PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
• AUTUMN 2016
YOUR BETTER LIFE STARTS HERE! IMPROVE • RELATIONSHIPS • FITNESS • NUTRITION LIFE-SAVING PROCEDURE THE SKINNY ON WEIGHT-LOSS SURGERY
WHAT THE FITNESS EXPERTS WANT YOU TO KNOW
HYPERTENSION: THE SILENT THREAT YOU MUST HEAR ABOUT
2016/02/16 11:58 AM
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falling leaves and hibernating trees right now (to paraphrase an old children’s poem)… It’s also the season when we welcome cooler weather and start preparing for the real winter chill, but resist the urge to completely slow down. This is the perfect time to get moving and Life Healthcare magazine has some tips from fitness experts to motivate you and help you set achievable goals (page 12). The hazards of sitting or a sedentary lifestyle has been likened to smoking and we tell you why on page 43. Instead, accept nature’s friendly dare and venture out in your city. Estee Kershoff has compiled a list of affordable activities to suit every age group on page 25. Start your day on a healthy note by trying one of Jamie Oliver’s delicious breakfast recipes on page 50, and learn to pack a work lunch that sustains you all day and keeps you functioning at your peak on page 16. For many, a change of season reawakens or heightens allergies and Catriona Ross finds out how the most common can be treated on page 37. As Life Healthcare magazine draws awareness to World Kidney Day on 10 March, Rafeeqah Isaacs shares her inspiring story of how a donor gave her a second chance at life on page 22. If you’re looking for another chance to get it right, start now. A new beginning is every time you decide to make changes that are better for your body, mind and soul. Use this turn of the season to put plans in place to live healthier, feel happier and mindfully savour every moment. SAMANTHA PAGE, editor
T THE INTERES PUBLISH ED IN BY OF YOUR HEALTH PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
SUMMER / 2015
SPRING / 2015
EAT, PLAY, LOVE
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
PUBLISHED IN THE INTEREST OF YOUR HEALTH
• SPRING 2015
• SUMMER 2015
BY LIFE HEALTHCAR E
THE DECEMBER 2015 ISSUE OF LIFE HEALTHCARE MAGAZINE IS AVAILABLE AT WWW.LIFEHEALTHCARE.CO.ZA ‘MAKING LIFE BETTER STARTS HERE’
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DO GOOD, FEEL GREAT YOUR GUIDE TO GIVING
10 to 16 March is Salt Awareness Week
A PUBLICATION BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP EDITORIAL Editor Samantha Page email@example.com Art Director Monique Mouissie Managing Editor Estee Kershoff Copy Editor Raadiyah Abrahams Managing Editor (Life Healthcare Group) Tanya Bennetts EDITORIAL COMMITTEE Yvonne Motsisi, Denis Scheublé, Dr Nilesh Patel, Lucy Balona (CANSA), Dr Adi Horak, Dr Vash Mungal-Singh (Heart and Stroke Foundation SA), Dr Steve Taylor, Janette Joubert, Dr Sharon Vasuthevan, Liesel van Oudenhove MANAGEMENT Managing Director Lani Carstens Group General Manager Rebecca Smeda Group Account Director Joanne Peltz Account Manager Sumeera Dawood Production Director Nina Hendricks Financial Director Ruschda Ismail Business Development Director Warren Harding Human Resources Director Aashiqa Petersen
ADVERTISING Advertising Sales Manager Tessa Fenton-Wells firstname.lastname@example.org 021 795 0430; 082 320 0014 PRODUCTION Production Co-ordinator Tessa Smith Reproduction Resolution Colour Printing Paarl Media Cape Life Healthcare magazine, 2nd Floor, Block A, North Side, Black River Park, Fir Street, Observatory, 7925 / PostNet Suite #2, Private Bag X11, Mowbray, 7705 Email: email@example.com Tel: 021 486 7600 Fax: 021 486 7614 www.johnbrownmedia.com For magazine-related queries, contact John Brown Media. Tel: 021 486 7600 Fax: 021 486 7614. PostNet Suite #2, Private Bag X11, Mowbray 7705.
Life Healthcare magazine is published by The Life Healthcare Group to provide patients, their families and the public with the most readable, interesting and relevant health and well-being 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.
2015/11/13 11:31 AM
THE FACTS ABOUT
LOOK OUT FOR LIFE PLUS BOXES IN OUR MAGAZINE FOR EXTRA INFORMATION AND HEALTH TIPS WWW.LIFEHEALTHCARE.CO.ZA
2016/02/19 11:24 AM
THIS MONTH’S FOCUS … HEALTH FIRST
Contents LIFE 01 LIFE IS…
A note from the editor
04 OVER TO YOU
Letters from our readers
Medical innovations, what’s new at Life Healthcare and latest reads
12 WHAT THE FITNESS EXPERTS WANT YOU TO KNOW The experts give sound advice and tips about getting fit and in shape By Charlene Yared-West
14 SPECIAL DELIVERY
Here’s what you need to know to have the best birth experience for you By Jocelyn Warrington
16 WHAT’S FOR LUNCH?
Break out of your lunch rut and learn to pack healthy options By Samantha Page
18 ADOLESCENT SUICIDE: A GROUP AT RISK
Why are our teens so troubled? By Lisa Lazarus
20 ARE YOU A GOOD COMMUNICATOR?
Take our quiz and evaluate how well you communicate with others
22 ‘MY DONOR GAVE ME A SECOND CHANCE AT LIFE’
GET OUT AND GET MOVING
Rafeeqah Isaacs shares her story of her life-saving kidney transplant As told to Lynne Gidish
25 MORE FUN FOR LESS
Keen to get out and about but on a budget? Try one of these activities for under R160 By Estee Kershoff
2016/02/16 12:15 PM
START THE DAY STRONG
ADOLESCENT SUICIDE: WHY ARE OUR TEENS TROUBLED?
WHAT YOU NEED TO KNOW ABOUT WEIGHT-LOSS SURGERY
30 THE SKINNY ON WEIGHT-LOSS SURGERY
48 BYE TO THE BUTTS
When diet and exercise don’t work and obesity poses serious health problems, bariatric surgery may be the answer By Glynis Horning
34 MIDDELBURG GETS A NEW RENAL UNIT
Life Midmed Hospital’s new facility serves the community and brings innovation to Mpumalanga By Mandy Collins
37 ALLERGY ALERT
How to treat the most common allergies By Catriona Ross
39 JOB PROFILE
What does a paediatric nephrologist do? By Catherine Eden
40 RESTFUL SLEEP
What you need to know when your child needs anaesthetic By Melanie Farrell
43 EVERYBODY’S TALKING ABOUT … SITTING
Is it the new smoking? And how do you get moving again? By Charlene Yared-West
45 BURNS FIRST AID
If you’re ready to give up the habit, here’s how to take charge of your health By Lisa Witepski
49 HYPERTENSION: THE SILENT KILLER
How to diagnose and control the disease By Mandy Collins
50 GOOD MORNING
Healthy breakfast recipes from Jamie Oliver’s new cookbook Everyday Super Food
61 LIFE HEALTHCARE HERO OF THE MONTH
Elizabeth Mziwabantu shares her story of courage
62 MIND GAMES
Take a break with our puzzles and crossword
64 BEING PRESENT
Author Ruby Wax on the power of practising mindfulness
57 PUTTING PATIENTS FIRST
This is how Life Healthcare puts patients at the heart of everything it does By Gillian Warren-Brown
59 THE SEED THIEF
An excerpt from Jacqui L’Ange’s intriguing new novel
EXPLORING BIRTHING OPTIONS
Five of the most effective ways to treat burns in the home
2016/02/16 12:15 PM
OVER TO YOU We’d love to hear from you
Good listener When the nurse at Life Dalview Hospital heard my friend’s child crying non-stop, she came to the ward. She said that she was sure the pain was unbearable, so she would give him something to feel better. I was so touched that she took it upon herself to come and assist us since she could hear we were trying everything to calm the baby, which was frustrating and distressing. Thank you for listening to a child’s cry, because whatever you gave him helped. It made the child’s mother and me feel reassured beyond measure. Mpho Mutshekwane, Gauteng
A MOTHER’S GRATITUDE My compliments to the excellent staff at Life Roseacres Hospital’s paediatric ward. It was the first time one of my children ended up in hospital, so I was nervous, scared and shaken considering that my son was only five months old. From the time we walked in to the time we left, all the sisters and staff were friendly and helpful. They went out of their way to make our stay comfortable. When my son cried at night, the sisters fetched him so that I could sleep for at least 30 minutes. There were always jokes and smiles, and even after a long night shift they were friendly. Their kindness kept on beaming. May this email reach everyone from the cleaners to the nursing staff because we are grateful for the selfless service we received.
HANDLED WITH CARE Thank you to the nurses and staff at Life Kingsbury Hospital’s gastro-intestinal (GIT) unit, for taking great care of my husband and making his stay pleasant. This was the first time that someone in our family was in hospital and we didn’t know what to expect. It was great to feel that the atmosphere was pleasant. Gone are the days of stuffy nurses of the ’80s and ’90s who made us feel like we were back at school.
Sumaiya Mohamed, Cape Town
AGE IS JUST A NUMBER I work at a retirement facility called Norfolk Place. The residents are all so kind and the oldest is 99. During my first week, one of the residents had been vomiting all night and day. I called ER24 and the resident was taken to Life Kingsbury Hospital’s emergency unit. The doctor and nursing staff were so caring towards this 90-year-old lady. I was super impressed and I now feel comfortable taking patients to this first-class facility. Thanks to the staff from Life Kingsbury Hospital’s emergency unit. Sr Debbie Hoffmann, Cape Town
TWEETS OF THANKS
Every morning at Life Robinson Private Hospital, I woke up to the sound of prayer and singing. It was the best feeling knowing that my child and I were in the hands of caring and dedicated nurses and staff. Your encouragement and jokes during the time my baby spent in ICU made it easier for my husband and me to cope. Janine, via @HiHelen
Charlene Zondagh, Gauteng
Win a Lifegain hamper valued at R1 000 Lifegain is a high-quality nutritional supplement in a shake format, which can be mixed with milk, water or juice. It is specifically formulated for use as a supplement during periods of increased nutritional needs to assist people in regaining their physical and emotional wellbeing when they are recovering from or managing the effects of illness or surgery. When essential nutrients are lacking over a long period of time, there is a greater risk of degenerative disease so there is also an increased nutritional need to supplement diets when people are elderly, undergoing stress, on restricted diets or physically or mentally ill. Email your thoughts on life, health or care to firstname.lastname@example.org and you could win.
2016/02/16 2:37 PM
Walk without pain Donâ€™t let joint pain rule your life
Visit our website for more information
High-tech cancer treatment in SA
s more South Africans seek cuttingedge cancer treatment options abroad, it is good to know that innovative technology is available here in South Africa. Novalis Tx radiosurgery (a form of radiation treatment) is a non-invasive, painless and versatile radiosurgery treatment of tumours of the brain and body. It allows for protection of surrounding healthy tissue, and takes body
or tumour movements into account, which has the propensity of increasing overall treatment accuracy. Life Vincent Pallotti Hospital oncology centre in Pinelands, Cape Town currently operates a Novalis Tx to treat cancer patients. A further two systems will become operational at specialist Life Healthcare oncology centres in Hilton, KwaZuluNatal and Pretoria, Gauteng later in 2016.
www.lifehealthcare.co.za About Life Healthcare Group
Life Healthcare Groupâ€™s primary business is private acute hospital care with 63 healthcare facilities in seven of South Africaâ€™s nine provinces and one hospital in Botswana. The Group also provides services for acute physical rehabilitation, acute mental healthcare, renal dialysis, occupational health and wellness. The Group includes an international presence through Max Healthcare in India and Scanmed Multimedis in Poland.
