AWARD WINNING MAGAZINE
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
POWERFUL IDEAS TO BOOST WINTER WELLNESS
BREASTFEEDING FOR BEGINNERS • BEATING WORKPLACE STRESS • CHILDHOOD CANCER • CARING FOR PARENTS
IT’S NOT JUST EFFECTIVE
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PROUDLY SOUTH AFRICAN
ED’S LET TER
A PUBLICATION BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP
Bees do it, snakes do it, even bears and bats do it – hibernate, that is – and while it’s impractical for human beings to sleep through the colder months, there is something to be said for taking inspiration from nature and pausing, resting and reflecting before pushing forward towards the second half of the year. In this month’s quiz, for example, researchers point out that to be a good listener you have to resist the urge to jump in when someone is talking to you, and instead pay attention and make a conscious effort to process what you hear. If you’re wondering about your listening skills, or want to refine them, pause and take our test on page 26. The experts also agree that you should allow yourself to press pause on your continual pace of productivity and rest because stress, particularly in the workplace, could be a bigger threat to your health and creativity than you could imagine. Read about how to counter the ill effects on page 46. But resting doesn’t mean you aren’t thinking, preparing and readying yourself for what’s to come, which is the essence of preventive medicine. Take, for example, our article about reducing the risk of dementia on page 24. Our experts encourage you to cut down your chance of getting the disease by eating a balanced diet, maintaining a healthy weight, exercising regularly and keeping your blood pressure at an optimal level. On page 52, we share some tips on how to keep your prostate in good form by, for one, scheduling regular screenings. Plotting and planning is an important part of this pause philosophy because everyone needs time to regroup and take a breath. Life at this time of year is warm and gentle and beautiful in unexpected ways and, when you stop to take stock of where you are and what you have, you’ll be amazed by how your body and soul are revived.
SAMANTHA PAGE EDITOR
EDITORIAL COMMITTEE Dr Sharon Vasuthevan, Janette Joubert, Dr Tony Booysen, Liesel van Oudenhove, Lucy Balona (CANSA), Nuraan Cader (Heart and Stroke Foundation South Africa) MANAGEMENT Managing Director Lani Carstens General Manager Joanne Hope Account Director Angela Childs Production Director Nina Hendricks Senior Financial Manager Charlton Jacobs Human Resources Business Partner Aashiqa Petersen
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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.
MUST-READ IN THIS ISSUE
IMAGE ANGIE LÁZARO
EDITORIAL Editor Samantha Page email@example.com Art Director Anelia du Plessis Managing Editor Alecia Erasmus Copy Editor Mariola Fouché Managing Editor (Life Healthcare Group) Tanya Bennetts
WHY YOU SHOULD SWITCH TO FIBRE
WHEN A CHILD IS DIAGNOSED WITH CANCER
MUST LOVE DOGS
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.
THIS MONTH’S FOCUS: FINDING BALANCE NEW UNIT ADDRESSES SOUTH AFRICA’S 12 AGROWING OBESITY PROBLEM Take a tour of Life Groenkloof’s new Bariatric and Metabolic Unit By Emily Pettit
14 NURSE YOUR HEART BACK TO HEALTH
After a heart attack, a cardiac rehabilitation programme can prevent a recurrent attack By Pippa Naudé
16 ‘I HAVE A NEW OUTLOOK ON LIFE’
Thanks to an organ transplant, this patient is able to share his remarkable journey By Lynne Gidish
18 HEALING FROM INCONTINENCE
It’s uncomfortable and embarrassing, but you can manage the condition By Charlene Yared-West
20 WHY YOU SHOULD SWITCH TO FIBRE
Consuming more fibre could be the secret to improved health By Sam Brighton
23 WHEN PARENTS AGE 7
01 04 OVER TO YOU 08 NEWS LIFE IS…
A note from the editor
Letters from our readers
The latest medical innovations, health information and ideas for living well
If your ageing parents are finding life difficult, it might be time to step in By Jolandi de Villiers
24 REDUCING THE RISK OF DEMENTIA
There’s good evidence that lifestyle changes can lower your risk By Julia Lamberti-Morreira
26 ARE YOU A GOOD LISTENER?
Take our test and find out if you are an actively engaged listener
28 EASING JET LAG
How to reset your body clock when you’re flying into a new time zone By Ryan Scott
WHEN A CHILD GETS CANCER
How to deal with every parent’s nightmare diagnosis By Glynis Horning
INNOVATING THE PRIMARY HEALTHCARE EXPERIENCE
A primary healthcare clinic that delivers affordable, quality care By Carla Hüsselmann
YOUR PHARMACEUTICAL A–Z
Need help with decoding your prescription or medication? By Mandy Collins
42 BREAST REALLY IS THE BEST
It can take weeks to get comfortable breastfeeding, but here’s a guide By Melanie Farrell
44 EVERYBODY’S TALKING ABOUT…KETO
What you need to know about this diet By Emily Pettit
AFRICAN FLAIR FOR 46 5 WAYS TO BEAT WORKPLACE STRESS 54 SOUTH SOUTH AFRICAN FARE
Anxiety about work could be a bigger threat than you think By Ruth Mwakanandi
WITH… 47 ANDR APPOINTMENT WENDY DHLOMO
gynaecologist/obstetrician from A Life The Crompton Hospital By Erin Coe
Delicious recipes from The Lazy Makoti’s Guide to the Kitchen by Mogau Seshoene
61 OUR HERO
How RN Veronica Visagie saved a neighbour’s life
62 MIND GAMES
50 MUST LOVE DOGS
64 SAVING THE WORLD, SAVING A LIFE
Take a break with our crossword puzzle, sudoku and word games
Life Healthcare’s animal-assisted therapy programme gets two new eager recruits By Emily Pettit
CANCER IS NOT 52 PROSTATE A DEATH SENTENCE
he inspirational story of how T a 16-year-old high-school student overcame health obstacles to win the grand prize at one of Google’s International Science Fairs
What men need to know about risk factors, symptoms and treatments By Trevor Crighton
OVER TO YOU
In short… The hospitality here at Life St Joseph’s is great. All the patients are treated with respect and care, which I admire. The facilities are clean and the food is good, so I have no complaints. I like eating in the dining hall so that the patients can socialise and make friends. I can recommend this hospital to anyone who needs rehabilitation and dedicated care. Sharon Munien, Morningside
A BITTERSWEET ENCOUNTER Miss T is a young Zulu teenager, who has resided with her mom on our property for the past 15 years. Miss T attends the local high school, and in January this year, shortly after arriving home from school, she came into the main house and told us she wasn’t feeling well. After a quick examination and plenty of questions, we established that she had been offered a cupcake at school. By this time, her speech was slurred, her eyes were vacant, she battled to stay awake, and her heartbeat was erratic, so we decided to rush her to Life Bedford Gardens Hospital. From the moment we walked into casualty, we were amazed at the concern of the staff. The nurses and doctor on duty were so kind and explained to Miss T what they were doing, every step of the way. A urine sample established that there definitely was cannabis present in the cupcake Miss T ingested at school. Miss T was treated accordingly, and when her heartbeat stabilised, we were able to take her home. The matter was dealt with immediately by her school, but we are so grateful to Life Bedford Gardens Hospital for their caring attitude, professionalism, discretion and concern for Miss T all the time she was under their care, turning a frightening experience into a positive result. Lynn Moolman, Gauteng
I was recently a patient at Life Vincent Pallotti Hospital for a coronary angiogram, done by Dr Adrian Horak. His professional leadership and skills, and those of the catheter lab staff, were impressive. The care I received from the nursing staff in Birch ward was also excellent, for all of which I am most appreciative. My wife and I noted with interest and pleasure the gentleness and courtesy of all the staff, including the ward cleaners. I have had similar procedures in two major hospitals in Canada and it was most gratifying to experience a world-class level of care and expertise at Life Vincent Pallotti Hospital. It is a privilege to be a healthcare professional and it gave me great satisfaction to be the recipient of care in the best tradition of medicine. Professor Solomon R Benatar, Cape Town
ART IN ACTION
They say that first impressions are lasting impressions and that is how I feel about Life Poortview Hospital. I received an excellent reception and I was given a bed within minutes. The daily activities were inspiring and educational as well as being motivational and therapeutic. Occupational therapist Pillay was amazing and helped us to create the most beautiful stuff. The activities also helped to stimulate my thinking and ignite my creativity. I got to make a necklace and earrings, which you can see in the picture. Thank you, Life Poortview Hospital. You deserve an A+ on every level. Lucky Mahlangu, Gauteng
At the end of last year, I was in labour at Life Chatsmed Hospital for 16 hours, and during the entire time the staff were caring, understanding and helpful. They encouraged me when I felt like I had had enough. I had a beautiful baby boy, and I’m so grateful to the doctors and nurses for a safe delivery. Laura Moodley, Durban I recently read your Life Healthcare magazine, and it was very interesting and informative. I especially loved the article about Professor Bongani Mayosi. His death has left a void in the medical fraternity. No one could ever replace his personality, intelligence, passion and zeal – he was irreplaceable. Shaun Kepeyi, East London
Lifegain®, the nutritional supplement formulated to help patients regain physical and emotional wellbeing, has added a delicious chocolate flavour to its vanilla, strawberry and cappuccino shakes. At just over R12 per serving, Lifegain® is high in energy as well as protein from a triple protein blend. Twenty-four vitamins and minerals, glutamine, fibre and essential fatty acids support immune and digestive health and overall wellbeing. Email firstname.lastname@example.org 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. 4
WIN A R1 200 LIFEGAIN® HAMPER
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.
COLDS & FLU
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STATE OF WEIGHTLESSNESS
A sure way to combat anxiety, stress and tension is to relieve muscle tension – and one way to do that is by floating. Entering a zone of sensory deprivation is a treatment used in Sweden and involves a series of flotation sessions. ‘Water has unique qualities that aid relaxation,’ says Cecilia de Villiers, a musculoskeletal physiotherapist who specialises in aquatic therapy. ‘Even your bath would work: lie back, submerging your ears. Float for at least a minute, breathing in through your nose and out through your mouth and feel the tension leave your body.’
LIFE NEWS Strength moves
Massage: more than a treat
You’ll be forgiven for thinking massages are only about luxury, indulgence and pampering, but the experts believe it’s more than a treat you might have once a year. The Mayo Clinic explains that massage is generally considered part of complementary and integrative medicine and is increasingly being offered along with standard treatment for a wide range of medical conditions and situations. The power of massage can be harnessed: • when you’re achy after exercise • to balance emotions • if you struggle with insomnia • to address joint and muscle pain
Asked and answered
Q&A IS THE GYM (OR EXERCISE) OFF LIMITS IF I HAVE A…? Cold: if you’re sneezing, coughing and have a runny nose with no other symptoms, you can most likely do light exercise, but remember to take in enough fluids and take extra care about keeping your bugs to yourself. Fever: if you have a temperature higher than 38˚C, exercise will only make it worse. Monitor your temperature and if it’s only slightly elevated, you can do light exercise, otherwise take a sicky and stay in bed. Tight chest: a decongestant contains ingredients that can raise your blood pressure, and exercise has the same effect, so if you’re taking this kind of medication, take it easy. You shouldn’t put more strain on your heart than necessary.
The number of people in South Africa that suffer a heart attack every hour, contributing to 17.3 million annual deaths related to heart disease globally – a number that is expected to grow by more than 36% by 2030. Source: Heart and Stroke Foundation South Africa
Did you know…? Certain medications are more effective depending on when you take them: ANTIHISTAMINES Some nasal allergies feel worse at night and peak in the morning, so many meds work best at bedtime, according to the American Academy of Allergy, Asthma and Immunology. COUGH SUPPRESSANTS When you lie down, mucus can drip down the back of your throat and activate the cough reflex. Strong cough meds can also cause drowsiness, so use them at night.
HOW TO BOOST YOUR IMMUNE SYSTEM When seasonal cold and flu germs abound, strengthening your immune system is the smartest approach to staying healthy. Here are a few tips: > Cook with mushrooms Who knew these edible fungi are powerhouses of nutrition that produce immune modulators? Mushrooms contain high levels of beta-glucans, which help protect against viruses and bacteria associated with colds and flu. > Go for a flu shot Flu vaccines are about 65% effective and generally only work for one season, but if you are over 65, have an underlying health condition or you’re pregnant, it’s worth a shot. > Think zinc While research into the use of zinc for the prevention and treatment of a cold is not conclusive, a recent study has shown that taking a zinc syrup as a supplement during the first few days of a cold may shorten the duration of the symptoms. > Get quality sleep Resting your body is crucial to an efficient immune system. Ensure sufficient sleep and practise good sleep hygiene, including a wind-down that’s free of devices. > Prioritise handwashing The easiest and most effective method of preventing the transfer of bacteria is effective hand hygiene. Wash your hands thoroughly and regularly – particularly after using the bathroom.
For more handwashing tips, visit https://www.lifehealthcare.co.za/patient-information/infection-prevention/
POWERING DOWN SUGAR
‘Don’t drink your calories! Dilute a third of fruit juice with two thirds water, and instead of a full serving of sweetened yoghurt, mix half with plain yoghurt. It’s also a good idea to eat low-GI foods, which help decrease cravings, as they keep you fuller for longer.’ Tristie van der Spuy, registered dietitian at Life Rosepark Hospital WWW.LIFEHEALTHCARE.CO.ZA
These breast prostheses are often referred to as partial breast prostheses & will fill the space where breast tissue was removed to restore your breast’s outline making your bra and clothes fit better and will restore the symmetry between your breasts.
Ask an expert
Antimicrobials Take care
Partial breast forms are made to fill the volume difference between your breast as depicted above in pink.
The M Store in partnership with CANSA
The M Store is a group of orthotic and prosthetic practices that specialise in fitting and supplying breast prostheses, garments and brassieres after breast surgery and they’ve recently partnered with CANSA, extending the services offered at CANSA Care Centres. Joining forces means that The M Store will provide its professional fitting services and full range of breast prostheses, 10 The M Store inand bras, swimwear lymphoedema partnership with CANSA garments at CANSA Care Centres nationally. They also stock a stylish collection of post-mastectomy swimwear. For more information, visit www.themstore.co.za or www.cansa.org.za
Antimicrobials are life-saving medications that are used to treat infections caused by micro-organisms such as bacteria, fungi, viruses and parasites. The overuse of antimicrobials over the past few decades has made resistance one of the biggest threats to global health today. Life Healthcare magazine interviewed clinical pharmacist Michelle Gijzelaar about using antibiotics – an antimicrobial – responsibly. Q: Can antibiotics help if you have a cold or flu? A: Colds and flu are viral infections that your immune system will fight, therefore antibiotics should not be prescribed.
Powerful partnership Marina Petropulos has been giving child-care advice and guidance for more than 30 years and her internationally renowned Baby & Child Care Handbook, which has sold over 1 million copies, has recently been re-released. The update gives parents access to a dedicated speaker website containing 120 talks by the world’s leading paediatric experts and professors on a broad range of topics. RRP: R349.
