump involuntarily every time it rings, my heart in my throat. Whilst waiting, I barely leave Jenna’s side. I barely leave our suburb. But now, today, I am not at home. I am not there to sit on the edge of Jenna’s bed, to check her pump, to mix fresh medication, to stroke her hair, make her tea and calm her. I’m not there to check the colour of her lips and the nuances of her energy levels. I am not there. I am not at home when the call finally comes. I am six hours away up the east coast 64
in Keurboomstrand, with my younger daughter, Kristi. Yesterday I found my first-ever pansy shell in the shallow waters of Keurbooms beach and thought with a hopeful heart that this might just be a sign. Now half-awake, groggy, I answer the phone. ‘Hello? Gabs? Gabs, are you awake?’ It’s Stuart, but he sounds different, apprehensive, excited and afraid. A pause ... a deep breath. ‘Gabs, we’ve got lungs. Angela just phoned. It’s happened, Gabs. We’ve got lungs for Jen.’ Thick, hot, sticky adrenaline floods my body, my knees are weak, my heart squeezes. For 200 days we’ve planned, waited for and imagined this moment, right down to the last detail, but right now I can’t think straight. My brain is exploding. Stuart’s voice cuts through my shock. ‘Gabs!’ Then more gently and soothingly, ‘Gabs, get Kristi, pack and get on a plane to Johannesburg, now. We’ll meet you there in about four hours. I must get off the phone to make the calls we planned, but get on a plane ... fast. I’ll stay in touch. I love you.’ This is not how I imagined I’d feel… an all-consuming flood of elation and terrible dread at the same time. It’s an unimaginable feeling. This is it. Jenna’s only hope, her chance at life has
arrived. But it’s not supposed to be like this. I am supposed to be with her, and with Stuart. We should all be at home together. I am supposed to be calm. But, no matter where I am, this is it. Operation O2 has kicked into action. I throw open the bedroom door and run down the passage, cold tiles braising the soles of my feet, shouting breathlessly, ‘Kristi, Kristi! We got the call, we got the call ... Kristi, we’ve got lungs!’ Hungover teenagers emerge from their bedrooms, staring at me wideeyed. Kristi, my 17-year-old daughter, runs from her bedroom pale as a ghost, eyes wide with shock. My inner lioness kicks into action. ‘Kristi, pack your stuff. We’re leaving for the airport in 10 minutes; 10 minutes, that’s all we’ve got, okay, my love? Go!’ This is an excerpt from Get Me To 21: The Jenna Lowe Story, which is on sale at all top book retailers around the country, including Exclusive Books, Bargain Books and PNA. The book is also available online at www.jennalowe.org and at www.amazon.com After a double lung transplant, Jenna spent months in ICU, but sadly passed away on 8 June 2015.
IMAGES FREEPIK, SUPPLIED
The call – Wednesday, 10th December 2014 Keurboomstrand
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