LIFE NATURE’S SUPER SPICE / SALT AWARENESS / INNOVATIVE BREAST SCAN / LATEST READS
‘ALL THERE IS TO DO, RIGHT AT THIS VERY MOMENT, IS BREATHE IN, BREATHE OUT, AND KISS THE JOY AS IT FLIES.’ DANI SHAPIRO
2016/02/16 12:18 PM
Medical innovations and Life Healthcare news
LIFE HEALTHCARE SAYS Salty potato chips, an extra sprinkling of butter-salt over your popcorn at the movies and a liberal dousing before launching into any meal could all contribute to your thirstiness. ‘The saltier your diet, the more water you’ll want,’ says Dr Mehmet Oz in his magazine The Good Life. According to Salt Watch, most of the food we eat already contains salt (always remember to check food labels) yet most of us add more to our food during cooking and at the table, often before even tasting. Salt extracts water from your cells and when your brain detects a drop in your water levels two things happen: it triggers thirst and instinctively conserves water, signalling the kidneys to turn less into urine, explains Edward Stricker, PhD, a neuroscientist at the University of Pittsburgh. If a friend is thirstier than you, even though you ate the same thing and exercised the same amount, it could simply be your biology: your friend may produce less of the hormone that tells the kidneys to conserve water. He or she probably urinates more away and has to keep replacing it. Age can also be a factor: as you get older, you get worse at detecting thirst – a 30-year-old and a 75-year-old could be equally dehydrated, says Stricker, but the younger person would feel it more and reach for replacement fluids faster. Visit www.saltwatch.co.za for more information.
Cinnamon It’s one of the oldest known spices and has long been used in traditional medicine. Recent findings also suggest that it promotes health with particular benefits for people with type 2 diabetes. These are a few health benefits: • Anti-inﬂammatory • Improves cognition • Lowers cholesterol and may cut the risk of heart disease • Regulates glucose levels • Rich in manganese, iron, calcium and fibre
Here are four ways to incorporate this super spice into your diet: • Add one or two teaspoons of ground cinnamon to a hot cup of green tea or cider. • Add it to your breakfast oatmeal while cooking. • Sprinkle it on top of your ground coffee before you brew it. • A dash of cinnamon added to soups, such as lentil or black bean, adds an exotic flavour.
C O M P I L E D BY SAMANTHA PAG E. I M A G E S G ET TY/GALLO I MAG ES, ISTOCK, FLATICON
Why are some people thirstier than others?
2016/02/16 12:20 PM
THE RIGHT WAY TO
Thoroughly inspect your feet daily and keep them clean and dry, especially if you have diabetes.
LACE YOUR SHOES Four common foot issues could be solved by correctly lacing your shoes.
C O M P I L E D BY SAMANTHA PAG E. I M A G E S G ET TY/GALLO I MAG ES, ISTOCK, FLATICON
TOPS OF YOUR FEET ARE SORE
Problem: Shoes rub tops of your feet, causing irritation or blisters, common in people with high arches. The fix: Skip lacing. Lace around (not over) the problem area to relieve pressure.
Problem: Shoes feel too tight on the tops of your feet. The fix: Parallel lacing. Don’t cross laces over each other after each eyelet – alternate going up and across to the next eyelet like a ladder.
TOO TIGHT SHOES
Problem: Your toes feel restricted. The fix: Double laces. Tying the shoe in two places allows you to make it looser at the forefoot. You’ll need two laces for each shoe. Start from the bottom with one lace and tie a bow in the middle. Then use the second lace, starting from the eyelets above the bow of the first lace, and tie a bow at the top. Experiment till you get the right fit.
Problem: Your heels slip up and down. The fix: Heel loops. Lace each shoe normally, but at the mouth use side holes (often left empty) to run the lace up and out to create a small loop. (Don’t cross over the tongue just run lace under and up through the next hole.) Then take ends of the lace, cross to opposite side, and run through these loops. Pull to tighten.
TRY IT OR
If Ignored Loose and / or Fungal Nails degenerate normal nail
See why ? and thé Solution! on: www.fix4nails.co.za R
THE QUESTION: A ‘cheat day’ once a week or a little treat every day? THE EXPERTS SAY: Enjoy little pleasures. ‘A food cheat day can get out of hand,’ says Lori Williams, a registered dietician at Ohio State University’s Wexner Medical Center. You could end up consuming as much as 2 000 (8 368kJ) additional calories, and then there’s the bloating, GI issues and guilt. On the other hand, having a small portion (about 418–627kJ) of something delicious every day makes you less likely to feel deprived. (Trying to lose weight? Indulge three days a week.) Life’s too short to live without the food you love,’ Williams says.
What is ... flibanserin*? Also known as ‘female Viagra’ this drug was recently approved by the FDA to treat premenopausal women with hypoactive sexual desire disorder (HSDD). It is estimated that around one in 10 women develop HSDD, and up to 40% experience the condition at some point in their lives. *Flibanserin is not yet available in South Africa
(at Dis-Chem, participating pharmacies and salons)
Tel 0861 9999 07 9
2016/02/18 9:07 AM
BITS & BY TES
A SITE TO SEE
cancerdojo.org International award-winning creative director and cancer surviver Conn Bertish has created a digital platform and mobile app that provides tools and content to empower people affected by cancer. The site employs a dojo ideology, which Bertish describes as ‘a playful, irreverent approach and attitude to facing big, hairy and seemingly serious problems. It’s a way of actually confronting your fear of things and then putting them into the context they deserve. This kind of thinking has well-documented physical, psychological and immune-boosting qualities that not only make you stronger during a difficult time, but can enable you to view the world in a fresh way that may very well deliver you the solution to something that seemed impossible or out of your grasp. It also makes life more fun – what a bonus!’
Can changing the font on your morning memo improve memory retention? According to research published in the journal Cognition, you should try using a different, slightly difficult-to-decipher font (not your conventional Times New Roman). Focusing on a new font may make your brain’s processing centre work a little harder, which could increase your recall. Change to Comic Sans italicised (the font used in the study) for a quick fix that you may not notice but your brain will. Source: health.com
Two-in-one breast cancer scan In November 2015, a home-grown piece of medical equipment, which for the first time combines digital mammography and ultrasound technology that will more accurately and quickly diagnose breast cancer, was unveiled at Groote Schuur Hospital in Cape Town. While one in eight women in South Africa develop breast cancer, about 40% of these cases have dense breast tissue, which makes screening and diagnosis difficult. Very often, women have a single screening and receive the all clear yet they may still remain vulnerable without a scan of the deep tissue. The Aceso machine is the world’s first imaging system to combine the two technologies and will allow for the instant detection of even the tiniest breast cancers. Designed and developed by Cape Ray, a Cape Town medical technology company, the R30 million unit has been proven effective and safe in screening for breast cancer after it was tested on more than 50 healthy volunteers and 20 patients with confirmed breast cancer. Testing continues in order to receive the CE mark – an accreditation that allows the technology to be marketed in Africa and Europe. It also needs Food and Drug Administration approval to be marketed in the US.
Did you know?
Life Anncron Hospital, located in the heart of the North West province in Klerksdorp, has been generating its own electricity to meet the hospital’s power needs since the end of January 2015. At a cost of R6.7million, 1 711 solar panels have been installed on the hospital roof, which will produce more than 50% of the hospital’s energy needs in summer and at least 40% in winter.
I M A G E S G ET TY/GALLO I MAG ES, ISTOCK, FLATICON
IMPROVING YOUR MEMORY TECHNIQUE
2016/02/16 2:30 PM
SHELF HELP The latest reads to nurture your mind, body and soul
I M A G E S G ET TY/GALLO I MAG ES, ISTOCK, FLATICON
HOW THE BODY KNOWS ITS MIND By Sian Beilock An award-winning scientist and author presents ground-breaking research on the mind-body connection and its profound impact on everything from advertising to romance. How does pacing around the room enhance creativity? What causes fitter children to score higher in exams? The answers to these and other thought-provoking questions are examined in Beilock’s book, which presents his theories around the new science of ‘embodied cognition’ and illuminates the power of our bodies and our physical surroundings to shape how we think, feel and behave.
We are giving away two copies of How the Body Knows its Mind. Email lifehealthcaremag@johnbrownmedia. com by 31 March 2016.
RISING STRONG By Brené Brown The New York Times best-selling author has done it again. She’s written a book that is searingly honest and revolutionary but ultimately focused on healing. ‘When we deny our stories, they define us. When we own our stories, we get to write the ending,’ says Brown, and this is how she has started a global conversation about courage, vulnerability, shame and worthiness. Rising Strong is about the rise from falling, which Brown says we’ll all experience at one time or another. She has listened as a range of people – from leaders in Fortune 500 companies to teachers and parents – shared their stories of being brave, falling and getting back up, and compiled them into this inspiring book. Rising Strong is a challenging book because it forces you to honestly look at your life, but like all of Brown’s books, it gives the reader hope.
COOKING FROM THE HEART 3 By Heleen Meyer and Ashleigh Badham-Thornhill Cooking from the Heart is a recipe book series, developed in 2012, in partnership with the Heart and Stroke Foundation SA. The cookbook was created to serve as a practical tool to guide the nation to healthier cooking and eating. This third instalment also features diabetes-friendly recipes, since research shows a strong correlation between heart disease and diabetes. Every page is packed with flavour, nutritional information and guidelines to eating healthy and living well. If you love cooking and (healthy) eating, this is definitely a book for your bookshelf.
We are giving away three copies of Cooking from the Heart 3. Email lifehealthcaremag@johnbrownmedia. com by 31 March 2016. WWW.LIFEHEALTHCARE.CO.ZA
2016/02/16 2:30 PM
FIT FOR LIFE
FITNESS EXPERTS WANT YOU TO KNOW
Movement can happen in the gym, or can be tickle ﬁghts, sex, a walk on the beach, playing sport – anything that gets you moving, explains Dr Greg Venning, author and chiropractor at Peak Chiropractic in Cape Town (www.capetownchiro.com). ‘Fitness has at least 10 different components and human beings do best when they have competence in each of these. They are: strength, speed, endurance, stamina, power, accuracy, mobility, coordination, balance and agility,’ he says. ‘How each person archives these is going to be personalised, as there is no single path to ﬁtness. Find the things you love and approach them playfully, and practise them for mastery. That will accelerate your short-term results and give you long-term staying power.’ Adele Pudney, a physiotherapist from ADK Physio & Hydrotherapy (www.wellspringcentre.co.za), agrees. ‘You must learn to love yourself and the movement you’re doing to be successful in maintaining your exercise goals. Be kind to and reward yourself for small improvements,’ she says. ‘See it as a journey; there will be times of great enthusiasm and moments of total disinterest – be prepared to cope with both ends of the spectrum.’
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The last thing you want to do is take advice from someone who doesn’t know what they’re talking about. Charlene Yared-West speaks to the experts and ﬁnds out what you should be doing to get ﬁt – and stay ﬁt
or many, becoming ﬁt and healthy is easier said than done; it seems an insurmountable challenge. According to the World Health Organization, obesity has more than doubled since 1980, and in 2014 more than 1.9 billion adults were overweight. One of the best ways to avoid becoming a statistic is to prioritise your health and wellness, meaning better nutrition, more movement and improving your ﬁtness.
2016/02/16 2:40 PM
FIT FOR LIFE
MOVEMENT FOR HEALTH
‘Quit exercise. Workouts suck. Practise and play with movement and rediscover the joy in it,’ says Dr Venning. He recommends moving for at least ﬁve minutes a day, which, as you start to enjoy the movement, will expand over time. ‘You require three types of movement for health; move moderately every day, move heavy things one to three times a week and move fast one to two times a week. Avoid long, repetitive cardio workouts; they aren’t as good for you as you think.’ Zeno Rossouw, a physiotherapist based at Life Orthopaedic Hospital at Life Vincent Pallotti Hospital, points out that 30 minutes of daily exercise can reduce both weight and BMI almost as much as a 60-minute workout. ‘Be time efﬁcient and rethink the value of a warm up. It is crucial to prepare your muscles for the activity they are about to endure,’ he says. ‘It also helps to choose an exercise that will keep your mind guessing, such as cross-training. Each new and different workout can target different muscle groups, which can reduce the risk of injury, boost energy levels and keep boredom at bay.’