GIVEAWAY! Life Healthcare magazine is giving away two copies of Baby & Child Care Handbook by Marina Petropulos. Email email@example.com with ‘Baby Handbook’ in the subject line by 31 July and stand a chance to win.
Q: What advice can you give readers about how to take this medication? A: It’s essential to take antibiotics exactly as prescribed by your doctor and as directed by your pharmacist. Never take leftover antibiotics or give them to family or friends. Q: Why is it important to take a probiotic when you’re taking antibiotics? A: While antibiotics are killing the harmful bacteria causing an infection, they also kill beneficial gut bacteria. Probiotics may be beneficial to replenish the good bacteria and reduce the chance of nasty antibiotic side effects. Read more about antimicrobial resistance at https://www. lifehealthcare.co.za/about-us/ clinical-and-support-functions/ pharmacy/pharmacy-services/
I M A G E S G ET TY/GALLO I MAG ES, SU PPLI E D C O M P I L E D BY SAMANTHA PAG E
THIS PRODUCT RANGE DOES NOT REQUIRE REFRIGERATION.
References: 1. Nielsen data. Package Share. January 2019. ProbifloraTM Adult Intensive Rescue. Each capsule contains total probiotics 5 billion cfu (colony forming units), probiotic blend consisting of Lactobacillus acidophilus NCFMÂŽ, Bifidobacterium lactis HN019, Bifidobacterium lactis BI-04, Lactobacillus rhamnosus HN001, Lactobacillus casei Lc-11, Lactobacillus plantarum Lp-115, Lactococcus lactis LI-23, Bifidobacterium longum BI-05, Streptococcus thermophilis St-21 and prebiotic: prebiotic FOS fibre 50 mg. ProbifloraTM Adult Classic Bowel Support. Each capsule contains total probiotics 5 billion cfu (colony forming units), probiotic blend consisting of Lactobacillus acidophilus NCFMÂŽ, Bifidobacterium lactis HN019, Lactobacillus casei Lc-11, Lactococcus lactis LI-23 and prebiotic: prebiotic FOS fibre 50 mg. ProbifloraTM Adult Everyday Flora Balance. Each capsule contains total probiotics 1 billion cfu (colony forming units), probiotic blend consisting of Lactobacillus rhamnosus Lr-32, Bifidobacterium longum BI-05 and prebiotic: prebiotic FOS fibre (ActilightTM) 100 mg. ProbifloraTM Junior Everyday Flora Balance. Each tablet contains total probiotic count 1 billion cfu (colony forming units), probiotic blend consisting of Lactobacillus helveticus R-52ME, Lactobacillus rhamnosus R-11ME, Bifidobacterium longum R-175ME. ProbifloraTM Probiflora Infant Drops 3 strain Regular. Each dose of 4 drops (0,167 ml) contains Bifidobacterium lactis 400 million cfu; Lactobacillus rhamnosus 300 million cfu, Lactobacillus salivarius 300 million cfu. ProbifloraTM Rx. Each capsule contains total probiotics 1 billion cfu (colony forming units), probiotic blend consisting of Lactobacillus rhamnosus Lr-32, Bifidobacterium longum BI-05 and prebiotic: prebiotic FOS fibre (ActilightTM) 100 mg. This unregistered medicine has not been evaluated by the South African Health Products Regulatory Authority for quality, safety or intended use. Adcock Ingram Limited. Reg. No. 1949/034385/06. Private Bag X69, Bryanston, 2021, South Africa. Tel. +27 11 635 0000. www.adcock.com 2019042510135185.
Life Groenkloof Hospital’s new Bariatric and Metabolic Unit is bringing hope and health to those with obesity and obesity-related conditions, writes Emily Pettit
WHAT DOES IT MEAN?
Laparoscopic surgery is less invasive than traditional surgery. Keyhole surgery is performed through small cuts in the skin instead of an exposed surgical site. Recovery times and hospital stays can be shorter using this approach.
The rooms and equipment at the new unit have been designed with convenience and patient safety in mind
WHY THE NEED?
‘South Africa is currently dealing with the highest adult obesity rate in subSaharan Africa – with 68% of women older than 15, and about 31% of men classified as being overweight,’ says Dr Thinus Smit, general surgeon at Life Groenkloof Hospital’s Bariatric and Metabolic Unit. This major health concern has resulted in a growing need for treatment centres and hospital units specifically dedicated to the management of obesity and its associated health problems. One of the most effective, long-term treatments for these patients is bariatric and metabolic surgery, which involves surgery on the stomach and intestine. The new Bariatric and Metabolic Unit at Life 12
Groenkloof Hospital is championing the way forward, providing a safe environment where patients in need of this surgery are treated with compassion and care.
THE NEW UNIT
Opened in November 2018, the new Bariatric and Metabolic Unit is one of three accredited Centres of Excellence for Metabolic Medicine and Surgery (CEMMS), and the only one in Pretoria. ‘We have a ward that is fitted with beds, bathrooms and other equipment that have been specifically designed to cater for heavier patients,’ explains Dr Smit. ‘There is also a specially designed hoist installed in the unit that enables us to mobilise patients
EXPERTISE AND CARE
The new unit has a staff complement of two surgeons and two anaesthetists, as well as a physician, dietitian, physiotherapist, psychologist and three nurses. Every one of these staff members has had to undergo special training provided by CEMMS. In order to get the necessary accreditation, the unit was also inspected by the CEMMS board to ensure that the right equipment and expertise was present and available. ‘In order to get accredited, surgeons had to perform at least 25 gastric bypass procedures,’ explains Dr Smit. ‘This is all in line with the proven principle that this surgery should be done in high-volume centres that regularly do these procedures, to improve the outcomes of patients.’ While the level of physical care is extremely high, the staff also prioritise the psychological wellbeing of those requiring surgery. As part of the preparation, there is a full-time psychologist on the team who sees all patients before surgery. ‘Obesity is not a lifestyle problem that can be cured with diet and exercise,’ concludes Dr Smit. ‘It is a disease, just like cancer and asthma are diseases. The best proven treatment for obesity is surgery, performed in a high-volume centre such as this one, by a team that can manage all the unique needs of these patients.’
LIFE PLUS WHERE TO FIND US Life Groenkloof Hospital 012 424 3600
A NEW UNIT ADDRESSES SOUTH AFRICA’S GROWING OBESITY PROBLEM
directly after surgery, which is necessary to limit complications.’ The theatre in the unit is also ergonomically designed. ‘Surgery is performed laparoscopically. This is technically demanding, but ensures a much quicker recovery, which is vital for patients undergoing this type of surgery,’ says Dr Smit.
NURSE YOUR HEART BACK TO HEALTH Cardiovascular disease is the leading cause of death after HIV/AIDS in South Africa, while five people have heart attacks every hour*. Fortunately, heart disease and heart attack survivors can make lifestyle changes to help improve their heart health, says Pippa Naudé
FIT FOR LIFE
I MAG ES GALLO/GETTY IMAGES, SUPPLIED
n-hospital treatment is just the start of recovery from a heart attack or heart disease, and it should be followed by a cardiac rehabilitation programme. ‘Research has found that cardiac rehabilitation programmes can reduce your risk of death from heart disease and reduce your risk of future heart problems,’ says Dr Lissele Botha, a rehabilitation doctor at the Life Rehabilitation Unit based at Life Riverfield Lodge. ‘The goals of cardiac rehabilitation include establishing an individualised plan to help you regain strength, prevent your condition from worsening, reduce your risk of future heart problems, and improve your health and quality of life.’
WHAT TO EXPECT Physical rehabilitation is holistic and managed by a team of experts, which include a referring cardiologist or cardiothoracic surgeon, rehabilitation doctor, nursing team, psychologist, speech therapist, dietitian, physiotherapist, occupational therapist, and a social worker. Cardiologist Dr Anthony Dalby, who practises at Life Fourways Hospital, explains that a patient’s programme will depend on the type of heart condition they have (for example, coronary heart disease or a valve problem), the treatment they have already received (such as a coronary stent or bypass, a valve replacement or a pacemaker), as well as factors such as age and general health. But patients can typically expect the following: •H eart healthy education: statistics show that up to 80% of cardiovascular disease-related deaths of people under the age of 65 are preventable through a healthy lifestyle.* Therefore a critical part of acute rehabilitation is educating patients about these risks, and helping them to adopt healthier habits – such as quitting smoking. • An exercise programme: Flora Mathebula, a clinical rehabilitation specialist at the Life Rehabilitation Unit based at Life Riverfield Lodge, says, ‘The heart is a muscle, and for it to become strong, it must be worked. Exercise reduces high blood pressure, high blood cholesterol, depression, obesity, smoking and diabetes – all known risk factors for heart attacks and heart disease.’ Early intervention such as exercise is often introduced while the patient is still
in hospital, says Mathebula, and continues at the rehabilitation unit and on an outpatient basis. It can include gentle stretching, paced strengthening exercises, breathing exercises, light cardiovascular endurance exercises (such as walking, swimming or biking), and energy conservation strategies. Progress must be made slowly while the patient’s heart is recovering, says Carina Basset, a physiotherapist at the Life Rehabilitation Unit at Life St Dominic’s Hospital. She teaches patients to exercise responsibly, which means they: >> STOP if they experience chest pain, nausea, dizziness, shortness of breath or palpitations. >> AVOID strenuous exercise – such as heavy lifting, lifting objects above their head, pulling, sweeping, sudden short bursts of movements – until cleared by their doctor. >> KNOW their body, by monitoring their heart rate to keep it within an acceptable range. •A healthy eating plan: the right diet can help to reduce cholesterol, lower blood pressure and promote weight loss. Dr Botha recommends the American Heart Association’s Diet, which encourages eating: >> a variety of fruits and vegetables >> whole grains >> low-fat dairy products >> skinless poultry and fish >> nuts and legumes, and >> non-tropical vegetable oils. It also advises limiting sugar, salt, red meat, saturated or trans fats and alcohol. • Medical treatment: Dr Dalby emphasises the importance of taking any prescribed medications for maintaining good health in the long term. • Additional support: a cardiac rehabilitation programme may also include post-op therapies (such as learning how to swallow after prolonged periods with tracheostomy tubes), stress-management techniques and practical support for returning home – for example, ordering a wheelchair. AN ONGOING COMMITMENT The acute rehabilitation phase typically takes six weeks, says Dr Dalby. ‘Once patients return home, they will be required to go for regular blood pressure, blood glucose, cholesterol and kidney function
checks. They should see a physician or cardiologist at intervals of six to 12 months to assess progress. A check on the electrocardiogram (ECG), a stress test and/or echocardiogram is usually required.’ Mathebula adds that patients greatly benefit from the support of family and friends because cardiac rehabilitation is a lifelong commitment. *Source: The Heart and Stroke Foundation of South Africa
MEET OUR EXPERTS Dr Lissele Botha is a rehabilitation doctor at the Life Rehabilitation Unit at Life Riverfield Lodge. She has a passion for the holistic management of patients. Flora Mathebula is a clinical rehabilitation specialist based at the Life Rehabilitation Unit at Life Riverfield Lodge. Her interest is in adult physical rehabilitation. Dr Anthony Dalby is a clinical cardiologist at Life Fourways Hospital. He has extensive experience in the treatment of coronary heart disease. Carina Basset has done advanced and basic neurodevelopmental therapy training, and is based at the Life Rehabilitation Unit at Life St Dominic’s Hospital.
LIFE PLUS NEED HELP? Mended Hearts is a free monthly support meeting for those who have suffered a heart attack or stroke, and their families and friends. Meetings are held at selected Life hospitals in Cape Town, Durban, Port Elizabeth and Johannesburg. To find out more, visit www.heartfoundation.co.za/support/
‘I HAVE A NEW OUTLOOK ON LIFE’ 16
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bsz celebrated A very happy and healthy Matt Jaco year last nika Vero to iage his marr
Matt Jacobsz has had kidney problems from the day he was born. Thanks to the miracle of organ transplantation, he’s able to share his journey. By Lynne Gidish
was born with a posterior urethral valve (PUV), an abnormality of the urethra, the tube that drains urine from the bladder for elimination. Had it been picked up, it could have been easily corrected, but unfortunately it was never detected. I was a very sick baby and by 18 months, I was in renal failure. One of my kidneys was functioning at 25%; the other at only 5%, so my doctors decided to remove it. I was given medication to try to kickstart my remaining kidney, but it was not to be, so I was put on the organ donor list. In October 1998, I had my first transplant and received my father’s kidney. I was 8 years old. After spending one week in hospital, I was sent home and remember lying on the couch, then waking up in ICU. I’d fallen into a coma due to post-operative complications, which required more surgery and another seven weeks of hospitalisation. ‘Although things obviously changed after the transplant and I was no longer chronically ill, my life was still very restricted. I went back to school, but was always under a lot of pressure from my teachers who had strict instructions from my parents about what I was and wasn’t allowed to do. Nevertheless, I lived a normal life. I started working and ‘living’ and, like many young men, I started rebelling, too. I smoked and drank even though I knew I wasn’t supposed to do so, but while I pushed the boundaries, I knew my limits as well. Life was great, until it wasn’t. ‘About six years ago, I chatted to my doctor about reducing the amount of medication I’d been taking my whole life. I was really frustrated, so we started experimenting together and got it down to a much lower dose. Then something went wrong. I travel into Africa quite a lot for work and my medical team suspects I may have picked up an infection, but whatever the cause, after 18 years, my body rejected the kidney. I was in total shock as I felt my world come crashing down. I was put on heavy medication to try to revive the kidney, but when that was unsuccessful, I found myself on the donor list once again, which was devastating. ‘My condition deteriorated and I was placed onto a strict and highly challenging self-dialysis regimen
IN THE WORDS OF
Reena Moodley, Practice Manager, Life Fourways Hospital ‘I met Matt Jacobsz when he was on peritoneal dialysis. He had to undergo a battery of tests and treatment to ensure that his future kidney wouldn’t be rejected. He is a very positive and pragmatic man, despite his illness. The Jacobsz family faced many health challenges with their baby boy from birth, but their faith and love managed to ensure that he was always taken care of. Renal failure is an emotional rollercoaster ride, but his pillar of strength was his family, who gave him a reason to continue to fight. His determination and will to survive has resulted in his leading a full, happy and productive life, now with the recent addition of his bride at his side!’
– called peritoneal dialysis – for the next 18 months while we searched for a suitable kidney. I spent a lot of time undergoing different treatments at the Life Renal Dialysis Unit at Life Fourways Hospital and they really made a big difference. I’ve been to a few Units in my life and this is by far the best. Reena Moodley runs a tight ship and she and her team are fantastic. This was a really bad stage of my life and they always went the extra mile to make things easier. So did my family. My mom and uncle were tested as possible donors, but neither was a match. Thankfully, my aunt was a perfect candidate and in May 2016 I received her kidney with no complications. ‘Three years down the line, I have a new outlook on life. I’ve grown up and, for the first time ever, I am thinking of the future and not just living for the moment. I married an amazing woman last year and Veronika and I would love to have a family one day. I’m looking after myself and because my health is a priority, I know and respect my limitations. I’m happy that I’m healthy and am very grateful to be alive.’
Urinary incontinence (UI) is common in pregnancy, but itâ€™s an uncomfortable and often embarrassing consequence of growing a life inside you. Charlene Yared-West spoke to two experts about managing and treating the condition
rinary incontinence (UI) during pregnancy is reported by about 60% of women. For these women, the severity of their condition can increase during the course of their pregnancy, peaking in the second and third trimesters. Of those who experience incontinence in pregnancy, 70% go on to resolve the condition post-partum – and within the first year, the prevalence of incontinence drops down to between 11 and 23%. Dr Bongi Makhubo, an obstetrician and gynaecologist from Life Anncron Hospital in Klerksdorp, sheds more light on the topic.
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EARLY INCONTINENCE IS NORMAL Pregnancy can affect the normal way your urethra relaxes and contracts and many women, particularly those who had a vaginal birth, can experience incontinence after childbirth. ‘The pubic and pelvic muscles and the anal sphincter can be injured in up to 40–80% of births and so leaking a little bit after birthing your baby vaginally is quite within the normal range, but it is not normal if it lasts for months afterwards,’ says Dr Makhubo. ‘Directly after birth, using a thick maternity pad helps to absorb the leaks, but once you have stopped bleeding and incontinence persists, you might need a specialist appointment to further discuss the problem.’ Stress incontinence is also common in new mothers and affects roughly a third of women in the first year after birth. Stress incontinence leaks happen when the mother laughs, coughs, sneezes or goes for a run. Lifting heavy things can also cause these leaks, which are due to increased intra-abdominal pressure and a defective urethral support or closure. WHAT CAN HELP? ‘Pelvic floor-muscle training or Kegel exercises are by far the best way to combat the problem post-partum, although the research differs as to how much of the exercises should be done. These can be performed anywhere, and one way to remember to do them is to pick an anchor as a reminder – for example, when stopping at a robot or boiling the kettle. Each time you do that, do some pelvic floor exercises too,’ says Dr Makhubo. She suggests that physiotherapy can also help in some cases. ‘A physiotherapist
will give you cones or a pessary that can be used to squeeze and strengthen the pelvic floor muscles.’ Dr Makhubo also encourages lifestyle modifications, such as drinking less coffee and alcohol, and stopping smoking. Decreasing BMI can also help improve incontinence issues. ‘If lifestyle modifications have been made and incontinence persists, then medical treatments can be offered,’ she says. ‘The last resort is surgery.’ MEDICAL TREATMENT AND SURGICAL OPTIONS • Medication: > Oestrogen creams, duloxetine and even Botox can help alleviate incontinence.
WHAT CAUSES INCONTINENCE AFTER BIRTH? Dr Makhubo shares the facts: • Weakening of the pelvic floor muscles or injury to the nerves supplying the structures of the pelvic floor, due to a prolonged or difficult labour. • Carrying a bigger than normal baby in utero, leading to difficulty in delivering, or stretching and compression of the pelvic floor. • High levels of elastin, a hormone that allows for more stretching of the skin and connective tissue, can cause prolapse and in turn, incontinence (as opposed to collagen, which is decreased during pregnancy). • Assisted delivery, especially with the use of forceps. Research shows that there is less injury and urinary incontinence noted with the use of a ventouse in comparison. • Maternal age; the greater the age, the higher the association with urinary incontinence. • Parity (the number of times a woman has given birth); incontinence is more common with parous women, however, of note is that the highest risk of incontinence is with the first delivery, thereafter a 10% risk increase with each subsequent birth. • Vaginal delivery definitely predisposes women to a higher risk of incontinence but most revert to normal within a year.
•M edical devices: > A vaginal pessary, which can be used for prolapses, is a ring-like device that acts as a support for the bladder. A disposable urethral insert may also serve as a leakage barrier. •B ulking agents: > Bulking agents are injected into the urethra to help plump up the tissues where urine is released from the bladder and help to hold it in. •S urgery: the underlying principle of surgery is to support the urethra so the bladder can work effectively. > ‘Retropubic urethropexy (Burch colposuspension) is the most common surgery for this condition. It is an abdominal procedure in which the pubocervical fascia is attached to a copper ligament or to the pubic symphysis (pelvic bone),’ explains Dr Makhubo. ‘This helps lift the anterior vaginal wall and tissues surrounding the urethra and bladder, which assists with alleviating incontinence.’ > Slings: there are various kinds of slings, all made of mesh. The use of mesh has been approved by the FDA and the South African Urogynaecology Society endorses and supports the use of this method for incontinence. A ‘hammock’ is created using mesh and tissue to support your urethra and can be done under local anaesthesia. >> Pubovaginal slings, mid-urethral slings, mini-slings and microslings are used as a means to help incontinence, but implanting mesh where it is needed, in and around the urethra. These range from being fairly invasive to non-invasive. Your care provider will help you decide on the best approach for you.
MEET OUR EXPERT Dr Bongi Makhubo is an empathetic female gynaecologist and obstetrician, who practises at Life Anncron Hospital. She qualified as an obstetrician and gynaecologist in May 2018, FCOG and her MMED (O&G) was published in SAJOG in January 2018.
T H E WA Y W E E A T
WHY YOU SHOULD SWITCH TO FIBRE (AND WE’RE NOT TALKING ABOUT YOUR INTERNET)
Knowing you need fibre in your diet and figuring out how to fit the right amount into your daily meals are two different battles. Here’s some advice on how to make the switch. By Sam Brighton
T H E WA Y W E E A T
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our body can’t digest it, but digestion can’t happen without it. This isn’t a brainteaser: it’s the wonder of fibre – when consumed in the right amounts. ‘Fibre, while not digested and absorbed into the bloodstream like other nutrients, plays a significant role in digestive health, cholesterol reduction, effective elimination of waste, appetite regulation and blood glucose control,’ says dietitian Kelly Francis of Life Westville Hospital in Durban. Vegetables, fruits, legumes, whole grains, nuts and seeds are all excellent sources of dietary fibre. If it isn’t digested, how does it impact my body? As fibre is resistant to digestion in the small intestine, it moves to the large intestine where it undergoes fermentation. ‘Fibre decreases the nutrient absorption from the [lining of the] gut by decreasing the amount of time food takes to pass through,’ says Dr Nnete Nimrod Mokhele, a specialist gastroenterologist at Life St George’s Hospital in Port Elizabeth. ‘This leads to frequent defecation and reduction of carcinogens that can be manufactured in the colon.’ Fibre works in many ways to keep your body healthy. Francis explains that fibre feeds probiotic flora in the intestines, keeping your gut bacteria balanced. There’s also evidence that a high-fibre diet can help with joint pain. A study at the Boston University School of Medicine in Boston, Massachusetts, USA, found that a high intake of dietary total or grain fibre, particularly the recommended daily fibre average intake of 25g per day, is associated with a lower risk of developing moderate or severe knee pain over time. Francis elaborates: ‘A diet that is high in fibre, and therefore the vitamins, minerals and unsaturated fatty acids that come with foods high in fibre, helps to reduce inflammation, which is a common cause of joint pain.’ Am I getting enough fibre? Constipation, hunger between meals and poor blood glucose control are some signs that you might need to up your fibre intake. Prolonged lack of fibre can
lead to diseases of the colon, high cholesterol and ‘over-absorption of nutrients, especially glucose,’ says Dr Mokhele. Conversely, a diet rich in fibre can reduce the risk of developing heart and colon diseases as well as diabetes mellitus. It can also help you lose excess weight ‘indirectly by regulating your bowel transit, giving a person a sense of being full with minimal intake,’ Dr Mokhele explains. From the numbers below, you can see why it’s important to include fibre-rich foods with each meal if you’re aiming to meet your daily requirement. However, it’s true that you can have too much of a good thing. Over-consumption of fibre can lead to constipation and bloating, particularly if you’re not drinking enough water throughout the day.
leafy greens. Soluble fibre supplements are widely available and can be of use to people who are avoiding certain high-fibre foods owing to a medical condition or a food sensitivity. However, there’s no substitute for insoluble fibre. Fresh is best and high-fibre foods provide a host of other good-for-you nutrients to keep you in tip-top shape.
Can’t I just take a fibre supplement? Fibre comes in two forms – soluble and insoluble. Soluble fibre is found in beans, oats, apples and blueberries. It dissolves in your gut and creates a gel-like substance that isn’t absorbed. Insoluble fibre, as the name suggests, does not dissolve and stays intact all the way through the digestive process. It is found in wholewheat products, bran, seeds, and veggies such as broccoli and
MEET OUR EXPERTS Dr Nnete Nimrod Mokhele is a specialist gastroenterologist who received his Bachelor of Medicine and Bachelor of Surgery (MBChB) degree from the University of Transkei before completing his specialist training at the University of Cape Town. He is currently in private practice at Life St George’s Hospital in Port Elizabeth. Kelly Francis is a registered dietitian who earned her BSc degree in Dietetics at the University of KwaZulu-Natal. She has been practising independently at Life Westville Hospital in Durban since 2010. Kelly enjoys educating both adults and children about good nutrition for optimal health, disease management and quality of life.
HOW MUCH FIBRE DO I NEED? Gender
Fibre per day
HOW MUCH FIBRE IS IN MY LUNCH BOX? Food
Apple (with skin)
Pear (with skin)
Wholewheat pasta (cooked)
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Standard Standard Wheelchair: Wheelchair: Standard R 2500 R 2500 RWheelchair: 1599 R 1599 R 2500 R 1599
3 Wheel 3 Wheel Mobility Mobility Scooter: Scooter: ST1ST1 Mobility Mobility Scoote Scoote r: r: ST1ST1 ST1 Scooter: Mobility R 13999 R Scoote 13999 r: R ST1 19000 R 19000 R 318500 RWheel 18500 RMobility 12999 R 12999 R 18500 R 12999 R 19000 R 13999
3 Crank 3 Crank Hospital Hospital bed:bed: Crank Hospital bed: R 11999 R 11999 R318000 R 18000 R 18000 R 11999
M4M4 Bubble Bubble Overlay Overlay Bubble R M4 4000 R 4000 R 1999 ROverlay 1999 R 4000 R 1999
Standard Standard commode commode Standard R 1400 R 1400 R commode 799 R 799 R 1400 R 799
Raise Raise up recliners: up recliners: Raise From From R up R recliners: 14999 14999 From R 14999
Electric Electric Home Home Care Care Bed: Bed: Electric Home Bed: R 32000 R 32000 R 19999 R Care 19999 R 32000 R 19999
M6M6 Ripple Ripple mattress: mattress: Ripple mattress: R M6 10000 R 10000 R 4999 R 4999 R 10000 R 4999
Shower Shower chair: chair: Shower chair: R 1400 R 1400 R 799 R 799 R 1400 R 799
Rollator Rollator Drive Drive Medical Medical - R6: - R6: Rollator Drive Medical R 1299 R 1299 - R6: R 2200 R 2200 R 2200 R 1299
Electric Electric Bath Bath Lift:Lift: Electric Lift: R 20550 R 20550 RBath 9999 R 9999 R 20550 R 9999
KD KD Electric Electric Wheelchair Wheelchair Wheelchair RKD 48000 RElectric 48000 R 35999 R 35999 R 48000 R 35999
Drive Hydraulic Hydraulic Patient Patient Lifter: Lifter: Avante’ Avante’ Adjustable Adjustable BedBed Drive Drive Hydraulic R 18000 R 18000 R 10999 RPatient 10999Lifter: Adjustable Bed RAvante’ 20000 R 20000 R 12999 R 12999 R 18000 R 10999 R 20000 R 12999 count count ry ry wide widery count delivery delivery wide delivery
Free Free delivery delivery forfor Free delivery for orders orders over over R1500 R1500 orders over R1500
Prices Prices areare subject subject to change to change without without prior prior notice notice Prices are subject to change without prior notice Tel. Tel. SA :SA 08611 : 08611 PRIMA PRIMA Tel. PRIMA 086SA 086 11: 08611 77462 11 77462 086 11 77462
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L I F E M AT T E R S
Poorer memory, orientation and comprehension You may start to notice that your parent, once meticulous about medication, for example, doesn’t remember to take it. They might miss their appointments, forget self-care and familiar daily routines, lose their way in known environments, leave doors unlocked, become confused with time, well-known persons and places, or leave finances in disarray by forgetting to pay bills or double-paying them, misplacing money and articles, and so on. Shifts in psyche and mood This could include a change in their normal temperament, for example, seeing mostly the negative side of life and showing a disinterest in activities that they formerly enjoyed.
WHEN PARENTS AGE
The shift from your parents being healthy and independent to ageing and in need of support can be unsettling. Social worker Jolandi de Villiers of the Life Rehabilitation Unit at Life Vincent Pallotti Hospital offers some insight into what you can expect
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nce you start to become concerned, you have no doubt already seen indications that your ageing parent is in need of some additional support. Some of the signs you might have noticed are a general decline or change in their normal function. These can include the following:
Changes in personal care A deterioration in personal hygiene can include a change in eating and drinking habits, not maintaining a normal regular routine of bathing or wearing clean clothes, unintentional weight loss, defaulting on prescribed medication by either stopping, forgetting to take it or taking too much. Other signs include regular falls and possibly unexplained dents in their vehicle.
A decline in care of home and safety Stay alert to the possibility of your parents’ normal home environment changing over time from its usual state of neatness to being unhygienic and disorganised. Some signs can include rotten food in the kitchen, trash not taken out, the presence of pests, or security gates and doors left open. Heightened isolation There may be a change from how your parent once socialised to preferring solitude, declining invitations and becoming disinterested in activities that they previously enjoyed. If your parent doesn’t trust their own abilities in a social environment, they will start to fear leaving their home, leading to a lack of emotional and social support.
For more information about the Specialist Geriatric & Memory Clinic at Life Vincent Pallotti Hospital, visit http://sgmclinic. co.za/specialists/
LIFE PLUS HOW TO APPROACH THE CONVERSATION As parents get older, their attempts to hold on to their independence can cause friction at even the most well-intentioned suggestions. It’s very important not to overreact and to approach the conversation calmly and objectively. Always share your concerns with them and explain that you are fulfilling your role and responsibility as their child, but do this without judging or blaming, and with respect. It’s important to note that this is not a time to switch roles and treat your parent like a child.
MEET OUR EXPERT Jolandi de Villiers is a social worker at the Life Rehabilitation Unit at Life Vincent Pallotti Hospital with an interest in assisting families.