Avoid long, repetitive cardio workouts; they aren’t as good for you as you think Dr Venning adds that a short duration (less than 20 minutes) of high-intensity intermittent training (HIIT) can help you get all the beneﬁts of cardio in a fraction of the time. ‘Avoid moving or lifting weights if you can’t move your own body weight well. Start small and do something you enjoy doing.’
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ARE THERE SHORT CUTS TO FITNESS FREEDOM?
The experts concur: there is no easy way – and no short cut, but you can still have fun. Liesl Way, a physiotherapist at Life Westville Hospital, says that consistency and discipline are key in the beginning of your path to ﬁtness. ‘Start with simple activities that you enjoy and realise that ﬁtness is built over time and not overnight, so don’t binge exercise. Doing so will make you lose your motivation and possibly cause injury. And you’ll feel awful (physically and emotionally) if you exercise beyond your current ﬁtness level,’ she says. Exercise creates opportunities to meet new people, leads to a sense of well-being, can combat feelings of depression, increases energy levels, can reduce insomnia and can be an enjoyable part of your day, adds Liesl.
Top tips to get ﬁt • Start small and make steady daily improvements. • Use positive and realistic afﬁrmations and pictures to motivate yourself. • Take part in outdoor exercise. Fresh air, the scenery on a trail run or mountain biking can boost your energy levels. • Tracking your activity is also a very useful exercise, whether it’s a ﬁtness diary or an app on your smartphone. • Get a workout partner; someone who will challenge you and thereby increase how long and hard you workout. • Enlisting the help of a personal trainer could increase motivation. They’ll supervise and ensure you’re using the correct technique
What should you avoid on your journey to fitness?
to prevent injuries and ensure good results. • Nutrition plays a major role: a six pack is made in the kitchen, not the gym. • Consider keeping a food diary to track how certain meals impact your performance. • Sleep is a vital aspect of a healthy, balanced lifestyle. Ensure you get six to eight hours per night. • A post-workout cool down can leave the impression that a workout wasn’t as tough as originally expected – this is a better mindset for getting back to the gym the next day. Perform static stretches with 20–30 second holds. • Love yourself enough to take care of yourself.
• Having a cheat meal after a good workout. • Procrastinating when to start your routine. • Focusing on the end goal. It becomes overwhelming and prevents us from moving forward. • Making excuses as to why you shouldn’t workout. • Setting unrealistic goals and time frames. • Continuing with an unhealthy diet. A balanced, healthy diet is important for joint and muscle health. • Starving yourself in an attempt to speed up the weight loss. • Ignoring the value of adequate rest as well as stretching before and after exercise. WWW.LIFEHEALTHCARE.CO.ZA
2016/02/16 2:40 PM
In an age where birth has often been overtaken by obstetrics, many women are unaware of the alternative options available to them. Here’s what you need to know to have the best birth experience for you. By Jocelyn Warrington
I M A G E S G ET TY/GALLO I MAG ES, FLATICON
espite the desire of the vast majority of women to have the most instinctive, self-directed, interventionfree birth possible, South Africa’s private sector has one of the world’s highest caesarean section rates: 70.7% of the births funded by medical aids in 2014 were caesarean sections, according to the latest Council for Medical Schemes annual report. ‘Historically, birth in this country is obstetrics led,’ says private midwife Sharon Marsay from the Genesis Clinic maternity hospital in Johannesburg. She explains that an obstetrician is a specialist trained in the ‘diseases’ of pregnancy. ‘While obviously crucial to the birthing process, an obstetrician is concerned with complications arising from pregnancy and birth, while a midwife focuses on the physiological process of healthy birthing.’ However, Marsay agrees that many mothers-to-be ﬁnd themselves torn between the desire for a natural childbirth with minimal medical intervention and the peace of mind offered by instant access to life-saving technology that only a hospital can provide. According to the midwife, there is no good reason that they should not be able to have both. ‘With the help of a midwife and doula, expectant moms can be
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GR OWING LIFE
equipped with the knowledge they need to ensure a satisfying hospital birth that they will look back on with peace and joy.’
MIDWIFERY FOR MODERN TIMES
In South Africa, a registered midwife has a diploma or degree in nursing and, explains Marsay, is trained to take expectant mothers right through pregnancy, birth and beyond, educating her in everything from diet to exercise to breastfeeding. ‘My job is to help the mom-to-be to truly experience her birth, to participate fully in its miracle,’ she says. ‘When the mother is in a calm, private and safe environment – be it at home, in a birth clinic or in a midwife-led maternity facility in a hospital – she is free to take up any position she feels is most comfortable and can work with the natural rhythm of her breathing. Her body is then able to release oxytocin, a powerful hormone that interacts with the receptors in the brain to reduce the
I M A G E S G ET TY/GALLO I MAG ES, FLATICON
My job is to help the mom-to-be to truly experience her birth, to participate fully in its miracle
perception of pain. In fact, it is 27 times stronger than pethidine, the drug widely used for pain relief in labour.’ Your ﬁrst consultation with your midwife can last up to two hours and provides the opportunity to establish your birth plan and the role your midwife will play in supporting you and your partner through it. ‘It is important to ﬁnd out from your potential midwife what training she has had (you may even check certiﬁcation credentials) and whether she has a back-up midwife for times when she is not available,’ advises Marsay. ‘Find out what kind of services she offers postpartum and when they begin. And, of course, ask her what her fee includes and what her refund policies are.’
THE DOULA DIFFERENCE
Also known as a birth companion, a doula is trained to provide non-medical support before, during and after delivery. ‘Research has shown that doulas help women have positive birth experiences, decrease the need for pain medication, improve breastfeeding success, and reduce the need for caesarean sections and other invasive procedures,’ says Tertia Alkema, a certiﬁed private doula based in Johannesburg. The doula will meet with the expectant mother and her partner up to four times before birth and as many times as needed after. ‘Ultimately, the doula’s job is to take the fear out of childbirth by restoring the woman’s faith in her own natural power to give birth with more ease, less pain and less medical intervention,’ says Alkema, who adds that doulas play an important role in supporting fathers-to-be too. When interviewing for a doula, ask her to tell you about her philosophy of childbirth and supporting women and their partners through labour, advises Alkema. ‘When you’ve chosen your doula and discussed your birth plan, don’t forget to ﬁnd out when she will join you in labour – does she come to your home or will she meet you at the place of birth? Also ask about her experience in breastfeeding support,’ she recommends.
The gift of life The Life Healthcare Group recently purchased Genesis Clinic in Johannesburg, a maternity hospital that marries medical expertise with a comforting environment in which the mother plays the dominant role in her birthing process. Wholesome meals, well-appointed private rooms and birthing baths are among the benefits available to clients at the clinic, as are a number of private midwives, doulas, obstetricians and paediatricians. There is also a Well Baby Clinic, where moms can return for weigh-ins and immunisations. Deliveries at Genesis Clinic are covered by most medical aids and require a booking fee of R1 350. The deposit required for a normal delivery without medical cover is R34 740, excluding midwife and obstetrician fees. Visit www. genesisclinic.co.za for more. The Group also offers Little Life Birth Basics, a more affordable midwife-led care programme for patients who do not have medical-aid cover, at two of its facilities: Life Springs Parkland Hospital and Life Cosmos Hospital.
What it costs Most medical aids will cover the full cost of a birth, be it normal delivery or caesarean. Midwife and doula fees are covered by certain medical aids. Normal delivery: Caesarean section: Private midwife hire: Doula hire:
R13 700*** R29 600* R7 000–R15 000** R2 000–R3 500**
* Approximate private-hospital rates ** Depending on training, experience and type of service offered *** Facility fee only
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T H E WA Y W E E A T
Master the art of packing meals for work and school that are nutritionally balanced, give you an energy boost and keep you performing at your peak I M A G E G ET TY/GALLO I MAG ES, ISTOCK C O M P I L E D BY SAMANTHA PAG E
2016/02/16 2:45 PM
T H E WA Y W E E A T
I M A G E G ET TY/GALLO I MAG ES, ISTOCK C O M P I L E D BY SAMANTHA PAG E
reparing and packing a healthy lunch is one way to start the year on a positive note. Maybe you’re trying to lose weight, or perhaps you simply want to ensure that you and your family stay satisﬁed during the day. Whatever the reason, there are so many pros to taking control of what you’re eating at work or what your kids are eating at school. Making your own lunch allows you to regulate your kilojoule, fat, sugar and sodium consumption, it’s more affordable and helps you to keep your health goals in focus. According to CNBC Africa, South Africans have a strong culture of eating out, which includes takeaways, fast food and convenient ready meals. In 2012, as a nation we spent roughly R62.3 billion alone on eating out. Is it any wonder then that we are the fattest country in sub-Saharan Africa, and one of the 20 fattest countries in the world? Many South Africans buy lunch at least three times a week, but it’s clearly not the healthiest option. ‘The workplace doesn’t always make it easy for people to make healthy choices – cafeterias sell unhealthy food, or the healthier options are often more expensive. And lunch times aren’t always adhered to because work takes preference, so by the time employees get to eat they are hungry and make unhealthy food choices. Stress at work contributes too,’ says registered dietitian Mpho Tshukudu. But there does seem to be an ever-increasing consciousness about meal planning and eating healthily – many retailers and medical aids reward members and clients for making healthy choices, and an inﬂux of new iPhone and Android apps help you check specials, share recipes, suggest meals and ingredients and highlight money-saving options. While the planning and preparing may sound like a lot of effort, focus on the beneﬁts for you and your family and use the strategies below to make packing lunches easier.
NUTRITIONAL BALANCE is about including all the components for healthy functioning. ‘We maintain good blood sugar levels by choosing a balance of carbohydrates, fats and proteins,’ says dietitian Nathalie Mat. Pack lunches that include at least three of the four food groups:
• Grains and starches: wholegrain bread or pasta, crackers, pitas and wraps • Fruit and vegetables: veggies with a dip (use yoghurt or low-fat cottage cheese instead of mayonnaise), stir-fry, soup, fruit slices and fruit kebabs • Milk and milk alternatives: yoghurt, cheese portions, soy/almond/cow’s milk, cottage cheese • Meat and meat alternatives: lean meat (turkey, chicken breasts, pork tenderloin), sustainable ﬁsh, eggs, peanut butter, hummus, tofu, nuts or seeds, lean biltong (but be mindful of the salt content)
Is it any wonder that we are the fattest country in sub-Saharan Africa?
Make your own
ADVANCED PLANNING is essential to
success since you are less likely to get up early to prepare food in the morning or pack mindfully as you are rushing out the door. Set aside Sunday evening to prep meals for at least the ﬁrst three days of the week. You can julienne vegetables, boil pasta and portion out proteins in advance, then simply assemble the night before. Involve your kids by bringing them to the grocery store and let them pick out fruit and vegetables they would like to try. Grab-and-go items like packets of raisins, dried fruit, nuts and pre-cut fruit and vegetables are essential elements too. You can keep some of these healthy snacks in your ofﬁce drawer to avoid temptation by sweets and chocolates when the mid-afternoon slump hits. Also keep fresh fruit on your desk or in the fridge.
HOMEMADE REALLY is best because it
allows you to control the ingredients, which means less sugar, kilojoules, sodium and fat. While convenience meals often score high in ofﬁce lunch options, they are laden with processed elements, salt and hidden kilojoules. Get creative with leftovers and use chicken, pasta, rice and veggies to create healthy, ﬂavourful lunch options.