REDUCE YOUR RISK OF DEMENTIA There are 50 million dementia sufferers worldwide, with nearly 60% living in less developed countries, like South Africa*. So, how can you lower your risk of becoming yet another statistic? Julia Lamberti-Morreira shares some ideas 24
DEFINING DEMENTIA ‘Dementia is a broad category of brain diseases that cause a gradual decrease in the ability to think and remember, as well as emotional difficulties, language problems and a decrease in motivation,’ explains Cheryl Holdsworth-Daniel, a psychologist at Life Vincent Pallotti Hospital in Cape Town. She asserts that the most prevalent type of dementia is Alzheimer’s disease, a chronic neurodegenerative condition, which starts slowly and gradually worsens over time. Unavoidable dementia risk factors include ageing, genes and ethnicity. ‘Yet, while ageing and genetic risk cannot be
modified, these factors do not predict with certainty that the disease will develop,’ adds Dr Faheema Parker, a sub-specialist geriatrician, based at the Life Mental Health Unit at Life Vincent Pallotti Hospital. ‘Furthermore, dementia risk can be reduced in a number of ways.’
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MOVE MORE ‘Studies have found that increased physical activity improves brain oxygen supply,’ asserts Dr Parker. ‘Keeping the heart healthy also keeps the brain healthy, thereby reducing the risk of developing dementia.’ One study in particular indicated that participating in physical activities was linked to larger brain volume in regions connected to cognitive functioning and memory. Researchers have also found that regularly active study participants with the APOE4 gene variant (which increases the risk for Alzheimer’s disease), showed no shrinkage in the area of the brain responsible for memory. Yet, physically inactive participants in this same study experienced a 3% reduction in this hippocampus region. So, aim for a minimum of 30 minutes of physical activity on most days to enjoy its brain-boosting benefits. Brisk walking, cycling, gardening, tennis, bowling, yoga, pilates, weight training and swimming are all good exercise options that are bound to boost your mood, too. USE IT … OR LOSE IT ‘Stimulating social engagements and mental tasks increase our neural connections and keep the brain active,’ says Dr Parker. ‘Remember, if you don’t use it, you lose it!’ Excellent ways to remain mentally stimulated include: • doing puzzles, crosswords, playing cards or enjoying board games • learning a new language • studying for a qualification or taking short courses • r eading • writing • v olunteering • joining a club or community group • nurturing friendships, and • offering to babysit grandchildren. GET SUFFICIENT SHUT-EYE Enough quality sleep can decrease your risk of dementia because sleep involves
‘Stimulating social engagements and mental tasks increase our neural connections and keep the brain active. Remember, if you don’t use it, you lose it!’ – Dr Faheema Parker a process of clearing out the toxins that potentially trigger Alzheimer’s. Aim for eight hours of sleep nightly to prevent toxin accumulation and keep your brain operating optimally. KEEP IT CLEAN ‘Prevent a build-up of brain toxins by avoiding excessive alcohol use, smoking and recreational drugs,’ advises Dr Parker. Firstly, studies suggest that heavy alcohol use can lead to dementia because of its toxic effect on the brain, which causes structural and functional brain damage. There is equally compelling evidence to indicate that smoking can cause inflammation and problems with the vascular system and blood flow to the brain. Drug use can also adversely affect neurological function and lead to symptoms of dementia. PROTECT YOUR HEAD ‘Reduce the likelihood of head trauma by avoiding risky activities, using
a helmet when necessary and buckling up when driving,’ recommends Dr Parker. This is because certain types of traumatic brain injury may increase the likelihood of developing Alzheimer’s or another type of dementia years after the trauma occurred. HEALTHY EATING Studies suggest that following a Mediterranean diet may slow cognitive decline in older adults and reduce the risk of mild cognitive impairment (MCI) and its progression to Alzheimer’s disease. This style of nutrition typically encompasses: • vegetables and fruits • whole grains • olive oil and nuts • l egumes • fish • moderate amounts of poultry, eggs, and dairy products • moderate amounts of red wine, and • minimal red meat. More research is needed to know exactly how a Mediterranean diet possibly prevents Alzheimer’s and slows cognitive decline. However, until definitive proof is available, there is no harm in following this type of heart-healthy diet, which potentially protects the brain, too.** We have no control over ageing or genetics. However, we can make smart lifestyle choices today to assist in staving off diseases such as dementia and ultimately ensure a healthier body and brain in the years to come. **You should consult your physician, dietitian or other healthcare professional before making any changes to your diet to ensure it supports your current health status. Each individual’s dietary needs and restrictions are unique, so it’s best to discuss any questions or concerns with your physician.
MEET OUR EXPERTS Dr Faheema Parker is passionate about optimising the care of the elderly living with dementia and diseases unique to the aged.
Cheryl Holdsworth-Daniel has a degree in psychology from the University of Stellenbosch. She is in private practice at Life Vincent Pallotti Hospital in Cape Town.
Most people believe they are good listeners without considering the important differences between hearing and listening. Hearing is typically an inherent ability. Listening means paying attention and making a conscious effort to process what you hear. So, are you the type of person who lets information in one ear and out the other – or are you all ears?
ARE YOU A
Read every statement and indicate which option applies to you. After finishing the test, sum up your points using the scoring table and view the results relevant for you. 1. When listening to someone, I pay attention to their words as well as their body language. a. Almost always b. Often c. Sometimes d. Rarely e. Almost never 2. If I find a conversation boring, my mind wanders. a. Almost always b. Often c. Sometimes d. Rarely e. Almost never 3. I will interrupt a person if I feel that I have something important to add. 26
a. Almost always b. Often c. Sometimes d. Rarely e. Almost never
a. Almost always b. Often c. Sometimes d. Rarely e. Almost never
4. I face the person who is speaking to me and make eye contact. a. Almost always b. Often c. Sometimes d. Rarely e. Almost never
7. I get bored if I’m not the one leading a conversation (i.e., choosing the topic or controlling the pace). a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false
5. I finish other people’s sentences. a. Almost always b. Often c. Sometimes d. Rarely e. Almost never 6. I multitask when someone is speaking to me (for example, type, do chores or watch TV).
8. When I disagree with what a person is telling me, I will make a disapproving sound or show it in my face. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false
I M A G E G ET TY/GALLO I MAG ES TE ST COPYR I G HT 2019 – WWW.QU E E N DOM.COM
Scoring yourself 9. I take a moment to process and think about what a person has said before offering my response. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false 10. I usually end up having to ask someone to repeat themselves or remind me about what they said. a. Completely true b. Mostly true c. Somewhat true/false d. Mostly false e. Completely false
Add up all your points according to this chart: QUESTION
Your listening skills are going to need a fair amount of work. You seem to have developed some practices that inhibit your ability to give your full attention to others. Listening is an important interpersonal skill – and one that can be developed. Start by being actively involved in a conversation: use eye contact, body language and verbal affirmations to indicate that you are interested and engaged in a conversation. You can ask questions, but make sure not to interrupt. Next, be attentive to distracting mannerisms that you may have developed. Habits such as finger tapping, fiddling with coins or jewellery, or even just doing other tasks, tells a person that you are not fully listening. Pinpoint your habits and focus on eliminating them. Most importantly, strive to be the type of listener you would want others to be if you were the one speaking.
You understand the importance of being a good listener, but as you are probably aware, there are certain areas where you can improve. To start, make sure to listen for understanding, not evaluation. Focus on what the speaker is trying to communicate and shut off your internal judge (we all have one). Remember, as soon as you switch to your internal thoughts (‘I really don’t agree with what he just said.’), your attention is diverted and you risk missing out on something important. Also, keep in mind that listening is active, not passive. Try asking open-ended questions to get a person to open up more. A yes/no question won’t get you much info. Consider, for example, the difference between ‘Do you like what I did?’ and ‘What is your opinion on what I did?’ Finally, try not to interrupt – a simple rule, but not easy to follow. If you need to, discreetly put your finger over your mouth to remind yourself to listen, not speak! Overall, you’re a pretty good listener. People probably really enjoy talking to you. Of even greater value is the fact that you understand how important it is to be an active listener, and not just sit there passively paying attention. As you’re listening to someone, make sure to empathise and put yourself in the other person’s shoes. Sometimes, what can seem completely unreasonable from our point of view might make perfect sense from someone else’s perspective. Try as much as possible to step back from what a person is saying and look at the message objectively. Secondly, consider the benefits of paraphrasing what someone has said. Repeat back to the person, in a condensed form, the core of what was discussed. This not only shows that you were paying attention, but it also clears up any potential miscommunications. This is especially important when the subject of the conversation is complex or has a lot of details. Overall though, keep up the good work!
People often mistakenly believe
that listening is a passive activity; that being a good listener simply means not speaking when someone else is talking (and many of us don’t even do this part well!). Attentive listening is ‘active’ listening. A good listener will speak in turn, make eye contact, and display an interest in the topic of conversation by nodding or smiling. Good listeners also use verbal cues (for example, ‘I see’ or ‘Go on’), ask questions and paraphrase what the speaker has said. Practised listeners are able to focus their full attention on a person despite external distractions (such as background noise or other conversations) or internal distractions (for instance, personal issues or boredom).
EASING JET LAG
Gaining a better understanding of jet lag can help you rise above the effects so you can still enjoy your holiday, get the most out of your business trip, or perform optimally in your sporting endeavours. Hereâ€™s what you need to know. By Ryan Scott
WHAT IS JET LAG? Your body has its own natural rhythm and disrupting that rhythm by placing it in a new time zone could cause a pounding headache, insomnia, disorientation, irritability and exhaustion, which are familiar symptoms of jet lag. Your body’s 24-hour sleep-wake cycle, which is referred to as its circadian rhythm, falls out of sync when you travel and experience different sunlight hours. This disturbance may leave you with physical and emotional symptoms and general impaired performance in whatever tasks you have planned at your destination. Light stimulation plays the most important role in this process as it activates fibres in the optic nerve communicating perceptions of light and dark to the hypothalamus, which is responsible for, among other things, the body’s timekeeping. When, during your travels, dawn or dusk are sprung on you many hours earlier or later than usual, the hypothalamus may trigger activities that the rest of the body is not ready for, and that’s when jet lag occurs.
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DESTINATION ADAPTATION But if you take the 30 000-foot view, there’s good news. New research has some ideas on how to beat the lag. BEFORE YOU SET OFF… >> Boost your immune system with vitamins and minerals by eating fresh fruit and vegetables. >> Drink plenty of water and reduce the amount of caffeine and alcohol you consume for about a week before you travel. >> Prepare your body for the shift a few weeks before you travel by adjusting your bedtime to be more in line with the time zone you’re going to. DURING THE FLIGHT… >> Prolonged sitting on the flight alone can contribute to jet lag and the dry, dehydrating air and change in cabin pressure need to be negated as much as possible. >> Stay hydrated by drinking plenty of water before, during, and after travel. >> Alcohol and caffeine can
CRUISE ON THROUGH
Embrace the new time zone before you arrive there.
Adjust your watch to your destination as you get on the flight.
Upon arrival, seek the sunshine at the earliest opportunity.
Avoid the initial urge to sleep. Stay awake till 10pm local time.
Keep the first few meals light when you arrive.
Avoid caffeine for at least four hours before sleep.
contribute to dehydration, so keep both to a minimum. >> Get up, walk up and down the aisle or stretch every few hours to reduce the risk of developing blood clots – also referred to as Deep Vein Thrombosis (DVT) – which can pose a health risk for long-distance travellers. >> Adapt to your new time zone during travel. If it’s night-time at your destination during the flight, sleep on the plane: earplugs, headphones and an eye mask will help block out stimuli. If it’s daytime, resist the urge to sleep. WHEN YOU ARRIVE… >> Introduce your body to the new light cycle so it can begin adapting naturally. Get outside and into sunshine or set your alarm to rise with the sun if you’re arriving at night. >> Maximise sleep during the first few nights and resist napping. Use a fan to create white noise to drown out disturbing sounds, and keep the air conditioning set at 19°C. >> Take your meals at local time, even if you aren’t hungry. When you’re preparing for sleep, consume more starches. Refined carbohydrates cause a rise in blood sugar level followed by a dip in insulin levels, which results in drowsiness.
IN-FLIGHT EXERCISE Here are four simple movements you can make from the comfort of your seat: Ankle circles Circle your foot clockwise and then anticlockwise. Repeat 10 times per foot. Foot pumps Raise your heels together, contracting the calf muscles at the top, and release. Repeat 10 times. Shoulder rolls Slowly roll your shoulders forward, upward, backward and downward and then reverse directions. Repeat 10 times. Forward bends Bend as far forward as your seat allows, reaching to grab the front of your knees. Hold for 10 to 15 seconds and ease yourself. Repeat 10 times.
>> Exercise sparks alertness and improves sleep quality, so don’t let the long flight keep you from physical activity.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) • Persistent cough?1a • Shortness of breath affecting normal morning routine?1a - Getting out of bed - Showering and drying off - Getting dressed • Sputum?1a • Symptoms worse than usual in the morning?1
Speak to your doctor References 1. Roche N, Chavannes NH, Miravitlles M. COPD symptoms in the morning: impact, evaluation and management. Resp Res. 2013;14:112. http://respiratory-research.com/content/14/1/112.
Chronic Obstructive Pulmonary Disease (COPD) has a profound impact on daily life, yet remains underdiagnosed and undertreated1,2. Are you at risk?3 1. During the past 4 weeks, how much of the time did you feel short of breath? None of the time
A little of the time
Some of the time
Most of the time
All of the time
2. Do you ever cough up any “stuff,’’ such as mucus or phlegm? Only with occasional Yes, a few days colds or chest a month infections
Yes, most days a week
4. Have you smoked at least 100 cigarettes in your ENTIRE LIFE? No
Don’t know 2
5. How old are you? Age 35 to 49
Age 50 to 59
About the score: • Score 5-10 — High risk of COPD • Score 0-4 — Low risk of COPD
Age 60 to 69
The higher your score, the more likely you are to have COPD. COPD is often referred to as chronic bronchitis and/ or emphysema and is a serious lung disease that slowly gets worse over time. While COPD cannot be cured, it is treatable, so please share your answers to the five question screener with your healthcare professional (HCP).
3. Please select the answer that best describes you in the past 12 months. I do less than I used to because of my breathing problems. Strongly disagree
If your total score is 5 or more, this means your breathing problems may be caused by chronic obstructive pulmonary disease (COPD).
If your total score is between 0 and 4, and you are experiencing problems with your breathing, please share your answers to the five-question screener with your HCP. Only your HCP can decide if you have COPD. Your HCP can help evaluate your breathing problems by performing a breathing test, also known as spirometry. Don’t wait. Call your HCP today to make an appointment to see if you may be at risk for COPD. Remember, when speaking to your HCP, be honest and open in describing your symptoms and explain how your breathing problems affect your activity level on a daily basis.
+ TOTAL SCORE
References: 1. Feldman GJ. Improving quality of life in patients with chronic obstructive pulmonary disease: focus on indacaterol. In J COPD 2013; 8: 89-96. 2. Allwood B, van Zyl-Smit R. Chronic obstructive pulmonary disease in South Africa: under-recognised and undertreated. S Afr Med J 2015; 105(9): 785. 3. Martinez FJ, Raczek AE, Seifer, FD, et al. Development and initial validation of a self-scored COPD Population Screener questionnaire (COPD-PS). COPD: Journal of Chronic Obstructive Pulmonary Disease.2008; 5(2): 85-95. Novartis South Africa (Pty) Ltd. Magwa Crescent West, Waterfa.ll City, Jukskei View, Johannesburg, 2090. Tel. (011) 347-6600 Fax. (011) 929-2038. Co. Reg. No. 1946/020671/07. Customer Careline: 0861 929 929. ZA1904670808 04/2021.
COLD DAYS, WARM MOOD
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Winter in the southern hemisphere is nowhere near as harsh as it is in Europe and the United States, but some people do feel a little down when it’s cold and rainy, so it’s important to be aware of your mood and take advantage of the days when the sun comes out. According to Psychological Science, the positive impact that warm, sunny weather has on your state of mind is palpable and spending time indoors on lovely days actually lowers your mood – so soak up the sun (safely) and up your intake of foods high in vitamin D, such as salmon.
H E A LT H F O C U S
H E A LT H F O C U S
WHEN A CHILD IS DIAGNOSED
WITH CANCER Each year about 1 000 children are diagnosed with cancer in South Africa, according to Cancer Association of South Africa (CANSA), and many more go undiagnosed or are misdiagnosed. In each case, lives are turned upside down as parents come to terms with the realities of caring for a seriously ill child. But knowledge is power, and there is support. By Glynis Horning
H E A LT H F O C U S
’m so sorry, your child has cancer.’ Words no parent wants to hear, and no doctor wants to say. ‘Parenting is tough as it is, but when a child is diagnosed with cancer, a parent’s life is never the same again,’ says RN Margie Havenga, Paediatric Unit Manager at Life Eugene Marais Hospital in Pretoria. ‘The diagnosis is usually sudden and unexpected,’ says Dr Michelle Mollentze, a paediatrician at the hospital. ‘Most parents are very shocked, some deny the diagnosis, others cry.’ All these reactions are normal and entirely acceptable. ‘There’s no need to be in charge and act strong,’ says Havenga. ‘It’s okay to break down for that moment and allow the people you love to support you.’ It’s common for parents to feel fear, anger (‘Why is this happening to my innocent child?’), even guilt that they may have somehow been responsible for the cancer. But childhood cancers are unlike the adult variety, which may be related to lifestyle choices, and most have no discernible cause. About 5% are linked to genetic factors, and a few to microbial ones, says Professor Michael Herbst, health specialist with CANSA. Promising outcomes Most occur in developing cells such as bone marrow, blood, the nervous system, the kidneys and connective soft tissue, and because of this, children’s cancers tend to grow faster than those of adults. So while, for example, bowel cancer cells in adults double in about 300 days, those in children can double in 30 days or fewer. But the good news is that this rapid growth makes the cancers more sensitive to treatment than adult cancers, and even those in stage four (the most advanced) of the disease can now achieve long-term remission. The reality is that many childhood cancers are today treatable, with success rates of 70 to 80% in well-resourced countries, says Professor Herbst – and in good hospitals locally. Just knowing this can help parents find strength and stay hopeful. In some communities, there is still stigma around cancer, but Dr Mollentze urges parents to be open about a diagnosis with family and friends – and to accept support, so as to get enough rest, eat well and keep up their strength. ‘I observe often that parents humbly deny help, saying they’ll be okay,’
says Havenga. ‘Take all the help you can get, be thankful, and focus on treasuring every moment with your child.’ Dr Mollentze also advises seeking spiritual support, and ‘reaching out to other parents who have walked this path’ through support groups. ‘One of the best ways to cope with the uncertainty and fear around cancer is to take control of decisions involving your child’s treatment,’ she says. Ensure you are in good medical hands and work with your medical team (oncologist, paediatrician, neurosurgeon or other specialists) to achieve the best result for your child, and build a relationship of trust with them. Also do your own research, she urges, but only from reliable sources, such as reputable websites and medical journals.’ A sense of normalcy Once you have been given a treatment plan, try to schedule normal home routines around it to provide a sense of normalcy for your child and any siblings. But don’t try to hide the diagnosis from them. ‘The easiest way is to tell your child about the cancer right way – don’t put it off; it only becomes harder,’ says Dr Mollentze. ‘It also gives your child time to ask questions before treatment starts. The paediatrician can help you explain the diagnosis to your child in terms they understand.’ Sharing the news ‘Most paediatricians will refer the job to the paediatric oncologist, because they are often able to contextualise it better,’ says Dr Marc Hendricks, senior specialist paediatric oncologist at Red Cross War Memorial Children’s Hospital in Cape Town. ‘It may be the case that we discuss with Mom and Dad beforehand what their preference is: do they want to share the diagnosis, or would they prefer that the doctor does it? Do they want to do it together, or do they want the doctor to do it on their behalf?’ Empower your child with choices wherever possible – even just to offer their right or left arm when having blood tests done. Encourage them to play out their fears with toys or in drawings, and listen carefully to what they say. Young children may wonder if they’re sick because they’ve done something bad, so reassure them.
WATCH FOR SIGNS If these persist, get professional medical help early – they could indicate childhood cancer: • Lump in the abdomen, pelvis, head, neck, limbs, glands or testes. • White spot in the eye, bulging eyeball, impaired vision, new squint. • Unexplained fever, loss of appetite and weight, fatigue, pallor easy bruising or bleeding. • Unexplained headaches, vomiting, seizures, or an enlarging head. • Aching bones, joints or back and easy fractures. • Change in balance, gait, behaviour or achievement of milestones. If cancer is confirmed or suspected, your doctor should consult a paediatric oncologist as soon as possible, preferably at a reputable oncology centre.
H E A LT H F O C U S
H E A LT H F O C U S
The way forward Your oncologist will also take you through a treatment plan carefully. ‘Be as informed about it and about side effects as possible’, he says. ‘And don’t break the rules when these are put in place by the medical team for your child’s protection – for example, ignoring instructions to act on a temperature immediately.’ But equally, don’t hesitate to ask questions about things that are worrying you. ‘Have them ready when the doctors do rounds; jot them in a diary,’ advises Havenga. Dr Hendricks adds: ‘Allow members of your medical team to inform and support you, and don’t be afraid to ask for help early, even for emotional support.’ Supporting a parent whose child has cancer is one of the most difficult things, the professionals say. But as Havenga puts it, ‘It is also one of the most rewarding’.
WHAT TO SAY – AND NOT SAY When a child has cancer, some friends stay away when support is needed most, uncertain what to say or afraid to say the wrong thing. Here are some guidelines: Don’t say: ‘Everything happens for a reason/God has a plan’ or other placatory clichés. Do say: ‘This is terrible, I’m so sorry,’ or ‘I’m praying for you.’ Keep your comments simple and sincere. Don’t say: ‘Your child will be okay’ – you don’t know that. Do say: ‘You must be so frightened. I’m here for you when you want a chat or a hug.’ Don’t say: ‘Let me know if I can do anything to help.’ Do say: ‘I’m making extra for dinner, what time can I drop it off for you?’ Concrete help is far better than well-meaning, vague offers. Don’t say: ‘I know how you feel, my gran/uncle had cancer.’ Do say: ‘I can’t imagine what you must be feeling,’ then listen well. Don’t make it about you. Don’t say: ‘Have you tried cannabis oil/essential oils/a grape diet?’ If they are following the treatment plan with reputable medical specialists, they don’t need to be confused. Do: nothing by way of medical advice. If you still can’t face talking to a friend about cancer, just send a card or text message: ‘I’m thinking of you’. And do stay in touch.
MEET OUR EXPERTS RN Margie Havenga has been the manager of the Life Eugene Marais Hospital’s paediatric unit since 2016. She is a registered nurse as well as a qualified neonatal nurse and holds a master’s degree. Dr Michelle Mollentze has been working as a paediatrician at Life Eugene Marais Hospital from 2007, and has a passion for providing excellent care to Life’s littlest patients. Dr Marc Hendricks is a paediatric oncologist based at Red Cross War Memorial Children’s Hospital in Cape Town, where he trained. He also teaches for the University of Cape Town and is an examiner for the College of Paediatricians of South Africa.
LIFE PLUS GET SUPPORT The CANSA TLC (Tough Living with Cancer) programme offers support to children, teens and families affected by cancer, including support groups, prosthetic assistance, medical equipment, school programmes and accommodation for parents or guardians where possible. Call 0800 22 66 22 (toll free), email email@example.com, visit www.cansa.org.za and Facebook CANSA TLC CHOC provides practical help to children with cancer and their families, and has branches countrywide; visit http://choc.org.za The South African Children’s Cancer Study Group website has all the treating units and heads of clinical units as well as information on childhood cancer; www.saccsg.co.za
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But never be tempted to lie to them: it breaks trust. Explain that yes, taking blood may hurt a little, but it will be over quickly. ‘There are things we can do that minimise trauma, such as pre-medicating with anxiolytics for a needle-phobic child, applying local anaesthetic cream to blood-taking sites, using assisted devices (ports or external lines) and distraction therapy,’ says Dr Hendricks. ‘This could be discussed during family meetings.’
TOLL FREE 0800 22 66 22
CANSA SUPPORT GROUPS Cancer Survivors
(living with, living through and living beyond cancer),
you are NOT alone!
CANSA also invites Survivors who would like to encourage fellow Survivors in their own community, to start a local CANSA support group.
A Caring Community for those Affected by Cancer
All Survivors in South Africa should have the opportunity to join a caring, supportive community, where their needs can be addressed, and to improve their quality of life.
Join a caring community
Join your local CANSA Support Group
www.cansa.org.za/cancer-counselling/ #CANSASupportGroups #CANSACares
or join our Facebook community of survivors and caregivers: @CANSA Survivors - Champions of Hope @CANSA Caring for the Caregivers
I N N O VA T I O N
INNOVATING THE PRIMARY HEALTHCARE EXPERIENCE With its sophisticated technology, world-class clinical protocols and highly skilled staff, the new MyLife Healthcare Centre in Johannesburg guarantees a hassle-free, affordable, quality care experience. By Carla Hüsselmann
hen you cross the threshold of Life Healthcare’s high-tech pilot clinic, MyLife Healthcare Centre, in Auckland Park, Johannesburg, you’re immediately impressed by this sleek future of primary healthcare. The walk-in clinic’s smart, quiet waiting room isn’t manned by busy receptionists and you don’t have to struggle through loads of admin. Instead you’ll use a mounted tablet for a quick, paperless registration process, confirmed with a text message to your phone, and then be whisked away by a nurse. In fact, its multiskilled staff promises that in a fluid 25 minutes you’ll get the best quality care for minor ailments, family planning and preventive health.
From sophisticated medical gadgets like the temperature gauge, which looks like a toy gun and uses infrared technology to read your temperature without skin contact, to the WBC DIFF device that checks your white blood cell count to determine whether you need antibiotics, and the HoloLens, a virtual reality headset that uses holograms to explain your symptoms to you, the clinic uses the most advanced medical equipment to tend to your health needs, says Leilani Kruger, the clinic’s operations manager. Surprisingly, too, you’ll only have to pay R300 to R350 for your appointment and basic medication – and less for some services – and the clinic specifically caters to those who don’t have medical aid.
I N N O VA T I O N
using high-tech medical devices like our interactive scale, which automatically calculates your height, weight and body mass index (BMI) when you step onto it, and the HB 01+ machine, which checks to see if you’re iron deficient. They’ll also do your clinical consultation, deciding on your diagnosis and the most appropriate treatment plan. Then the doctor will review your case via a video conference call and a prescription will be written, and a medical certificate issued, when necessary.’ At all times you’ll be able to view the data the nurses are collecting on you, as there are big screens in the consulting rooms displaying this vital info to keep you in the loop. Once you’ve finished with your consultation, you’ll do a quick customer satisfaction survey at the survey station and then pay with cash, credit or debit card. Soon patients with medical aid will be able to pay and claim, too, says Kruger.
MyLife Healthcare Centre’s mission is to put the world’s best primary healthcare in the hands of the many, says Dr Kelli Willson, Life Healthcare Group’s Primary Healthcare Integration Lead. ‘A large section of our population – the employed uninsured – isn’t currently catered for by traditional primary healthcare models,’ she explains. ‘MyLife aims to solve this problem by offering convenient, affordable, quality care through the use of cutting-edge technology, world-class clinical protocols and outstanding clinical staff. ‘We drew inspiration from a range of international healthcare solutions, including CVS Minute Clinic in the USA and Babylon in the UK. But for the most part, we based our clinic on what our potential customers advised they needed and wanted, to solve their primary pain points.’ Efficiency and transparency Opened in November last year, MyLife took a brisk five and a half weeks to construct and kit out. Conveniently, its highly efficient team will see to your needs seven days a week, says Kruger. ‘Our nurses will do your vitals assessments, such as height, weight and blood pressure,
Affordability A general consultation costs R300 to R350 and includes any medication from the essential drug list, which comprises basic medication. ‘Anything outside of this list is for the patient’s own account,’ explains Kruger. ‘You pick up your prescription at the pharmacy a few doors down. Two days later you’ll receive a follow-up text message checking up on your recovery.’ The clinic is exceeding its monthly growth rates, says Kruger, and their patients’ feedback has been very positive. ‘We’re currently achieving a 98% satisfaction score in our post-consult survey,’ confirms Dr Willson. ‘Our patients are particularly impressed with the technology and they feel it’s “good value for our money”.’ Owing to this resounding success, additional MyLife Healthcare Centres are planned for Gauteng and other provinces.
How MyLife can help you 1. T HE TREATMENT OF MINOR AILMENTS, INCLUDING: • urinary tract infections • uncomplicated infections • headaches • earaches • sinusitis • colds and flu • upper respiratory infections • sore throats • pink eye • skin irritations • simple wound care • sexually transmitted infections 2. GASTRO-INTESTINAL CONDITIONS, INCLUDING: abdominal pain, indigestion, nausea, vomiting, constipation, diarrhoea 3. MINOR INJURIES 4. ADMINISTERING INJECTIONS 5. S UPPORTING THE MANAGEMENT OF CHRONIC CONDITIONS: • high blood pressure • diabetes • asthma • HIV/AIDS • cholesterol 6. FAMILY PLANNING 7. PREVENTIVE HEALTH: • Pap smears • breast examination • HIV testing and counselling Main images, from left: Registration at MyLife Healthcare Centre is quick and paperless; high-tech equipment is used in treatment rooms to ensure accurate diagnosis and efficient treatment
For more info, visit https://mylife.clinic/
MEET OUR EXPERTS Dr Kelli Willson is a medical doctor with clinical and management experience in both traditional and commercial international healthcare environments. For 15 years she has focused on the design, implementation and management of comprehensive health and wellbeing programmes.