Lunch tips 101 • Invest in tiny resealable containers to pack sauces, dressings and condiments. • When packing soup, freeze it so it stays cold for several hours. • Pack orange wedges with apple slices to keep the apple from turning brown. • Freeze fruit overnight, then add it to yoghurt in the morning to keep it cool until lunchtime. • Yoghurt, pasta and salad require napkins and cutlery, so remember to include.
GREAT ENERGY BOOSTER
Makes 16–18 bars 2 cups (230g) rolled oats 1 cup (120g) granola ¾ cup (185ml) honey ½ cup (125ml) peanut butter 1 cup (150g) mixed dried fruit, chopped 1 tsp (5ml) vanilla essence 1 large egg, beaten • Preheat oven to 180˚C. • Mix all the ingredients together until well combined. • Press the mixture into a greased, foil-lined baking tray and bake for 35 minutes or until golden. • Cool and slice into bars.
2016/02/16 2:45 PM
SUICIDE: A GROUP AT RISK
I MAG E GETTY/GALLO IMAGES
South Africa’s suicide rates are among the highest in the world. Lisa Lazarus gives insight into why our teens are so troubled
n South Africa, there’s a suicide every hour, according to the South African Depression and Anxiety Group (SADAG). A growing number of these casualties are teens. Even children as young as seven have attempted suicide, explains international expert on suicide and author of Suicidal Behaviour in South Africa, Professor Lourens Schlebusch. The highest number of youth suicides are in the 15 to 19 age group, mostly among girls aged 15 to 19. Klara Göttert was only 14 when she leapt to her death from Northgate Shopping Centre in Johannesburg in August last year in what was understood to be a suicide. ‘For her to have done something like this leaves a myriad of questions that is just so hard to answer,’ says her mother Liesl Göttert on the Voice of America website. Tragically, Klara Göttert is not alone. SADAG reports that the suicide rate for children aged 10 to 14 years has more than doubled over the past 15 years. Males are most at risk, although females are more likely to attempt suicide. However, for every successful female suicide there are four to five male suicides. Nine to 10% of non-natural adolescent deaths are suicide related – this hospital statistic does not even take into account the suicide rates in rural areas as those numbers are not reported. If it did, the rate would be even higher. But ‘suicidal behaviour’ has ‘many faces’, explains Professor Schlebusch. Distinctions should be made between suicidal behaviour that has intent, even if the attempt was unsuccessful, and parasuicidal behaviour
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where the person doesn’t actually want to die. There is also a range of indirect self-destructive behaviour, for example, drinking or drug-taking, where the person is clearly taking chances with his or her life. No matter the kind of suicidal behaviour, it should be taken seriously. But why is the rate among this age group so high? Dr Jason Bantjes, a psychologist and lecturer in the Department of Psychology at Stellenbosch University, explains that there are a number of psychological challenges associated with adolescence, including negotiating potentially challenging transitions such as entering young adulthood, changes in family and peer relationships, leaving home, entering a new peer context, increased opportunities for substance misuse and an increase in academic pressure. ‘The stress of dealing with these transitions may contribute to poor psychological functioning and precipitate suicidal behaviour,’ he says. This is true even if the adolescent doesn’t necessarily suffer from any mental illness.
I MAG E GETTY/GALLO IMAGES
Adolescents at risk experience a feeling of hopelessness and the solution, at its simplest, is to give them a sense of hope Professor Schlebusch adds that adolescents use suicidal behaviour as ‘an inappropriate coping skill,’ because they lack the social skills to deal with interpersonal problems, particularly conﬂict resolution. Interpersonal problems extend across a wide range of situations, from bullying (including cyberbullying) to difﬁculties with parents, peer groups and intimate others, such as boyfriends and girlfriends. If these skills are lacking, adolescents may resort to the inappropriate coping skill of suicidal behaviour. Other risk factors could include a history of exposure to violence, especially family violence and child abuse, a history of suicidal behaviour in the family, socio-economic pressures and the imitative or ‘copycat suicide’ (known as the ‘Werther effect’, named after the maudlin ﬁctional suicide in Goethe’s The Sorrows of Young Werther). The Lancet Psychiatry journal reports on a study that showed that the media’s
What to watch out for: The warning signs Psychologist Dr Jason Bantjes warns that it is not always easy to recognise the warning signs. ‘Sometimes suicidal behaviour is impulsive and occurs without obvious warnings,’ he says. However, typical signs for suicide include: • Sleep disturbances • Marked agitation • Dramatic mood changes
• Engaging in reckless and life-threatening behaviour • Lack of purpose and meaning in life • Feeling trapped • A loss of autonomy • Feelings of humiliation and defeat • Any communication to others of intention to commit suicide
reporting of a suicide – how sensational it is, the details included, the prominence given to the story – could precipitate additional suicides. To prevent cluster suicides, any suicidal behaviour in a group setting, such as a school, must be handled carefully by professionals, explains Professor Schlebusch. If the suicide is made to look melodramatic or heroic, or even if the person was an important ﬁgure in the school, this could lead to other children mimicking the behaviour. Because the reasons for suicidal behaviour are so multifaceted, ranging from poor interpersonal skills to socio-economic problems, treatment is complicated and requires the input of multiple agencies. But at heart, says Professor Schlebusch, adolescents at risk experience ‘a feeling of hopelessness and the solution, at its simplest, is to give them a sense of hope’. Elevated stress levels need to be lowered. And if there are underlying psychological disorders, particularly depression, then treatment is required. ‘Psychological disorders are often not correctly diagnosed, because parents tell their children to “pull themselves together” and consequently, miss the underlying disorder.’ Most importantly, children who are at risk need to ﬁnd an adult they trust. Parents should not hesitate to take their child to a registered mental health practitioner if they are concerned. Adolescence is an extremely tumultuous period of discovery of one’s own identity. A rocky path is to be expected, but there are ways to make the journey more manageable during this potentially stressful developmental period.
MEET OUR EXPERT
Professor Lourens Schlebusch, a clinical psychologist, suicidologist and accomplished author, is Emeritus Professor of Behavioural Medicine at the University of KwaZulu-Natal. He is in private practice at Life Entabeni Hospital.
In an emergency The South African Depression and Anxiety Group (SADAG): Suicidal emergency 0800 567 567 24-hour helpline 0800 12 13 14 LifeLine national 24–hour counselling line: 0861 322 322
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ARE YOU A GOOD COMMUNICATOR?
Communicating with others is an essential skill in business dealings, family affairs and romantic relationships. When it comes to communication, what you say and what you don’t say are equally important. Find out how your interpersonal skills rate with this test
1. I have difficulty putting my thoughts into words. A Quite often B Often C Sometimes D Rarely E Almost never 2. I am comfortable expressing my feelings to others. A Quite often B Often C Sometimes D Rarely E Almost never 20
3. I have to repeat myself often because people don’t understand my message the first time around. A Completely true B Mostly true C Somewhat true/false D Mostly false E Completely false 4. When I know what someone is going to say, I finish his or her sentence. A Quite often B Often C Sometimes D Rarely E Almost never 5. People complain that I don’t appear to be listening when they are speaking to me. A Quite often B Often
C Sometimes D Rarely E Almost never 6. When I talk to someone, I put myself in his or her shoes. A Completely true B Mostly true C Somewhat true/false D Mostly false E Completely false 7. I will share my opinion even if there’s a chance that others will disagree with it.
A Completely true B Mostly true C Somewhat true/false D Mostly false E Completely false 9. I will stop a speaker mid-sentence if I disagree with a statement he or she has made. A Completely true B Mostly true C Somewhat true/false D Mostly false E Completely false
A Completely true B Mostly true C Somewhat true/false D Mostly false E Completely false
10. When conversing with someone, I pay attention to the person’s body language (for example, facial expression, posture, gestures, etc.).
8. If I don’t understand someone’s explanation the first time around, I feel stupid asking for clarification.
A Completely true B Mostly true C Somewhat true/false D Mostly false E Completely false
2016/02/16 2:49 PM
I M A G E S G ET TY/GALLO I MAG ES C O P YR I G HT 2016 – WWW.QU E E N DOM.COM
Read every statement carefully and indicate which option applies best to you and your feelings, attitudes, behaviours and life in general. After finishing the test, you can sum up your points using the scoring table and view the relevant results for you.
S C O R IN G YO U R S E LF
I M A G E S G ET TY/GALLO I MAG ES C O P YR I G HT 2016 – WWW.QU E E N DOM.COM
QUESTION 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
A 0 10 0 0 0 10 10 0 0 10
B 2 8 2 2 2 8 8 2 2 8
C 5 5 5 5 5 5 5 5 5 5
D 8 2 8 8 8 2 2 8 8 2
E 10 0 10 10 10 0 0 10 10 0
Your communication skills could use some work. You are likely experiencing frustration when trying to get your point across to others, or trying to understand their point of view. The good news is, like most skills in life, practise makes perfect! All it takes is a little know-how and effort. Try asking those close to you for feedback on how you’re communicating, like the pace at which you speak and the manner in which you transition from speaking to listening. Or, if you’d really like to pinpoint some bad habits (and we all have them), set up a camera and film yourself during conversations. Pay attention to the way you communicate with different people and the type of skills you use. Keep in mind that body language can speak just as loud as words, so be sure to make eye contact when interacting, avoid crossing your arms and try to keep distracting mannerisms like fidgeting to a minimum. And don’t overlook one of the most crucial interpersonal skills: listening. Even if you’re not the best conversationalist, being a good listener counts for a lot.
While there is still a little room for improvement, you already have some decent interpersonal skills and the potential to master the communication process. It would be a good idea to put some time and concentrated effort into developing the abilities you already have, and pick up a few new strategies along the way. For example, when interacting with someone, make sure to consistently check for understanding; don’t assume people know what you’re talking about! Essentially, you need to be able to adjust your interaction style (the words you use, your tone of voice) according to your audience. Other factors such as empathy and authenticity also play a significant role in communication. The only way you can truly understand others is to see the world from their perspective, even if you don’t agree with their point of view. Most importantly, be straightforward about your own thoughts and feelings – in a tactful way, of course. People can often sense when someone is being evasive or lying. Remember that what you don’t say is just as telling as what you do say.
You possess some rather impressive interpersonal skills – well done! You are able to get your point across in a clear, concise way, you are an active and attentive listener, and are able to appreciate where others are coming from. Communicating is, in any case, a two-way street; understanding others is just as important as making yourself understood. You definitely have a solid grasp on the criteria for effective communication and, most importantly, put that know-how into practice. Unless your score was perfect, however, there is always room for growth. Make sure to use tact when criticising others by reframing feedback from your point of view (for example, ‘I get frustrated when we don’t get to spend time together’). Also, show that you want to hear what people have to say. If you look bored, preoccupied or annoyed, you will shut down the flow communication. This doesn’t mean you should fake interest – just be willing to hear people out, even if you don’t entirely see eye to eye with them. You are definitely on the right track, however, so keep up the good work!
The foundation of solid interpersonal skills is more than just making yourself heard, it also involves an understanding of where other people are coming from. Unfortunately, there are so many of us who fall victim to poor habits like interrupting, hogging the conversation and not paying attention – often without even realising it. These all act as barriers to communication, making it difficult for us to understand others and to be understood in turn. In essence, rather than talk with each other, we talk at each other. Communicating effectively needn’t feel forced or incredibly unnatural. Even the most tongue-tied communicators can become gifted speakers with a bit of effort and attention to detail. WWW.LIFEHEALTHCARE.CO.ZA
2016/02/19 11:24 AM
‘MY DONOR GAVE ME A SECOND CHANCE AT LIFE’ Rafeeqah Isaacs battled with poor renal function for many years and was advised to go on to the transplant list in 2013. Expecting a long wait, she was stunned when an old friend and neighbour offered to be her donor
Rafeeqah is using her second chance to live out her dreams and make every day count
such a good person, and brushes off my really thought Zaahier was joking. Testing to see if he was a suitable donor gratitude with complete humility. The We’d been neighbours for many years took nine very long, very anxious months. transplant was a huge success and I feel but lost touch until we met again at As my condition deteriorated, I became more alive than ever before. I continue his sister’s home in August 2014. increasingly breathless and I worried how to see Dr Stead every month and am My family had already been tested I’d carry on if we were unable to go ahead. so grateful for his support before and but no one was a suitable donor, and The day we were given the thumbs up was after my surgery. There are no words to I knew that the next step was to go the best day of my life – I couldn’t stop describe what it’s like to be given a second on to the transplant list. I also laughing and crying. I had the chance at life. People don’t realise the knew that I faced a possible transplant on 4 August last year value of organ donation, which not only wait of four to ﬁve years and (2015), and Zaahier and I GIVE SOMEON E saves the life of one individual, but of an had no idea how I was going spent four days together in THE GIFT OF LIFE: entire family. Without Zaahier’s generous to survive till then. I had ICU building a bond that’s Visit www.odf.org.za to gift, I’d still be battling to get through each so much to live for. I was only hard to describe. He has said find out how to become day; right now I’m living each one of them 33, a married mother of a from the start that he wanted an organ donor. to the full, brimming with energy and joy! nine-year-old daughter and to do this for me because I’m was studying law. I’d battled with kidney function since high school and had been a patient of Dr Piers Stead, a nephrologist at Life Vincent Pallotti Hospital, since 2006, because According to Dr Stead, there were approximately 250 kidney transplants performed after the birth of Ridwah my kidney in South Africa in both the private and public sector last year, majority in the Western function dropped to 28%. He was Cape and Gauteng. ‘Many of these patients had been on dialysis while waiting for absolutely amazing and was constantly at their transplants,’ he explains. ‘Donors can either be living or deceased. The average my side, educating me about my condition waiting period for a kidney transplant from a deceased donor is four to five years, and guiding me through the emotional while the majority of living donors are family members. Rafeeqah’s situation is very journey as my kidneys continued to fail. rare. Unrelated donors only make up 10% of cases and this is usually a spouse. This I felt very comfortable with him and makes her transplant extremely unique. Invariably, there’s a special person who’s needing when he told me it was time to go on to a kidney and an equally special person who’s donating one. Rafeeqah is an extremely dialysis, and later on to the transplant generous, warm person with a larger than life personality. Her kidney transplant went list when my kidneys were functioning off extremely well and her kidney is working almost 100% normally. She’s extremely at 5%, I trusted his judgement implicitly. vigilant about taking her medication and attending follow-up appointments, which My quality of life was badly affected. will ensure that she has an excellent long-term outlook with her transplant.’ I was permanently exhausted and would fall asleep anywhere, anytime. I was on home dialysis for 12 hours every single Dr Piers Stead is a nephrologist/physician at Life Vincent day and my roles as wife and mother Pallotti Hospital in Cape Town. He is also a member of the South were very limited. I’d be up and down African Renal Society, the South African Transplant Society and emotionally and would often question the International Society of Nephrology. ‘why me?’ I’d go through stages of being depressed, which was when Dr Stead would step in with words Visit www.worldkidneyday.org to find out more. of encouragement. And then came Zaahier’s incredible offer.
WORLD KIDNEY DAY IS ON 10 MARCH
A S T O L D T O LY N N E G I D I S H
IN HER DOCTOR’S WORDS
2016/02/16 2:51 PM
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FOR LESS Whether you have a few hours or a day to while away, our round-up of fun activities in South Africa – each under R160 per person – will keep young and old entertained
I M A G E S G ET TY/GALLO I MAG ES, ISTOCK, SU PPLI E D, M ICK EY HOYLE, FLATICON D E S I G N E R: HALDAN E MARTI N (TR UTH)
1. Walk among the butterflies
Everyone will enjoy the magical experience at Butterfly World Tropical Garden just outside Cape Town, where visitors get to wander between a wide range of butterflies fluttering about in a massive greenhouse. R72 per adult, R65 per pensioner/student, R41 per child www.butterflyworld.co.za
2. Get your caffeine fix
Named the number-one coffee shop in the world by The Telegraph, Truth is the place to go for artisanal coffee. Various www.truthcoffee.com
3. Visit the penguins
A visit to SANCCOB allows for a behind-the-scenes tour of the seabird hospital. Visitors may get to meet one of the facility’s ambassador penguins and see how the birds are fed and cared for.
R50 per adult, R20 per scholar, R30 per pensioner www.sanccob.co.za
4. Go wine tasting
The Winelands is peppered with beautiful estates. Taste some of the latest and greatest vintages at Groot Constantia in the Southern Suburbs. Their award-winning wines are paired with beautiful scenery. From R45 per person www.grootconstantia.co.za
5. See a movie
With its old-world charm, The Labia Theatre (the oldest independent art cinema in the country) is a wonderful venue for the latest art movies and doccies. R40 per person www.labia.co.za
Tilt back and marvel at our magnificent universe as you go on the ultimate armchair travel adventure
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at the Planetarium, exploring the stars and planets of the cosmos. A variety of shows ensure that there is something to capture the attention of young and old. R40 per adult, R20 per child/student/pensioner www.iziko.org.za
7. Go tobogganing
The first toboggan run in Africa can be found at Cool Runnings in Bellville, where visitors can whizz down a curved stainless-steel track at 40km/h on a sled. From R40 per ride www.coolrunnings. capetown
Gauteng 8. Laugh out loud
Enjoy side-splitting local comedy at Parker’s Comedy and Jive at Silverstar Casino every Friday and Saturday evening. R80 per person www.parkerscomedy.com
9. Take a dip
The historic Zoo Lake Swimming Bath, close to the lake, is the perfect place to cool down. There are also lovely picnic spots to enjoy. R12 per adult, R9 per child
10. Go climbing
Soweto’s Orlando cooling towers boasts a 25m climbing wall, soon to be extended to 100m. For an additional R70 per person, visitors can also book a game of paintball at the towers. R50 per person www.orlandotowers.co.za 26
11. See the animals
Established in 1904, the Joburg Zoo is one of the few places in the world where visitors can spot white lions and Siberian tigers. If you’re part of a large group, for R120 per person you can also book an overnight camp at the zoo. R75 per adult, R46 for pensioners/children under 12 www.jhbzoo.org.za
12. Walk the maze
Get lost in – and find your way out of – the giant Elemental Maze made of reeds at Honeydew Mazes. From R120 per adult, R80 per child www.honeydewmazes.co.za
13.Take a hike
The Hennops hiking trail consists of two main routes as well as a shorter trail for children. Unique features of the trail include two river crossings – one by suspension bridge, another by cable car – and historical sites along the way. R60 per adult, R30 per child (under 12) www.hennopstrails.co.za
14. Stand at the top of a waterfall
The Walter Sisulu National Botanical Garden was founded in 1982 and remains a Gauteng favourite to this day – particularly because visitors can climb to the top of Jozi’s only waterfall. R35 per adult, R25 per pensioner/student, R12 per child, free for children under 6 086 100 1278
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KwaZulu-Natal 15. Order a bunny chow
No visit to Durban is complete without tasting a deliciously spicy bunny chow. Various
16. Go zorbing
Rolling down a hill suddenly becomes much more fun if you do it in a giant transparent ball. Visit the Groovy Balls adventure park in Cliffdale where you can try this zany activity. There are different courses to choose from, including the ‘Kamikaze Run’, a 150m downhill roll. From R150 per person www.groovyballs.co.za
17. Tour a stadium and see Durban from new heights
A two-minute SkyCar ride will take you to the top of the Moses Mabhida Stadium for 360° views of the city from a 106m high viewing platform. Tours are R50 per adult, R40 per pensioner,
R25 per child under 12, free for children under 6; SkyCar rides are R60 per adult, R55 per pensioner, R30 per child under 12, free for children under 6 www.mmstadium.com
18. Go for a fun ride
Situated near the beachfront in Durban, the Funworld amusement park offers rides for kids and adults, including a cable car that runs parallel to the beach. R10–R15 per ride www.travelground.com/ attractions/funworld-durban
19. Take a ride
The best – and most scenic – way to get around Durban is by rickshaw. Take a ride along the promenade in one of these colourful vehicles. From R30
20. Go birdwatching
The Umgeni River Bird Park houses over 800 birds from 200 species. No visit to this park is complete without the popular free-flight bird show. R50 per adult, R30 per pensioner/child www.urbp.co.za
21. Taste the best ice cream
Scoop is a small-batch ice-cream company that uses local produce to make the dreamiest scoops in wonderful flavours, such as honey, lemon and ginger, and toasted coconut ice cream with pineapple sorbet. Buy a cone or two at Home-Grown or Salt Cafe in Salt Rock. Various www.scoopicecream.co.za
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HEALTH WEIGHT-LOSS SURGERY / ANAESTHETIC AND YOUR CHILD / ALLERGY ALERT / HYPERTENSION
‘IT IS HEALTH THAT IS REAL WEALTH AND NOT PIECES OF GOLD AND SILVER.’ MAHATMA GANDHI
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THE SKINNY ON WEIGHT-LOSS
I MAG ES GETTY/GALLO IMAGES, ISTOCK, SUPPLIED
When diet and exercise donâ€™t work and obesity poses serious health problems, bariatric surgery may be the answer. Chrysalis Clinic at Life Kingsbury Hospital in Cape Town specialises in this. Glynis Horning reports
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I MAG ES GETTY/GALLO IMAGES, ISTOCK, SUPPLIED
outh Africa is now ofﬁcially one of the fattest nations on earth and has the highest overweight and obesity rate in sub-Saharan Africa, reports the Heart and Stroke Foundation SA. Six in 10 women and three in 10 men are overweight or obese – conditions strongly linked with heart disease, stroke, hypertension, type 2 diabetes, joint pain and even certain cancers. ‘If overweight and obesity could simply be cured by managing energy imbalance, where the energy you take in becomes equal to the energy you use, we’d have had no need to medicalise the disease,’ says Professor Tessa van der Merwe, chairwoman of the SA Society for Surgery, Obesity and Metabolism (SASSO). But it’s not that simple. When intake is reduced, the body becomes more efﬁcient with its fuel, and increased obesity leads to less spontaneous physical activity. What’s more, obesity can also be caused by endocrine disorders and other biological factors. For difﬁcult cases, bariatric (weight loss) surgery can be a lifeline. Today, this procedure is offered in stringently accredited centres with specialist teams, and among those leading the way is the Chrysalis Clinic at Life Kingsbury Hospital in Cape Town, established 10 years ago under the leadership of laparoscopic surgeon Dr Graham Stapleton. ‘Obesity is a complex disease that much still needs to be learnt about,’ he says. ‘The Chrysalis Clinic provides a holistic, multidisciplinary, professional approach. First prize is always to accomplish signiﬁcant weight loss and sustain this by non-surgical means, but in severe obesity with established co-morbid diseases, surgery offers a very viable solution. However, results of surgery are, in our opinion, far superior when backed up by psychological and psychiatric support, intensive dietetic advice and ongoing support, and a sustained, graduated-intensity exercise programme supervised by a biokineticist. A patient support group also assists those contemplating and recovering from surgery.’
WHO IS ELIGIBLE?
All bariatric surgery candidates go through an intensive screening process.