Leilani Kruger has held various non-clinical roles in the healthcare industry, from systems development and implementation to customer relationship management, for nearly 12 years. She is skilled in basic financial principles, risk management and stakeholder relationship management.
YOUR PHARMACEUTICAL S
ometimes reading a package insert or looking up your medication online can leave you more baffled than you were before you started. Life Healthcare magazine asked Philna Botha, a pharmacist at Life East London Private Hospital, Life St James Hospital and Life East London Renal Unit, to help us compile an easy-to-understand glossary of terms.
Active substance – The ingredient in a pharmaceutical drug that is biologically active. Some medication products may contain more than one active ingredient.
Antibiotics – Medicines that are used to prevent and treat bacterial infections. However, when they’re not used as indicated, or are prescribed for viral infections such as colds or flu, antibiotic resistance occurs and the bacteria are no longer susceptible to the antibiotic. Such bacteria may cause infections that are more difficult to treat. Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality. Before you take your medication – Take special precautions to ensure that you know what the medication is used for and what other treatment or food to avoid while using it.
Contraindication – This is a condition or factor that is a reason you should not be taking a certain medication, because it will harm you. For example, if you have an egg allergy and a medication contains egg products, it’s contraindicated for you. Dose – The recommended quantity of a medicine to be taken at a particular time. It’s also important to take it at the correct time, so ensure you discuss this with your doctor and/or pharmacist. Expiry date – Medicines don’t last forever. Ensure you don’t take expired medication – have a regular clean-out
The pharmaceutical world can be filled with confusing jargon. We’ve compiled a handy list to make things simple for you. By Mandy Collins
and take expired medication to your pharmacist to dispose of safely. Frequency – How often you should take your medication. Divide it over 24 hours – three times a day means every eight hours; twice a day means every 12 hours. Generic – A drug product that is comparable to the original in dosage form, strength, route of administration, quality and performance characteristics, and intended use. The only difference is that the generic medication is more affordable. Homeopathic and herbal products – Homeopathy is a medical system that uses tiny diluted amounts of natural substances, such as plants and minerals, and is based on the belief that the body can cure itself by stimulating the healing process. It is important to inform your healthcare professional if you are using any of these products as they might interact with your other medication.
Indication – The condition (illness or disease) that makes a particular treatment or procedure advisable; the reason you’ve had the medication prescribed for you.
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Jaundice – A medical condition that results in yellowing of the skin or whites of the eyes, arising from an excess of the pigment bilirubin. It can be caused by underlying conditions affecting the liver and can also be a side effect of some medications.
pregnant or breastfeeding. Some medication should be avoided during this time. Minimum inhibitory concentration – The lowest concentration of a chemical that prevents visible growth of a bacterium. Neutropenia – This occurs when you have too few neutrophils, a type of white blood cell important for fighting certain infections, especially those caused by bacteria.
OTC drugs – Over-the-counter medications that you can buy directly from the pharmacy without prescription. It is important to inform your healthcare professional if you are using any of these products, as they might interact with your other medication. Pharmacological action – This refers to the specific biochemical interaction through which a medicinal substance produces its pharmacological effect in the body, e.g., lowering blood pressure.
QID – Some medicine is used QID. This simply means four times a day (from the Latin quater in die).
Renal function – An indication of the kidneys’ condition. Some medications may affect renal function, which will be listed in the potential side effects.
Keep out of reach of children – Appropriate storage of medication is important. Confirm the manufacturer’s instruction for storage and keep the medication stored safely out of reach of children at all times.
Side effect – A secondary, typically undesirable effect of a drug or medical treatment. If a side effect is listed in a package insert, that does not necessarily mean you will experience it. Developing drugs is a complicated process, because no two individuals are the same, so even drugs with virtually no side effects might have an undesirable effect in some people.
Lactation and breastfeeding – Inform your healthcare professional if you are
Tachycardia – A rapid heart rate, usually greater than 100 beats per minute.
Unlicensed medication – Look for the registration number of your medication on the package insert. Laws regarding the licensing of medicines have been developed to reduce the likelihood of harm through their use. Unlicensed medicines lie outside that harm management process and are potentially unsafe to use. Viral infection – An infection caused by the presence of a virus in the body. Viruses can infect almost any type of body tissue. Remember, you do not need an antibiotic if you have a viral infection – it can’t kill a virus. Weight – In children, medication is usually prescribed according to the child’s weight to make the dose more accurate. The weight of adult patients is also important for the calculation of correct doses of certain medications.
XRT – Extended-release tablets are tablets specifically designed to release their active ingredient over an prolonged period of time. It is important to use the medication only as prescribed as, for example, crushing these tablets will disrupt the mechanism of release and provide an incorrect dose to the patient. Yeast infection – An infection caused by the Candida fungus. Zero tolerance – There’s no compromise on safety and quality at Life hospitals.
MEET OUR EXPERT Philna Botha qualified as a pharmacist in 1985. She has a special interest in people and is passionate about the role pharmacists play in a patient’s life.
BREAST REALLY IS THE BEST
The romantic view of breastfeeding is of a contented infant suckling calmly at its motherâ€™s breast, but the early days of breastfeeding can sometimes be a time of tears. Experts from Life Healthcare explain why they believe breast is best and share their tips for settling into breastfeeding. By Melanie Farrell
THE BABY FILES
other’s milk is perfect for babies in a number of ways. It’s nutritionally balanced, boosts the immune system and is always on tap. ‘Breastfeeding is the biological norm and the gold standard for babies,’ says certified lactation consultant Hettie Grove, at Life Springs Parkland Hospital in Gauteng. ‘It changes according to the baby’s demands and has a feedback mechanism to supply whatever the baby needs. If baby is sick, it will communicate through the mouth to the breast with each feed.’ The experts agree that breast milk is a wonder food for babies, but getting the hang of breastfeeding can sometimes be tricky for both mother and child. RN Sunette Cordier, Maternity Unit Manager at Life Anncron Hospital in Klerksdorp, says most of the new mothers in the ward breastfeed their babies. ‘We see an average of 40 births every month and we support and motivate the new moms to breastfeed as much as we can. Of course, we respect the wishes of those who don’t want to breastfeed or are unable to breastfeed due to medical reasons,’ says Cordier. ‘We start off with doing skin-to-skin kangaroo care directly after normal deliveries and put the baby to the breast within the first hour of birth. It’s natural for new mothers to be concerned about breastfeeding. For example, many worry that they won’t produce enough milk. In cases where a mom is struggling, we’re on hand to give support and if needed, we can bring in a lactation expert,’ she adds.
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ASK A LACTATION EXPERT RN Hettie Grove answers some of the most frequently asked questions about breastfeeding. What is the best position for the mother to hold the baby when trying to get them to latch on? ‘No position is perfect because each mother-baby pair differs. The ideal would be to let the baby go through the nine instinctive stages* just after the birth and crawl to the breast and latch on by itself.’ How often should a newborn be fed and when can some sort of a routine be introduced? ‘In the first two weeks, babies should drink
between 10 and 12 times in a 24-hour period because this is the calibration period for milk supply later. The baby will settle in its routine by week five to eight, but scheduling a routine is detrimental in the early days and will decrease the supply of breast milk. Production works on a supply-demand basis: the more the baby demands, the better the supply.’ When can a feeding schedule be introduced? ‘I don’t recommend a routine till the baby is 12–14 weeks old because it will decrease the milk supply.’ Will my baby get enough milk? ‘If a nursing mother is worried about her milk supply, she can ensure plentiful milk through a healthy diet, rest, and a lot of liquids. There is only one thing that increases supply and that is to feed or pump more. Skin-to-skin contact should be encouraged as much as possible: there’s plenty of research that demonstrates the benefit of thermoregulation, stabilisation of blood sugar and increased milk supply.’ CONCLUSION When asked for her top tip for new breastfeeding mothers, Cordier said: ‘Enjoy the journey. There will be a lot of ups and downs, but remember you are not alone. Breastfeeding is like riding a bicycle for the first time: you will fall off, but you just need to get back on and try again. And make use of support groups and experienced people.’ Grove has similar advice: ‘When I see new nursing mothers, I tell them: trust your body. It was able to grow a baby for nine months. Your breasts will take over and feed the baby.’
*THE 9 INSTINCTIVE STAGES AFTER BIRTH 1. the birth cry 2. relaxation 3. awakening 4. activity 5. resting 6. crawling 7. familiarisation 8. suckling and 9. sleeping.
Marvellous breast milk Being breastfed has a host of advantages for babies, says RN Sunette Cordier: • Breast milk contains important antibodies, especially immunoglobulin A, which helps your baby fight viruses and bacteria. • Breast milk lowers the baby’s risk for allergies. If exclusively breastfed for the first six months, the baby has a lower risk of infections, illnesses, diseases and diabetes. • Breast milk has all the right amounts of nutrients, is easily digested and readily available. It contains everything your baby needs for the first six months of life. • Babies who are breastfed may have a lower obesity rate. • Breast milk affects your baby’s brain development positively • Being breastfed can reduce the risk of behavioural and learning problems.
DISCLAIMER: Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information and the support of their family, the healthcare system and society at large. If you are unable to breastfeed for health reasons, your doctor, paediatrician or clinic can advise you on the best alternatives to keep you and your baby healthy.
MEET OUR EXPERTS RN Hettie Grove is a nurse, advanced midwife, Community Health nurse, certified lactation consultant and childbirth educator, and has been at Life Springs Parkland Hospital for 22 years.
RN Sunette Cordier is Maternity Unit Manager at Life Anncron Hospital in Klerksdorp. She has been supporting new mothers there for five years.
EVERYBODY’S TALKING ABOUT...
With A-list celebrities and professional athletes touting the benefits, Emily Pettit presents the facts about the latest fad diet that’s said to turn your body into a fat-burning machine
How it works
The aim of the keto diet is to force your body into burning a different fuel, says Meagan Atcheson, clinical dietitian at Life Bedford Gardens Hospital in Germiston. ‘When an individual is in a state of ketosis, the body switches its fuel supply to run on fat and ultimately burn fat, instead of carbohydrates, which is what the body usually relies on for energy.’ When on the diet, you consume large amounts of fats like butter, oil, cream or coconut oil; moderate amounts of proteins such as eggs, bacon, fish, seafood, meat or chicken; low-carb vegetables; nuts; seeds; and high-fat cheeses and yoghurt. The ratio is 70% fat, 25% protein and 5% carbohydrates. 44
Effects of the keto diet
‘It’s no surprise that people on the keto diet lose weight. By cutting out carbohydrates and high-sugar foods completely as well as limiting proteins, the total calorie intake per day reduces drastically,’ says Atcheson. However, eating large amounts of fat is a big adjustment and doesn’t come without side effects. The term ‘keto flu’ is one experienced early on in the diet and can last for a few days to weeks as your body transitions into a ketotic state. Symptoms include nausea, diarrhoea, extreme fatigue, bad breath and altered mental function. There is also no room for cheat days on this diet. It’s strictly all or nothing – one bite of cake will immediately bring your body out of ketosis and you then have to start the process all over again. Atcheson also notes, ‘Individuals should be wary of drastic weight loss at the beginning of their diet as it’s likely due to loss of water weight. Carbohydrates bind with water, so when carbs are restricted, there will be a drop in water weight instead of actual fat mass. Proper fat loss will come with time and consistency.’
Does it come recommended?
The majority of registered dietitians would not recommend the diet to someone looking to lose weight.
They would rather opt for a balanced, nutritious lifestyle change instead of a short-term, restrictive diet. However, for children with epilepsy, the keto diet is considered a specialised treatment option, but can only be prescribed by a trained medical professional. Ultimately, it’s important to remember that an eating plan is a personalised strategy. If you find something that works for you and improves your health and relationship with food, then go for it. There is no one right way to eat for everyone and no one miracle for weight loss. Please talk to your doctor or registered dietitian before making a drastic change to your diet.
MEET OUR EXPERT Meagan Atcheson is a registered dietitian working in a clinical setting at Life Bedford Gardens Hospital in Germiston, as well as in private practice in Bedfordview, Johannesburg. She is passionate about plant-based diets, health promotion and educating individuals about wholesome, balanced lifestyle changes.
I MAG ES GALLO/GETTY IMAGES, SUPPLIED
ove aside, Atkins. With the popularity of high fat-low carb lifestyles showing no sign of abating, the ketogenic diet has become the eating plan on everyone’s lips. A-listers like Halle Berry and Kim Kardashian swear by it, and famed US athletes Tim Tebow and LeBron James credit it for their sporting prowess. Although it’s new in the spotlight, the ‘keto’ diet was originally developed in the 1920s as a treatment option for paediatric patients with epilepsy whose seizures were not controlled by other medications. So how does it work and what does it involve?
POWER OF FIVE
WAYS TO BEAT WORKPLACE STRESS
According to a World Health Organization study, stress-related sick leave accounts for 3 to 10% of gross domestic product lost every year
Stress can motivate you to achieve your goals, but when it’s excessive in the workplace, employees become less productive. Here are some tips to help you cope. By Ruth Mwakanandi
Ask for help
If none of these steps works for you, consult a mental health practitioner. Counselling or coaching will teach you effective ways to handle job stress. If your company has an employee wellness programme, make good use of your access to professional services, as many employees are recognising that poor mental health and regular absenteeism equates to low productivity and profits.
Change your perspective
When your workload becomes overwhelming and starts to impact your mental health, take a step back and identify the areas where you need to adjust your mindset, actions or priorities. Shift your focus onto your strengths and achievements. Prioritise tasks and tackle them one at a time. Learn to say no, as taking on too much can lead to failure – and more stress.
Set achievable goals
Work stress is often self-imposed by setting project deadlines, ideal salaries and positions in the company. This creates anxiety and a fear of failure, leaving you dreading going to work. The Mayo Clinic advises working with colleagues and leaders to set realistic goals. And if you are your own worst critic, ask yourself whether you would speak to a colleague the way you speak to yourself.
Take a break
Pre-empt burnout by switching off work-related digital devices and taking a mental break from work in the evenings. Set aside time to do things you enjoy, such as catching up with friends or family, or escaping with a book or movie. Taking regular breaks during your workday will also relieve some pressure. Chat to a colleague or step outside to get some fresh air.
Get enough exercise
Exercise promotes both physical and mental wellbeing. According to the World Health Organization, adults aged 18 to 64 should do at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week, or an equivalent combination of both. Aerobic exercise raises energy levels and sharpens focus, helping you to perform your tasks better.