PATIENT: Melt Holtzhausen SURGERY DATE: 21/05/2012 TOTAL WEIGHT LOSS: 158kg
before & after In line with international criteria, you need a BMI above 40, or 35, if you have serious obesity-related health problems such as high blood pressure, type 2 diabetes or severe sleep apnea. You also need to have no drug or alcohol issues or serious emotional problems, and to have made concerted attempts to lose weight. Above all, you must be willing to make permanent changes
Studies have shown that obese people treated by surgery live significantly longer than those treated by non-surgical means towards a healthier lifestyle, says Claire McMahon, a dietitian at Life Kingsbury Hospital and the Chrysalis Clinic. Exercise is key to the success of bariatric surgery, improving your general health, helping burn excess energy stores and reducing risks
‘My starting weight was 243.6kg. I lost 50kg pre-opp and weighed 193kg at the time of the operation. After the procedure I lost a further 108kg, of which 16kg was excess skin that was removed. After stabilising and going to gym over the last three years, I gained 10kg again, but I am maintaining my weight at 95kg now.’
associated with anaesthesia. Chrysalis Clinic insists on an eight- to 12-week programme with a biokineticist to help you learn to exercise correctly, and to keep raising targets and motivate you. Surgery is not a soft-option for the weak-willed. It is major surgery that carries risks of complications and even a small risk of death, which is why it requires committed preparation and long-term monitoring. It is also not a ‘magic bullet’ and doesn’t cure all obese patients, Dr Stapleton says, ‘especially those who eschew advice about correct eating and regular exercise, or have unresolved psychological issues or unrecognised psychiatric disease’. It requires a hefty ﬁnancial outlay too – around R130 000, depending on the procedure most suitable for your individual case. Medical aids are increasingly covering bariatric surgery (including Bankmed, Bonitas, Discovery, Massmart, Medshield, Metropolitan, Momentum and Parmed), but few will cover all clinicians’ bills in full, especially those of dietitians and psychologists.
TYPES OF SURGERY
Today there are a number of varieties available, each with pros and cons. Your specialist team will decide which suits your speciﬁc needs. All surgery carries
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some risks, from bleeding, clotting, leaks and infection to breathing problems and adverse effects to anaesthetic, and when you are obese these risks are greatly increased. Today, most surgery is done laparoscopically – through tiny incisions in the abdomen – making recovery faster. The overall mortality rate for bariatric surgery has been quoted as 0.3%, and against that you will be greatly reducing your mortality risk from diseases of obesity, says Dr Stapleton. ‘Studies have shown that obese people treated by surgery live signiﬁcantly longer than those treated by non-surgical means.’
on insulin-resistance, says Dr Stapleton, which is why obese people with type 2 diabetes often see major improvements in their blood-sugar control, many even dispensing with medication. ‘Patients feel fuller sooner on smaller amounts of food,’ says McMahon. ‘Their taste preferences also change and they tend to go off sweet things.’ Pros: Weight loss from the bypass has been shown to reduce long-term mortality from obesity-related conditions, such as type 2 diabetes by as much as 80%, she says. Cons: As some of your gastrointestinal tract is bypassed, there’s a risk of vitamin and mineral deﬁciencies, so you will generally need to take supplements for life. Some people regain weight after initial success, usually because they don’t stick to the recommended maintenance diet and exercise advice. All surgery carries risks, and a 2006 study showed 15% of patients had complications, and 0.5% died within six months of surgery because of complications.
THE ROUX-EN-Y GASTRIC BYPASS It involves creating a small pouch from the upper part of your stomach and linking it to the small intestine, bypassing most of the stomach and duodenum (small intestine). You lose weight because you eat less at a sitting, partly because of the small capacity of the pouch and partly because secretion of the hormone ghrelin, (which stimulates appetite) is reduced. Secretion of other gut peptides is also modulated, with profound effects 32
2 Restrictive surgery
The most crude approach is by wiring your jaws together, but this has proved ineffective long term as it doesn’t address appetite and the feeling of fullness, says Dr Stapleton. • LAPAROSCOPIC ADJUSTABLE GASTRIC BAND This is the currently practised purely ‘restrictive’ operation. It’s the simplest form of bariatric surgery, with none of the gastrointestinal tract removed or bypassed. An inﬂatable cuff is placed around the upper end of your stomach. This cuff is connected by a tube to a port implanted below your skin and liquid is injected into the port to inﬂate the band, which narrows the inlet to your stomach to restrict the passage of food. Pros: The surgery is relatively simple so there is less risk of post-op complications, and it can seem cheaper. Cons: It’s much less effective in weight loss than a gastric bypass,
LAPAROSCOPIC ADJUSTABLE GASTRIC BAND
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says Dr Stapleton, and has little effect on co-morbid disease unless major weight loss has occurred – on average, you lose about 50% of your excess weight, compared to about 75–80% with more radical operations. In the longer term, the gastric band may slip or erode and, being a foreign body, there’s risk of infection. While it may be cheaper, most medical aids will not pay for the procedure because in more than 30% of cases, beneﬁts are unsatisfactory or complications develop, he says. • SLEEVE GASTRECTOMY This involves removing about 80% of your stomach and leaving a thin, sleeve-like tube of it. Though not as simple as the gastric band operation, this is much simpler than the gastric bypass and, because the continuity of your gastrointestinal tract is not interrupted, there is little risk of nutritional deﬁciencies. Pros and cons: It’s more effective in reducing weight than the gastric band and usually improves diabetic control, but not to the same degree as gastric bypass, says Dr Stapleton. It also carries a greater risk of leak than a bypass and if you have a tendency to reﬂux this can be greatly exacerbated. If necessary, a sleeve gastrectomy can be easily converted later to a gastric bypass or biliopancreatic diversion. • BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH This very complex operation has not been done in the Chrysalis Clinic, because although highly effective in causing weight loss and reversing diabetes and other co-morbid diseases, the short and long-term risks are much greater than with the other operations, says Dr Stapleton. ‘There are also concerns about the risks of it causing late-onset protein malnutrition, chronic diarrhoea and deﬁciencies of several essential vitamins and minerals.’
It’s important to have realistic expectations of any bariatric surgery. Weight loss is progressive over up to 18 months. After that you may gradually regain some weight, usually due to
STANDING: Dr Alex Landau (plastic surgeon), Cathy Brunger (clinic coordinator), Claire McMahon (dietitian), Gina Fourie (dietitian), Dr Martin Brossy (anaesthetist), Mandy Banks (biokineticist), Dr John Turner (critical care physician), Dr Ian Marr (surgeon), Dr Nick Kairinos (plastic surgeon), Celia Smith (physiotherapist) SEATED: Dr Hilton Kaplan (endocrinologist), Dr Kim Ragsdale (psychiatrist), Dr Graham Stapleton (surgeon), Fadilah Haroun (GIT ward sister), Dr Wayne May (endocrinologist) NOT IN THE PICTURE: Carol Jeffery (biokineticist), Dr Spencer Burke (anaesthetist), Graham Alexander (psychologist), Gradville Konnight (GIT unit manager), Sr Michelle Jones-Phillipson (clinical nurse specialist)
lapsing into unhealthy eating and neglecting exercise. All surgery carries the risk of complications, and bariatric procedures can occasionally result in hernias, bowel obstruction, stomach perforation and gallstones, Dr Stapleton explains. A phenomenon called ‘dumping syndrome’ is caused by rapid transit of reﬁned carbohydrate into your small intestine. Signs include nausea, vomiting, diarrhoea, dizziness and palpitations. If you notice this, see your doctor straight away. After bariatric surgery you will need to eat very carefully, having ﬁve or six very small meals a day and chewing food really well before swallowing, says McMahon. ‘Avoid drinking at meals and opt for high-protein, low-fat and lower-carbohydrate foods. Eat plenty of fruit and vegetables.’ After a Roux-en-Y gastric bypass, you will usually have to take calcium, vitamin B12, vitamin D and a multivitamin for life, she says, and possibly iron. Along with a dietitian, you may need the help of a psychologist to deal with
changes in your self-image and possibly your relationships, and to get insight into how you became obese or formed a destructive relationship with food, says Graham Alexander, a consultant clinical psychologist at Chrysalis Clinic. Individual counselling and support groups can be invaluable. ‘Bariatric surgery changed my life,’ says 41-year-old Manie Pretorius. Once a rugby player and Free State provincial wrestler, his career came to a dead halt at 24 due to a knee injury. ‘The weight crept up. . .,’ he says. By February last year, he weighed in at 198kg, and had type 2 diabetes and high cholesterol. That month he had a gastric bypass. ‘The change was immediate. I left hospital no longer diabetic or on twice-daily injections. My cholesterol is now normal too.’ But the biggest impact, he says, has been on his sense of self. ‘You tell yourself you don’t care, but you do. I feel different. Best of all, I can now walk around a school rugby ﬁeld, supporting and guiding my sons.
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I N N O VA T I O N
MIDDELBURG GETS A NEW
renal unit Additional dialysis facilities in Middelburg are helping to ease the lives of patients who require treatment. By Mandy Collins
state-of-the-art, six-bed renal dialysis unit was opened at Life Midmed Hospital in Middelburg, Gauteng, towards the end of 2015. It was a welcome addition to an already well-equipped hospital and will provide top-notch care for patients in the area who require renal dialysis. Middelburg and surrounds have needed additional capacity for renal dialysis for quite some time. This unit is in a safer area than some of the others, has parking and is attached to a hospital, says Dr Rachael de Zeeuw, a visiting nephrologist at the unit. ‘The acute dialysis and slow continuous therapies are done in the hospital. Only the chronic patients are dialysed in the unit.’ The following services are offered: • Chronic haemodialysis and haemodiaﬁltration • Acute dialysis • Continuous renal replacement therapy (CRRT) • Slow continuous therapies. ‘We have a great team of people working in the unit,’ says Dr De Zeeuw. ‘I am the only nephrologist, but there’s support from Dr Chaumba, a specialist physician at Middelburg Hospital. The nurses in the unit are very
specialised. They need to be able to needle ﬁstulae and work the dialysis machines. Together we ensure that our patients receive world-class treatment and care.’ Dialysis is a treatment that ﬁlters and puriﬁes your blood using a machine. This helps to keep your body in balance when your kidneys can’t do their job. Kidneys purify your blood by removing waste and excess ﬂuid from your body. When they don’t work properly, dialysis does the job for them.
When your kidneys don’t work properly, dialysis does the job for them There are two different types of dialysis: haemodialysis and peritoneal dialysis. Haemodialysis is the more common type – it uses an artiﬁcial kidney, known as a haemodialyser, to remove waste and chemicals from your blood. To get the blood to ﬂow to the artiﬁcial kidney, doctors surgically create an entrance point into your blood vessels. This allows a larger amount of blood to ﬂow through your body during dialysis, which means more blood can be ﬁltered and puriﬁed.
If you require peritoneal dialysis, a catheter is surgically implanted into your belly area. During treatment, the catheter is used to introduce a special ﬂuid called dialysate into your abdomen. It draws the waste from your bloodstream and is then drained from your abdomen. Not all kidney disorders are permanent: dialysis can temporarily serve the same function as kidneys until the patient’s kidneys repair themselves and begin to work on their own again. However, in chronic kidney disease, the kidneys rarely get better. Patients go on to dialysis permanently, or remain on it until they can have a kidney transplant. The renal unit doesn’t perform transplants itself, says Dr De Zeeuw, but they do prepare patients for transplant surgery. ‘Transplant work-up requires the patients to be in good physical and psychological health. They need to have a scope of their tummy, a full cardiology work-up, a chest X-ray, a full urological work-up, and a psychological assessment. ‘Women of appropriate age need a Pap smear and mammogram. They need to be cancer free for ﬁve years. Most importantly, since there is such a long wait on the deceased donor list (ﬁve to eight years) they need to look for a suitable living donor.’
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I N N O VA T I O N
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I N N O VA T I O N
DIALYSIS: WHAT YOU NEED TO KNOW If you are otherwise healthy, you can still live a full, normal life after kidney failure, thanks to dialysis. Here’s what you need to know: • Except for the initial needle prick, dialysis doesn’t hurt. • Since the late 1960s, dialysis has been used in place of kidneys lost to disease, birth defects or injury. • Dialysis acts as an artiﬁcial kidney. About 90% of dialysis patients receive haemodialysis, in which the blood is circulated outside the body and cleaned inside a machine before returning to the patient. • Children often do a type of dialysis called continuous cycling peritoneal dialysis (CCPD). Their treatments can be done at night while they sleep.
• One thing all dialysis patients must know a great deal about is diet. They need a good amount of protein and lower amounts of potassium and phosphate, which tend to accumulate in the blood and cannot be removed very well with treatment. • Dialysis patients must limit ﬂuids because the treatment removes only a certain amount of water. Excess ﬂuids make body tissues swell. • Living relatives can donate a kidney if their remaining organ is healthy. Even with a kidney from a close relative, however, a transplant recipient must take medication to suppress the immune system from rejecting the organ.
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Do you become an itchy, sneezy, sniffing mess in certain seasons, or are you a walking symptom year-round? Here’s how to treat some of the most common allergies. By Catriona Ross
eople say love is all around, but for many of us, allergens are all around and we’re fighting a constant battle with the air we breathe. An allergy occurs when your body’s immune system develops an acute hypersensitivity to harmless substances in your environment, explains Dr Adrian Morris of the Allergy Clinic in Cape Town and Johannesburg. It can be dust mites in bedding, feather pillows, mould, grass and tree pollen in the breeze, or peanuts in a Thai curry. The possible result? Hay fever, eczema, rhinitis, asthma or even life-threatening anaphylaxis.
CONTROL WHAT YOU CAN
Avoid your known allergens and manage what you can’t control with medication, advises Dr Preba Pillay, an ear, nose and throat surgeon at Life Brenthurst Hospital in Johannesburg. ‘Because an allergy is for life, you should only treat it if you are symptomatic to the extent that it interferes with your lifestyle.’ Seasonal rhinitis is most common, particularly in spring, but can strike in autumn when dry wood is abundant. He recommends an antihistamine first, as it works within an hour and lasts for 24 hours. ‘If you aren’t symptomatic the next day, you don’t need to take it.’ The next option is a steroidal nasal spray to stabilise the mucosa of the nose and decrease reaction to allergens. This takes four to six hours to kick in and must be taken daily. Allergies are exposure related, so stop treatment when you’re either able to cope with the symptoms, or when the symptoms disappear. For hay fever sufferers, ‘proactive, regular treatment works better than chasing symptoms, as your body is better prepared to fend off pollen,’ says Dr Morris. He recommends starting in early September with both a non-sedating antihistamine (generics include cetirizine, loratadine and fexofenadine) and a low-dose steroidal nasal spray, such as fluticasone (available on prescription) and inexpensive beclomethasone (available over the counter). Keep pollen at bay by closing windows during the day at home and in the car, applying Vaseline to the inside of your nostrils, changing clothing after a day out, and showering and washing hair. A daily teaspoon of raw, organic local honey – taken two months before the hay fever season begins until it ends – can help reduce symptoms, says Dr Morris.
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GET PROFESSIONAL ADVICE
It’s advisable to consult a GP, who’ll check medical history to identify possible allergens, perhaps run a skin prick test or radioallergosorbent blood test (RAST) and treat your allergies accordingly. Beware of self-diagnosis, warns Polly Edwards, 39, a PA and mother from Cape Town, who bought allergy tablets and an over-the-counter nasal spray for her blocked nose. ‘I ended up completely addicted to it for eight years. I was taking the spray six times a day, and at night, plus the tablets, in a desperate attempt to clear my head. In
The more a baby is exposed to pollen, germs, other children’s bugs, animals and food allergens, and the fewer antibiotics he or she is given in the first five years, the less allergy prone a child is likely to be the morning, I’d be so blocked I’d pour the stuff down my nose.’ It would bring instant relief, but in general she felt very depressed. Eventually, she consulted her GP, who stopped her taking the spray and tablets. ‘The problems disappeared,’ says Polly. Over-the-counter vasoactive nasal sprays cause blood vessels to shrink, giving fast relief. ‘But four to six hours later, the symptoms are probably back with a vengeance,’ warns Dr Pillay. Steroidal sprays prescribed by a doctor, however, can safely be used daily for up to two years.
If you have a signiﬁcant reaction to a food allergen (peanuts and tree nuts, milk, soy and shellﬁsh are the most common), carry an epinephrine auto injection with you, advises Dr Pillay. It could save your life. For an acute attack of allergy, he believes conventional medicine is the only safe option. However, ‘homeopathic doctors 38
MEET THE EXPERTS
Dr Adrian Morris is an allergy consultant with postgraduate diplomas in allergy, dermatology, family practice and paediatrics. He was an honorary consultant at the UCT Lung Institute Allergology Unit and the Allergy Clinic at Red Cross War Memorial Children’s Hospital, and holds honorary posts in allergy and respiratory medicine at the Royal Brompton Hospital in London.
have a lot of success in treating allergies because they try to get the patient well overall, whereas clinicians treat the symptoms.’ Finally, help allergy-proof your children. ‘Allergies are switched on or off during the ﬁrst year of life and early exposure to allergens turns them off,’ explains Dr Morris. Although one may inherit a genetic predisposition to allergies, the more a baby is exposed to pollen, germs, other children’s bugs, animals and food allergens, and the fewer antibiotics he or she is given in the ﬁrst ﬁve years – in particular, the ﬁrst year – the less allergy prone a child is likely to be. Antibiotics destroy the gut microbes required for a healthy immune system, he explains. Harmful abnormal bacteria can develop in the bowel and the immune system may start attacking harmless substances in the environment, from food to animal hair. So eat nuts during pregnancy, feed your baby peanut butter in the ﬁrst year, avoid antibiotics for young children whenever possible and don’t keep your house too clean – with the experts’ permission!
Dr Preba Pillay, an ear, nose and throat surgeon at Life Brenthurst Hospital, qualified with an MBChB at Wits University, is a fellow of the College of Surgeons of South Africa and holds a Master of Medicine degree from Wits University. For 33 years, he’s been in specialist practice and held a teaching position at the Chris Hani Baragwanath Hospital.
• Find information on common allergies and a South African pollen and allergen forecast updated weekly for Johannesburg, Cape Town and Durban: www.allergyclinic.co.za • Visit Pollen Sampling South Africa for posts on recent pollen counts and other factors affecting hay-fever sufferers: www.pollensa.co.za • The Is it Allergy? website allows you to browse information about symptoms and triggers, and answer quick questions to create an allergy proﬁle to show your doctor: www.isitallergy.info/en-za • Take an allergy test and ﬁnd practical information for various situations, such as travelling with allergies, and allergies and pregnancy, at the European Academy of Allergies and Clinical Immunology: www.eaaci.org/patients
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THE BABY FILES
WHAT DOES A PAEDIATRIC NEPHROLOGIST DO?
Dr Rashinta Moodley is a paediatrician and paediatric nephrologist at Life Entabeni Hospital in KwaZulu-Natal. Her speciality is the treatment of urinary tract and kidney diseases in babies, children and adolescents. This includes acute and chronic dialysis as well as kidney transplantation. By Catherine Eden How common is kidney disease in children?
Babies can be born with renal and urinary system abnormalities. Nephrotic syndrome, obstructive urinary tract abnormalities and post-infectious kidney disease are the most common types of renal disease in children. These can occur as a result of congenital abnormalities, genetic or immune abnormalities, or infection.
What are the warning signs?
Decreased amounts of urine, swelling of face and body, recurring urinary tract infections, blood in urine and incontinence.
What treatment is available?
Nephrotic syndrome is treated with Albusol and steroids, but often stronger immunosuppressants are needed. Obstructive/ developmental abnormalities of the urinary system may require surgical intervention. Kidney disease can progress to kidney failure, at which point dialysis and transplantation will be necessary. Depending on the child’s condition and response to treatment or surgery, the prognosis can be very good. However, once the patient has renal failure, the prognosis depends on the success of dialysis and kidney transplantation.
I MAG ES JOANNA FROM COLOURISE STUDIO, DURBAN
What are the biggest challenges of your job?
It is always tough to diagnose a child with chronic kidney disease and to explain the condition and counsel parents. They naturally find the news very distressing, as every aspect of their child’s life will be affected. Once the child is on dialysis or has had a transplant, there is the challenge of establishing compliance with the strict treatment protocols. Lastly, there are practical challenges of working with tiny patients: handling the equipment and catheters for dialysis, for example. Managing patients with acute kidney failure requires special skills and the ability to deal with very small children.
What aspect of your job is most satisfying?
Treating a child with the fewest number of drugs and managing the kidney condition for as long as possible before resorting to dialysis. It is rewarding to see a child in remission with minimal side effects, and it is especially satisfying to find a live, related
donor and achieve a successful transplant. Parents are often willing to donate a kidney (an adult’s kidney can be transplanted into an infant as long as the clinical and donor matching criteria are met), but if the parent is not a suitable donor, the child may have a long wait before a cadaver organ is available.
Is South Africa equipped to deal with kidney disease? There are many renal centres in the private and public sector that are able to manage various kidney conditions. However, a growing number of patients require dialysis and transplantation. Paediatric renal transplantation is carried out in Cape Town and Johannesburg, and the first in Durban took place in May at Inkosi Albert Luthuli Central Hospital, with the assistance of a Joburg team. Acute and chronic dialysis is available and functions well in most provinces.
What changes do you wish to see in the management of this disease? I’d like to see the development of a renal transplantation unit specifically for paediatrics in KwaZulu-Natal, with a multidisciplinary team that includes a paediatric transplant surgeon, sub-specialist paediatricians, trained nursing staff, dietitians, psychologists and patient support groups. My long-term goal is to be part of such a team that can take the care of kids with renal disease to a whole new level.
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THE BABY FILES
o one likes the thought of their child getting an anaesthetic. When my son had major surgery at four months old, I didn’t cope very well. And it probably didn’t help either him or the theatre staff that I was weepy and distraught. But it doesn’t have to be that way. For Life Healthcare, the emphasis is on care and this is why Life St George’s Hospital in Port Elizabeth has introduced its KIDZ pre-operative programme. It aims to reduce fears experienced by parents and children around the surgical procedures that involve general anaesthetic. Life St George’s Hospital invites parents and children to arrange a visit to the hospital prior to surgery, where they can tour the wards and ask any questions. Visitors are also given the opportunity to handle certain surgical equipment – stethoscopes and 40
anaesthetic masks – and will receive a ‘doctor’s bag’. There is a lot you can do to prepare your child for surgery. Depending on age, some ideas include reading books about hospital visits or even buying a toy doctor’s kit. Anything that helps to familiarise your child with a hospital environment will go a long way towards relieving any anxiety he or she may feel when they’re checked in. It also helps to have a familiar toy or comforter nearby to help your child to self-soothe if he or she is feeling distressed.
IN GOOD HANDS
Sr Hinddevi Naicker, 60, has been a theatre scrub sister at Life Mount Edgecombe Hospital for 16 years, and worked in the field of nursing for 35 years. ‘I enjoy working with children and their parents,’ she says. ‘When I see anxious parents, I explain to them that administering anaesthetic is a routine
procedure and one that we do on a daily basis. ‘Children may cry not because of pain, but rather of fear. I reassure parents that we will give their child the best possible care. When moms or dads come into the operating theatre with their child, it prevents separation anxiety for children. They’re reassured because they aren’t among strangers. Parents are also reassured that the environment is safe.’ If there are pre-existing intravenous lines, medication is administered to put the child to sleep. If not, gases are utilised via a fruity scented mask. ‘Mom or Dad can stay in the room until their child falls asleep. After this, we’ll escort them out and comfort them. The parent usually finds the anaesthetic experience more upsetting than the child, because they are watching as their child loses consciousness. It’s best for parents to be prepared beforehand, so they don’t find it traumatic,’ says Sr Naicker.