LIFE PLUS EMPLOYEE WELLNESS ‘The increasing demands of today’s fast-paced business environment means employees need more personal health, wellness and lifestyle support than ever before,’ says Dr Leanne Mandim, Chief Operations Officer of Life Employee Health Solutions at Life Healthcare, who feels investing in wellness can help: • improve employee engagement and build individual resilience • s trengthen the employer value proposition to attract and retain the best talent • reduce safety risk through behavioural change solutions • e nhance the value and sustainability of the organisation’s most critical resource – people – and demonstrate this to stakeholders • a chieve the organisation’s wider purpose and improve the lives of people, and • b uild the organisation’s reputation and brand. For more info, visit https://www.lifehealthcare.co.za/ about-us/life-employee-health-solutions/
I M A G E G A L LO / G E T T Y I M A G E S 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
AN APPOINTMENT WITH…
DR WENDY DHLOMO
An obstetrician and gynaecologist at Life The Crompton Hospital in Pinetown tells Erin Coe why she is passionate about women’s health, and what she considers a good day at the office DR DHLOMO IN
30 SECONDS… • COFFEE OR TEA?
• HEELS OR FLATS?
• MOVIES OR BOOKS?
• CATS OR DOGS?
• NIGHT OWL OR EARLY BIRD?
How do you define your speciality? Obstetrics is the field of study focused on pregnancy, from conception to post-pregnancy, looking after two lives – the expectant mom and her unborn baby. Gynaecology is the medical practice that deals with women’s health and involves female organs and hormones, from puberty to menopause.
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What conditions do you deal with on a daily basis?
As an obstetrician, many of my patients are pregnant women who come in for antenatal check-ups throughout their pregnancy – until they deliver their baby. While most pregnancies are low risk, there are often challenging, high-risk pregnancies complicated by hypertension, gestational diabetes or other conditions affecting the unborn child. Gynaecology is broader – some women come in for a routine screening or need help with contraception, or else the conditions that are most common include pelvic pain, abnormal bleeding and endometriosis.
Describe an average day.
My days can be unpredictable because babies can arrive at any time, but on a
good day, I manage to go to the gym in the morning, get my kids ready for school and get to the hospital around 7.30am. I then do my ward rounds, which means I check on my overnight patients. The rest of the day is spent consulting with patients in my rooms and a few afternoons are dedicated to scheduled surgeries such as caesarean sections or gynaecological procedures such as hysterectomies or removal of ovarian cysts. Because I have family commitments and I’m actively involved in academic research, I do not work full days, but as you can see, they are still very busy!
Why is women’s health so important to you?
Supporting women during their pregnancy is important as it’s such an incredible time in a woman’s life. My patients are always so appreciative, but they are the ones doing the hard work – I’m just there as a support. The pregnancy journey can be emotional for the family, so it’s wonderful to be part of the joy when the baby arrives. Gynaecology gives me the opportunity to empower women by teaching them how their body works, which is the essence of preventive medicine. I get to do a little bit of everything, so no one day is the same.
• NETFLIX OR NIGHT OUT?
• SMALL TOWN OR BIG CITY?
• BEACH OR SKI HOLIDAY?
• CHOCOLATE OR VANILLA?
MEET OUR EXPERT Dr Wendy Dhlomo is an obstetrician and gynaecologist practising at Life The Crompton Hospital. She obtained her MBChB at University of KwaZulu-Natal in 2002, an MPH from Harvard University (USA) and FCOG from the College of Medicine of South Africa. She is currently completing research towards a PhD, which focuses on prevention of cancer of the cervix.
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CARE GIVING LIFE MEANING
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Finding purpose during the most difficult seasons in your life isnâ€™t easy but it could be one of the most important skills you learn in your life, and science agrees. According to an article published in The Atlantic, a body imbued with meaning becomes physically healthier. Referring to research published in the journal Proceedings of the National Academy of Sciences, scientists found that people with a greater sense of purpose in life were more likely to embrace preventive healthcare: things like mammograms, prostate exams, colonoscopies and flu shots. People with purpose in their lives were clearly more engaged in their own health.
DOGS Life Rehabilitationâ€™s animal-assisted therapy programme has welcomed two new furry family members who are spreading unconditional love and support to those who need it most. By Emily Pettit
rish setters were not traditionally used as therapy dogs in South Africa. However, Charlene Kruger, therapy dogs coordinator at the Life Rehabilitation Unit based at Life New Kensington Clinic, discovered how excellent they are by accident. ‘I took in a red setter from a family who were emigrating, and she came to work with me one day and just thrived,’ she says. ‘This is a breed of dog that loves people and people love them.’ After doing her own investigation, Kruger discovered that Irish setters are used extensively abroad in therapy situations because of their intelligence, stable disposition and endless loyalty. They are also highly trainable, eager to please and have plenty of stamina. Thus convinced, Kruger set about finding the perfect pair to join her furry family at the Life Rehabilitation animal-assisted therapy programme.
I MAG ES GETTY/GALLO IMAGES, FREEPIK, SUPPLIED
What is animal-assisted therapy?
It’s a form of therapy that makes use of animals to improve a patient’s emotional, social and mental functioning, helping them recover from or manage physical and mental health problems. Dogs are most commonly used, but horses, rabbits and guinea pigs are gaining popularity, too. Animal-assisted therapy has a long history. It was first recorded at a retreat in England in the 18th century, where patients were encouraged to interact with domestic animals. More than 150 years ago, founder of modern nursing Florence Nightingale understood the healing power of pets, recording in her book Notes on Nursing that small pets helped reduce anxiety in patients living in psychiatric institutions. Psychoanalyst Sigmund Freud also famously included his dog at sessions, as it helped patients relax. ‘Dogs create peaceful thoughts and good feelings, especially breeds such as golden retrievers and Irish setters,’ explains Kruger. ‘Just visiting patients on the wards provides benefit, as it boosts goodwill and puts patients in a better frame of mind to receive therapy.’
Flanagan and Isla
Meet the newest additions to the Life Rehabilitation animal-assisted therapy programme – both Irish setter puppies, Flanagan is just over a year old and Isla is seven months. ‘They are both amazing with people. Flanagan is a bit of an airhead
Natural healers While dogs are most commonly used, other animals are gaining popularity as emotional support animals. There are very few clinical studies that show the specific benefits of these other animals; it really comes down to the affinity of the patient. Horses Equine therapy is used to help individuals overcome emotional hurdles and physical trauma. Caring for a large animal requires your full attention and offers a break from disruptive thoughts or behaviours. Cats They are best used with individuals who are intimidated or frightened by dogs. They will often be found in nursing homes or hospices, weaving in and out between patients, offering warmth and companionship. Smaller animals Rabbits, guinea pigs and even pigs are being used to offer companionship and help improve fine motor skills. Reptiles Gaining popularity in the UK, reptiles are proving to have benefits for patients with struggles ranging from autism to substance abuse, eating disorders and depression. Their care requires a great deal of concentration and, while not as cuddly as their fellows, they’re slow-moving, calm and interesting to look at. Birds Parrots are known to have high levels of empathy and are finding increasing favour as emotional support pets. They are primarily used to offer affection and comfort to people in hospital, retirement homes, nursing homes and hospices. and loves to “almost” sit on your lap! Isla is calmer and more attentive,’ says Kruger. Both dogs have been in training since they were eight weeks old and go to puppy school every week. They are taught to walk obediently on a lead, sit next to wheelchairs, give way when someone wants to pass and not to jump up. ‘They’re taught not to “kiss” unless they are invited to.’ After months of training, they were ready for their first day in the ward, which
was a great success – both were keen and well behaved. Patients were given treats to hand out and Kruger explains how Isla sat like a lady, waiting patiently while Flanagan behaved impeccably – albeit with a little more fidgeting.
Choosing the dogs
When selecting from a litter, Kruger says she looks for the quiet one. ‘They are often referred to as the “runt” but they are not. I want the one who is lying to one side, who drinks when it needs to but doesn’t make unnecessary demands on its mother.’ They need to be comfortable with all types of people, some in wheelchairs or on crutches, some withdrawn and others loud and aggressive; they need to be okay around machinery and fine with being constantly touched and fussed over. Happily, Flanagan and Isla have passed with flying colours, showing enormous aptitude for their life as therapy dogs. Says Kruger, ‘Their enthusiasm is wonderful to see. They are an excellent addition to the programme, offering patients nothing but affection and unconditional love.’
MEET OUR EXPERT Charlene Kruger is an animal behaviourist, dog trainer, dog handler and Kennel Union obedience judge. She has been training and breeding dogs for 30 years. She also owns a dog training school in Midrand where she supports and rehabilitates rescue dogs.
M Y H E A LT H
PROSTATE CANCER IS NOT A DEATH SENTENCE
While a positive diagnosis can mean the patient needs to make significant lifestyle changes, with early detection there is hope for a full recovery, says Trevor Crighton
rostate cancer is the second most common cancer among men – it is reported that nearly one in five men, worldwide, will be diagnosed with the disease during their lifetime and, in South Africa, more than 4 000 men are diagnosed with prostate cancer every year. The prostate is a walnut-sized gland positioned below the bladder outlet, with the urethra (the tube that carries urine from the bladder) running through it. It secretes seminal fluid and is responsible for about 80% of the ejaculate volume.
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PROSTATE RISKS Urologist at Life Fourways Hospital in Johannesburg, Dr Bradley Wood, says that while genetic predisposition is by far the biggest risk of developing prostate cancer (PCa), behaviours such as smoking, obesity, low testosterone levels and a diet high in fat can increase the chances of developing the disease. The risk of PCa also increases with age – but that doesn’t mean it’s a disease that affects only older men. If detected early, there’s a 98% chance of survival beyond five years, while late detection statistically offers a 26% survival rate over the same period. In terms of prevention, Dr Wood says that a healthy lifestyle is key. ‘Regular exercise and a balanced, low-fat diet of fresh fruit and vegetables contribute to lessening your chances of developing the disease,’ he says. ‘Increased intake of anthocyanins (red pigments) from foods such as tomatoes, berries and grapes also helps, and a Harvard study showed a marked reduction in PCa from men who had more than 21 ejaculations per month.’ SCREENING IS KEY TO EARLY DETECTION Regular screening remains pivotal to early detection, with annual routine prostate-specific antigen (PSA) testing recommended for men from age 40 onwards – and twice a year, beyond the age of 50. For those at high risk (men with first-degree relatives who have been diagnosed with PCa), an annual digital rectal exam is recommended from the age of 40 – but in others, starting at age 50 should be fine. Dr Wood says that the presence of symptoms is often too late a warning sign, as PCa is often already relatively advanced by the time secondary symptoms like backache, blood in the urine or semen or a loss of weight present.
Regular check-ups can catch the disease in its early stages and provide the best possible treatment opportunities. ‘Early detection means Stage 1 disease or PCa confined to the prostate,’ says Dr Wood. TREATMENT OPTIONS VARY Medical interventions for prostate cancer are determined by the progress of the disease and whether it has spread or not. PCa is slow-growing and may not require surgery: options include active surveillance, prostatectomy, radiotherapy, hormone therapy, and chemotherapy. Dr Wood says that unfortunately in South Africa there is a big divide between patients who have access to preventive screening and early innovative treatments and those who do not. ‘Resources are more freely available to those with medical insurance in the private sector. These are generally the patients who are screened for PCa with earlier detection, innovative treatments and higher cure rates,’ he says. While a PCa diagnosis is stressful, it’s not necessarily a death sentence. ‘Find a urologist with whom you’re comfortable, who can walk you through all the potential treatment options and the side effects of each. Don’t be coerced into any treatment modality,’ Dr Wood says. ‘It’s important to advise your male family and relatives that they should get screened for PCa, too.’
PCa SIGNS AND SYMPTOMS The proximity of the prostate gland to the bladder and urethra often means that PCa presents with urinary symptoms, especially in the early stages. Depending on its size and location, a PCa tumour may inhibit the flow of urine. Other symptoms include: • burning or pain during urination
KNOW YOUR PROSTATE TAKE OUR TEST AND SEE HOW MUCH YOU KNOW. 1. Men of any age can get prostate cancer. TRUE FALSE 2. There is nothing that can be done to lower your chances of getting prostate cancer. TRUE FALSE 3. Prostate problems often cause men to have trouble passing urine. TRUE FALSE 4. Prostate cancer is very common in South Africa. TRUE FALSE
ANSWERS: 1. TRUE: While rare, prostate cancer can be found in men younger than 40. The risk of prostate cancer rises rapidly after 50. 2. FALSE: We don’t know exactly what causes prostate cancer, but you can reduce your risk by adopting a healthy lifestyle that incorporates a balanced, low-fat diet and exercise, and avoiding smoking or excessive alcohol use. 3. FALSE: In its early stages, prostate cancer does not inhibit the passing of urine, but as the disease progresses, this can become a problem. 4. TRUE: Prostate cancer affects one in 19 men in South Africa.* *Source: www.cansa.org.za
• difficulty urinating, or trouble starting and stopping while urinating • more frequent urges to urinate at night • loss of bladder control • decreased flow or velocity of urine stream • blood in the urine (hematuria) • blood in semen • erectile dysfunction, and • painful ejaculation.
MEET OUR EXPERT Dr Bradley Wood is a urologist at Life Fourways Hospital in Johannesburg. He obtained his Fellowship of the College of Urologists in South Africa in 2010 as well as his MMed Urology degree from the University of the Witwatersrand.
Roa ste dr ed pe pp e p ou rs
South African flair for South African fare Whether you’re looking to serve up a heart-warming winter soup, cook a lazy Sunday lunch for friends or spoil those you love with a little sweetness at the end of a delicious meal, Mogau Seshoene of The Lazy Makoti’s Guide to the Kitchen has the perfect recipes to get you started
Roasted red pepper soup 10 MINUTES (PREPARATION TIME)
• 3 large red peppers • 1 onion, chopped • 1 tsp garlic, minced • Oil, for frying • 3 medium tomatoes, chopped • ½ cup water • ¼ cup coconut milk • ¼ cup cream • 1 tsp dried basil or 2 tsps fresh basil, finely chopped
40 MINUTES (COOKING TIME)
• 2 tsps sugar • Salt and pepper, to taste 1. Preheat the oven to 180°C and line a baking tray with foil. 2. Place the peppers on the tray and roast until tender and charred on all sides (about 15 minutes). Wrap them in foil to steam them for a few minutes. 3. Meanwhile, fry the onion and garlic
in a pot until soft. Add the remaining ingredients and bring to a simmer. 4. Unwrap the peppers and allow them to cool. Remove the charred skin, seeds and stems, and add the flesh to soup. 5. Transfer the soup to a blender and process until smooth. Return to the pot and simmer gently. 6. Season to taste and garnish with fresh basil just before serving.
Bak ed ho ne y-m us t
en ick ch
Baked honeymustard chicken 15 MINUTES (PREPARATION TIME) 45 MINUTES (COOKING TIME) SERVES 6–8
•8 chicken thighs •S alt and pepper, to season • 1 tbsp oil •2 tsps garlic, minced • 1 onion, chopped •¼ cup honey •3 tbsps wholegrain mustard •2 tbsps Dijon mustard •½ cup orange juice •5 00g baby potatoes, halved •F resh thyme, to garnish 1. Preheat the oven to 180°C. 2. Season the chicken thighs with salt and pepper. 3. Heat the oil in a saucepan that can go from the stove into the oven. 4. Brown the chicken pieces for a few minutes on each side and set aside. 5. Drain any excess fat from the saucepan and, in the same pan, fry the garlic and onion for 1 minute, until fragrant. 6. Add the honey, mustards and orange juice to the pan. Whisk well and bring to the boil. Reduce the heat to a simmer and season the sauce to taste. 7. Return the chicken to the pan and add the potatoes. 8. Transfer the pan to the oven and bake for 45 minutes or until the potatoes are tender and the chicken is golden and cooked through. 9. Garnish with thyme to serve.
Dressed corn 20 MINUTES (PREPARATION TIME)
30 MINUTES (COOKING TIME)
Cook eight cobs of sweetcorn by grilling them over hot coals and dress with one or more of the following: GARLIC AND PARMESAN
In a small bowl, combine 2 tsps of peeled, crushed garlic, 2 tbsps of melted butter, ¼ cup of grated Parmesan cheese and 1 tbsp of fresh lemon juice. 56
In a small bowl, combine 1 tsp of melted butter, a dollop of mayonnaise, ½ tsp of chilli powder and a pinch of cayenne pepper.
PARSLEY AND CHIVES
In a small bowl, combine 1 tbsp of melted butter with ½ tsp of kosher salt and 1 tbsp each of finely chopped fresh parsley and chives.
d se es Dr
All -ro un de rm ari na de
Jew ell ed
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.
This is an extract from The Lazy Makoti’s Guide to the Kitchen by Mogau Seshoene (Quivertree, RRP R340).
GIVEAWAY! Life Healthcare is giving away two copies of The Lazy Makoti’s Guide to the Kitchen by Mogau Seshoene. Email firstname.lastname@example.org with ‘Lazy Makoti’ in the subject line by 31 July 2019 to stand a chance to win.
All-rounder marinade 10 MINUTES (PREPARATION TIME) 35 MINUTES (COOKING TIME) SERVES 6
Sal ted ups caram e ide -do l and a wn cak pple e
• ½ kg pork spare ribs and • ½ kg chicken wings • 2 × 2 tbsps white vinegar • 2 × 1 tsp salt MARINADE
• ½ cup chicken stock • ¼ cup soy sauce • 3 tbsps maple syrup • 1 tbsp brown sugar • 3 tsps garlic, minced • 1 tsp ginger, minced 1. Boil the spare ribs and chicken wings separately with the vinegar and salt for 15 minutes or until done. 2. Drain the meat and place into pans. 3. In a separate bowl, combine all the ingredients for the marinade. 4. Divide the marinade in half and add half to the boiled ribs and half to the wings. 5. Cook over low heat until sauce is absorbed into the meat (about 20 minutes), stirring occasionally.
Jewelled pap Salted caramel and apple upside-down cake 20 MINUTES (PREPARATION TIME) SERVES 8–10
•6 –8 apples, cored and quartered
TO MAKE THE SAUCE:
•⅓ cup butter •½ cup brown sugar •¼ cup cream •½ tsp salt
1. In a saucepan, heat the butter and add the sugar, cream and salt. Stir to dissolve the sugar, bring to a simmer and cook until the sauce turns a caramel colour. 2. Pour the caramel over the apples and set aside.
TO MAKE THE CAKE:
IMAGES CRAIG FRASER, FOOD STYLIST MOGAU SESHOENE
60 MINUTES (BAKING TIME)
• 4 ⁄5 cup butter •¾ cup sugar •3 large eggs •2 tsps vanilla essence • 1 ½ cups self-raising flour 1. Preheat the oven to 180°C. Grease a cake tin and place the apple pieces side by side to cover the base, creating a circular or spiral pattern.
1. In a large bowl, beat the butter with the sugar until fluffy. 2. Add the eggs, one at a time, and combine well. 3. Stir in the vanilla essence and fold in the flour. 4. Spoon the batter over the apples. 5. Bake for 1 hour until a skewer inserted in the cake’s centre comes out clean. Cool and turn upside down onto a plate.
10 MINUTES (PREPARATION TIME) 30 MINUTES (COOKING TIME) SERVES 6
•½ red pepper, chopped •½ yellow pepper, chopped •½ green pepper, chopped •O il, for frying •½ tsp turmeric powder •3 cups water, salt added •2 cups maize meal • 1 tsp butter •½ tsp salt, to season 1. Fry the peppers in a pan, adding the turmeric to the oil. 2. Bring salted water to the boil in a pot. 3. Add the maize meal while stirring until the mixture is thick and smooth, breaking any lumps as you stir. 4. Add the cooked peppers and butter, and combine well. 5. Season with salt, then cook on medium heat for 30 minutes, stirring occasionally.
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RN VERONICA VISAGIE
When Veronica Visagie heard the panicked cry of her neighbours, her instincts and training went straight into action. Her bravery and perseverance on 18 November 2018 saved a young life. This is her moving story, as told to Emily Pettit
lthough it is regular practice for the Visagie family to attend church on a Sunday morning, on 18 November last year they thought it would be better to stay at home so their eldest daughter could study for her exams. This was an exception for them and one that would lead to a remarkable outcome. They hadn’t yet met their new neighbours, so when RN Veronica Visagie’s daughter came downstairs to say she could hear loud shouting coming from their yard, she didn’t know how to respond at first. ‘We didn’t know them, so I initially told my daughter that perhaps the children are just playing; let’s not interfere.’ But a few minutes later, when they heard the mother’s panicked scream for an ambulance, she and her husband wasted no time rushing around to their neighbour’s garden. ‘I saw the mother running and screaming, carrying her two-year-old son in her arms. He was wet and limp and I knew immediately he had been in the pool. I didn’t even speak; I just took the child, lay him on the grass and began CPR.’ Three months before this day, Veronica had completed a CPR BLS (Basic Life Support) course at Life Midmed Hospital in Middelburg. At the time she wasn’t sure if it was something she would ever need, as in her role at the hospital, a doctor is always called when a patient needs reviving. She even said to the facilitator that she wasn’t sure if
DID YOU KNOW?
Brain death occurs four to six minutes after the heart stops beating. CPR keeps the blood flowing and provides the brain and other vital organs with oxygen, giving the victim a better chance at full recovery.
she would ever use this new skill, but the facilitator assured her it was important to have, and that you just never knew when the knowledge might make the difference between life or death… ‘I saw the child’s face and knew instinctively he was dead. There was no heartbeat and I said to my husband that the baby was gone, but I persevered with the CPR. I was counting and compressing and putting my ear to his chest. But there was nothing.
Then I tried a second round of CPR and listened. Again, nothing. I kept looking at my husband, feeling it was pointless to continue, but he just said to me “keep going, keep going, keep going”.’ After the third round of CPR, she put her ear to his chest and there was a faint heartbeat. ‘I cannot explain what I felt when I heard that little murmur,’ she says. The beat gradually grew stronger under her expert administrations and they made the decision to immediately jump into the car and drive to Life Midmed Hospital. ‘I ran with Brandon in my arms to casualty, shouting for help, and we were immediately seen to by the staff on duty.’ Little Brandon spent two days in ICU before he was moved into a ward. A mere five days later he was sent home – happy, healthy and very much alive. ‘He is now like a member of our family. He runs in and out of our home, playing with my children and asking me for snacks. I know he doesn’t remember me from that day, but I will always feel that he is like another child to me.’ Veronica remains humble, and chooses to believe that she was merely an instrument used for a higher purpose on that morning. However, her level-headed response and perseverance were nothing short of heroic – and the result is one less tragic death, one less broken family, and a healthy young boy who has the chance to live a full and happy life.
PUZZLE THIS... Test your mental agility with our brain-teasers
1. CROSSWORD PUZZLE 2. SUDOKU
Difficulty level ***
ACROSS 1 Hard wood 4 Bottle stopper 8 Remain 12 _____ Jima 13 Reed instrument 14 Misplace 15 Stats on a perp 17 ‘My bad’ 18 Hits, old-style 19 Pair 21 Raw rock 22 Pomeranian, e.g. 26 ‘Filthy’ money 62
29 Join together 30 Inseparable 31 Grad 32 More, to Manuel 33 Grown-up nits 34 Office-holders 35 Hen-house invader 36 Moisten 37 Serviette 39 Debtor’s letters 40 USNA rank 41 Swamp 45 Spill the beans 48 Astaire speciality WINTER 2019
50 Tiny bit 51 Prior nights 52 AAA task 53 Foolish 54 Depend (on) 55 ‘Monty Python’ opener DOWN 1 Melodies 2 Crossed the Channel 3 Arizona tribe 4 Hold together 5 Very large 6 Caviar, essentially
7 Vessels for boiling 8 John B of song 9 As well 10 Cleo’s slayer 11 Undeniably 16 Rampage 20 Bankroll 23 Porter’s ‘Let’s ____’ 24 Formerly 25 Will ‘The Waltons’ 26 Reclined 27 Radius’ neighbour 28 Zodiac border 29 Tussaud’s material
32 Lab creation? 33 Michelle’s predecessor 35 Half a sawbuck 36 ‘Give a hoot, don’t pollute!’ owl 38 Skewered entree 39 Urge 42 Con 43 Highlander 44 Wields a needle 45 Auction action 46 Singer Rawls 47 $ dispenser 49 Rd.
3. WORD SLEUTH
Find the hidden words in the diagram. They run in all directions
Beautiful Blustery Breezy Calm
Clear Cloudy Cold Drizzling
Foggy Freezing Frosty Hazy
Muggy Overcast Torrential
Change one letter in the top word to one of the letters that appears in the bottom word, then rearrange the tiles to form a new common word. Do the same with each new word untill you arrive at the bottom word. For example, one path from BARK to PLUM is BARK, MARK, RAMP, RUMP, PLUM.
Whew Whey They Type Pity
Goal Loan Nail Main Mink
I M A G E S 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
June is National Youth Month and 16 June is Youth Day
WHEN LIFE HAPPENS… In her book Youth Revolution, Kiara Nirghin documents how she overcame huge health obstacles to win the grand prize at the 2016 International Google Science fair for her innovative solution to worldwide drought
she said. ‘After reviewing your past medical history, unexplained weight loss, loss of appetite and your blood results, it seems that you have had a parasite in your body for the past 10 months or so,’ the doctor revealed. In just a few words, I knew that what she was saying had to be true. ‘From past case studies, I can confidently infer the parasitic behaviour as bilharzia,’ she explained. ‘Bilharzia, now most commonly known as schistosomiasis, is essentially a parasitic disease caused by worms and primarily contributes to chronic ill health. The eggs of the worm have damaged your intestines and liver. It has been left untreated for just shy of a year, which obviously points to your serious medical complications. The parasite has been thriving in your liver.’ ‘It doesn’t make sense, though,’ interjected my mother. ‘How would a parasite have got into her system?’ ‘Well, the disease originates once the person’s skin has come into contact with
contaminated fresh water. The parasites begin to enter the host’s skin, and will then migrate through the body towards the blood vessels of the lungs and liver. The eggs that the worms will lay will either be passed in the urine or faeces, or they will remain in the tissues of the human host that are usually found in the liver,’ she explained. The liver diagnosis that most of the doctors had come up with finally made sense. ‘Symptoms are often atypical, making diagnosis difficult. Although it has been infecting your body with its eggs for the past 10 months or so, it is possible to get you on a course to recovery. The medication will play a small part in your recovery. Your health, however, will take much longer to improve than the duration of the actual treatment,’ concluded the doctor. After leaving the medical centre, I was fully convinced. My parents were sceptical as to how I would have contracted the disease, but as soon as I got home, I headed straight for my room to start combing through websites, online medical journals and research papers on bilharzia. I found that it is, in fact, the second-most prevalent tropical disease, and that people contract it most often from swimming in the contaminated water of canals, rivers, streams or lakes. Unlike my parents, the cause of all my problems was quite clear to me: mix one fateful school trip and one ‘beach day’ splashing through mud pools, and what do you get? A big helping of bilharzia. Excerpted from Youth Revolution (Penguin Random House, RRP R210) by Kiara Nirghin. Available at all good bookstores.
t was a Tuesday after the April school holidays when my mother informed me of an afternoon appointment I had at a medical health centre in the north of Johannesburg. Both my parents were there to pick me up after school, which wasn’t unusual for the more important appointments. We were 10 minutes late, but the receptionist guided us to an examination room, where a middle-aged doctor was waiting for us. The preliminary questions that fleshed out my medical background were very similar to those asked by the other doctors, but instead of opening a textbook or scratching her head and attempting to give a reason for my poor health, all the doctor did was prescribe three blood tests, which needed to be done immediately. I was confused, as all the blood tests I had had previously were very comprehensive and reflected most of the information that the doctors had needed in the past to make a diagnosis. However, I took the doctor’s note, covered in medical jargon, and a checklist with three ticks, across the hallway to the room where blood was drawn, a procedure with which I had become extremely familiar. I was also asked for a urine sample, which I handed over to the medical assistant. My father received the call 13 days after my initial appointment. We had to see her that same afternoon. As we made our way to the medical centre, we were already expecting a vague ‘liver problem’ diagnosis. We were taken to the doctor’s room. ‘As you know, the test results came in yesterday and I had time to review them. I had to call this urgent appointment,’
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fungal damaged & loose nails
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‘loose nails’: ‘fungal damaged nails’:
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A loose nail can be the forerunner to a fungal infected nail and vice versa, but fortunately most loose nails are not fungal infected. Both conditions however cause severe damage to the nail if not addressed timeously. Only a laboratory test can conﬁrm if it is fungal infected or not and thus we seldom know exactly what we are dealing with - a fungal infected nail or just an unsightly, loose and damaged nail, but without any fungus? There are about 80 causes for nails becoming separated from the nailbed of which fungal infection is only one. http://www.dermnetnz.org/topics/onycholysis Some of these conditions can only be treated by a doctor; but fortunately most fungal damaged and / or loose nails regrow normally if the under-nail conditions get restored; that is, the nailbed being made fungus-free and no longer dry. Using an antifungal alone might eradicate the fungus but it does not change the look of the damaged nail. Until it has regrown to its original splendour, it remains unsightly.
Application Insert one drop under the nail every morning and evening as indicated here:
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In this issue of Life Healthcare magazine, we are making our focus winter wellness, which could begin with adding more fibre in your diet or...
Published on May 31, 2019
In this issue of Life Healthcare magazine, we are making our focus winter wellness, which could begin with adding more fibre in your diet or...