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When your child needs to have general anaesthetic, it’s normal to feel a little uneasy. Try not to worry – they’re in expert hands. By Melanie Farrell
THE BABY FILES
THE THREE STAGES OF ANAESTHESIA Induction This takes less than five minutes when the child is sedated. Where is the parent? One parent is allowed into the theatre while the child is falling asleep. They will then be escorted from the room. During the induction phase, the child may enter a stage called ‘excitement’, during which they appear agitated. This can be upsetting but it is completely normal.
The length of the surgery will vary depending on the procedure that is being carried out, but the child will be anaesthetised throughout and their vital signs are monitored to check that they are stable.
After the procedure, the anaesthesia will be stopped and the child will be moved to the recovery room where he or she will start to wake up.
Where is the parent? Most parents prefer to be nearby during surgery. Chat to your surgeon beforehand and find out how long the procedure is expected to last. Ask a nurse to update you regularly. And remember: your child is in the hands of medical experts and, for them, surgical procedures are routine.
Where is the parent? All children have a different response to anaesthetic. Some wake up quickly, while others may take a bit longer and may be upset when they come to. You will be reunited with your child as soon as possible, so it’s best to take your cue from the nursing staff. They know that you want to be with your child and will try to make this happen as soon as possible.
Children may cry not because of pain, but rather of fear
EXPERT ADVICE FROM A SCRUB NURSE
Sr Hinddevi Naicker, a theatre scrub sister at Life Mount Edgecombe Hospital, says: The best way for a parent to prepare a child for an operation is to explain exactly what is going to happen.
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• A mask is going to be placed on his or her face as if being nebulised, and he or she will fall asleep.
For more information about Life St George’s Hospital’s KIDZ programme, contact: Life St George’s Hospital 40 Park Drive, Central, Port Elizabeth 041 392 6111, www.lifehealthcare.co.za
• The doctor will then make him or her feel better. • He or she will not feel anything during the operation.
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EVERYBODY’S TALKING ABOUT…
Sit, stand or move? How can you overcome physical inactivity in your everyday life? Charlene Yared-West investigates
esearch shows that people who sit for 11 hours or more a day have a 40% higher risk of dying over the next three years than people who sit less than four hours, whether physically active or not. Movement is a vital nutrient for health. Considering your levels of stress, increasing workload at your desk and the amount of exercise you do, this can be a frightening statistic… So how can you avoid this risk?
LET’S START AT THE BEGINNING
A sedentary lifestyle is rewarded and cultivated in our society from a young age, says Adele Pudney, physiotherapist at ADK Physio & Hydrotherapy (www.wellspringcentre.co.za). Babies are often overprotected to the extent that it lowers their natural, necessary exploration of the environment, she says. ‘When they grow up, at school they’re forced to sit for long hours behind a desk. Now add to this poor alignment and ergonomics and these little bodies grow into the patterns adopted for extended periods, which don’t have good health outcomes. The World Health Organization recommends at least 150 minutes of exercise a week in the face of the statistic that adults typically spend 90% of their leisure time sitting down.’
SITTING ON HEALTH PROBLEMS
Obesity, high blood pressure, excess body fat, type 2 diabetes, cardiovascular disease, cancer, abnormal cholesterol levels, hypertension, non-alchoholic fatty-liver disease and even depression are some health problems that result from a sedentary lifestyle, says Zeno Rossouw, a physiotherapist based at Life Orthopaedic Hospital at Life Vincent Pallotti Hospital. ‘I’ve seen clients who take for granted their access to information and education and have a lack of
commitment to their overall health.’ He adds that people can only control that which is in their capability, such as ensuring a healthy diet, adequate exercise, not smoking and avoiding alcohol. Australian research shows that the average ofﬁce worker only spends 73 minutes of their daily life walking – not sitting – and so in 73 minutes, all cooking and any exercise is done, adds Dr Greg Venning, author and chiropractor at Peak Chiropractic in Cape Town (www.capetownchiro.com). ‘We are genetically wired to love movement. It triggers the reward pathways deep in our brain and should make us want to move more, but modern sedentary living disconnects us from that primal joy. Body movement, especially the spine, acts like a windmill that generates stimulation and energy for the brain, and every moment we spend sitting we’re robbed of that stimulation,’ he says.
HIT PAUSE – AND MOVE!
A central problem is the structural damage that sitting causes, leading to organ dysfunction, nerve damage, muscle tightness, pain, fatigue and a host of problems, says Dr Venning. ‘Getting your body moving again will limit future damage, but there’ll be some damage that your body cannot undo on it’s own. You can get a good idea of that damage by testing your relaxed posture,’ he says. ‘If you slump, then there are problems that need to be assessed and addressed. Your body should hold you up effortlessly and you shouldn’t need to hold your body up.’ Liesl Way, a physiotherapist at Life Westville Hospital, suggests simple changes to interrupt long periods of sitting, which can make all the difference. • Set an alarm for every 30 minutes to move for two to ﬁve minutes. March on the spot, walk and stretch your neck, lower back and shoulders out of the slouch position. While sitting, squeeze buttocks, pump ankles, march legs, bend and straighten knees. • While sitting or standing, maintain good posture. • Exercise regularly: 30 minutes, ﬁve times a week. • Take stairs, walk to colleagues instead of emailing, walk to get ﬁles, have walking meetings, stand while reading, park further away from the ofﬁce. • Have two work stations – for sitting and standing – and do different aspects of your job at these. • Don’t fast-forward TV ads, exercise while they are on!
BEFORE YOU SIT DOWN, STAND OR, BETTER YET, TRY A TREADMILL DESK! Standing workstations and treadmill desks have become more popular over the years. Experts agree that they have their benefits, but they also have a downside. In everything, balance is key. ‘When using a standing workstation, blood can pool in the legs and put strain on the feet and legs, which can lead to plantar fasciitis and knee, hip and back problems. You will have to build up your standing tolerance slowly by listening to your body,’ explains Pudney. ‘If your body starts aching, change your position and make sure you wear comfortable shoes with good support as high heels will not be kind to your feet.’ Dr Venning suggests making a game of it, which will encourage movement among employees. ‘Put penalties in place for every time you are caught not standing for a phone call. Standing workstations are a great idea if they are managed well,’ he says. Rossouw points out that treadmill desks could improve attention and memory after the user has stopped walking. ‘The constant slow pace will add to energy levels, and soothing of joints and muscles, thereby having a positive impact on the health of the employee,’ he says.
2016/02/16 3:28 PM
DID YOU KNOW? CANSA provides care, support, guidance and advice to cancer survivors
Get in touch with us. Our CANSA Care Centres country-wide offer comprehensive care and support programmes for all those affected by cancer to find the best care solution and advise on the managing side effects of treatment, be it physical, emotional and / or spiritual. Dedicated toll-free line. Friendly and informed staff at our toll-free centre provide compassionate customer service, awareness materials, fact sheets, information and referrals for anything related to cancer support and care.
Toll-free 0800 22 66 22 | www.cansa.org.za
POWER OF FIVE
BURNS FIRST AID
Burns are among the most common household injuries, especially in children. Here are ﬁve of the most effective ways to treat them
1 2 3 4 5
I M A G E G ET TY/GALLO I MAG ES C O M P I L E D BY SAMANTHA PAG E
are the least serious since they extend to the outermost layer of skin. Immediately immerse the burnt area in cold water or place the burnt area under running water. Don’t use butter, oil, ice or ice water, which can worsen the damage. Cover the burn with antibiotic ointment or aloe vera cream.
can involve blistering since it affects the skin tissue below the epidermis. Soak the burn in cool water, apply an antibiotic cream and cover with a non-stick dressing. Watch for signs of infection, which could include redness, swelling, pus and pain. Don’t break blisters since they provide a natural barrier to infection.
damage all layers of skin and usually cover a large proportion of the body. They can be life-threatening so you need to go to a hospital immediately. Emergency treatment will prevent dehydration and shock. It’s useful to note that this type of burn is the least painful because the burn has damaged nerves in the skin.
such as sodium hydroxide or hydrochloric acid, should be doused with large amounts of water and any clothing that has been splashed by the chemical should be removed. Don’t administer anything other than water since you could set off a chemical reaction that will make matters worse.
can occur from lightning, stun guns and contact with household current. This kind of burn can cause internal injuries with no external signs of injury so it should be treated as a medical emergency. If possible, ensure that the person is no longer in contact with the electricity and go directly to a hospital or call a paramedic.
Life Healthcare paramedic service employs paramedics in fully equipped response cars and offers free emergency paramedic assistance to their communities. There is only a cost if an ambulance is dispatched. Life The Glynnwood, 078 137 4304; Life Springs Parkland Hospital, 082 504 8500; Life Flora Hospital, 011 470 7744; Life Fourways Hospital, 0860 444 044; Life Rosepark Hospital, 0800 22 22 22; Life Vincent Pallotti Hospital, 0860 532 532
2016/02/16 3:44 PM
I’m so tired of that bloated feeling... Ya, and a sore tummy isn’t great either...
Not to mention embarrassing flatulence.
Constipation is my worst
So what is the solution, to feel good tummy?
For further information available on request. ZA.15.CNM.042 05/2015
Adcock Ingram Healthcare (Pty) Ltd. Reg. No. 2007/019928/07. 1 New Road, (cnr New Road & 7th Street), Midrand, South Africa. Tel: +27 11 635 0000
CARE FIRST-CLASS PATIENT CARE / BREAKFAST RECIPES / HEALTHCARE HERO / SHORT STORY
‘SOMETIMES OUR LIGHT GOES OUT, BUT IS BLOWN AGAIN INTO FLAME BY AN ENCOUNTER WITH ANOTHER HUMAN BEING.’ ALBERT SCHWEITZER
2016/02/16 3:57 PM
BYE TO THE BUTTS Kicking a habit is never easy, especially when it involves an addiction – as is the case with nicotine in cigarettes. But armed with these tips, you can look forward to throwing your ashtrays away, just in time for World No Tobacco Day on 31 May. By Lisa Witepski
FIND A REASON
According to Dr Vinod Thomas, a cardiologist at Life Vincent Pallotti Hospital, your battle against the butts will be more successful if you have a powerful, personal reason to stop smoking – whether that’s the desire to improve your own health or to protect your family from the effects of second-hand smoke. ‘Choose a reason that is so strong it trumps the desire to light up,’ he says.
DON’T GO COLD TURKEY
Smoking is an addiction as real as any other. Because your brain is hooked on nicotine, it’s not simply a case of throwing away your last pack and never looking back – do this and you’ll experience all the discomfort of withdrawal. Dr Thomas advises that you line up support: once you’ve had your last cigarette, throw out your ashtray and thoroughly clean anything, from clothes to your car, that may retain the smell of smoke. Next, inform your friends and family of your plan so that they can keep you going, especially when your motivation flags. If possible, buddy up with someone who is quitting at the same time as you, and who understands the challenges involved. Finally, get some professional assistance: ask your doctor about nicotine replacement therapies, courses, hypnosis and counselling.
IDENTIFY NEW WAYS TO UNWIND Dr Thomas points out that one of the reasons people enjoy smoking is that it helps them relax. Investigate different ways to let off steam: do yoga, treat yourself to a massage or take up a hobby. ‘Try to avoid stressful situations during the first few weeks after you quit,’ he suggests.
Does your glass of whisky always go down more smoothly with a cigarette in hand? Do you end your meals with a smoke and a cappuccino? Time to establish new rituals, says Dr Thomas. Stay away from alcohol for a few weeks as drinking makes it harder to quit, and give other triggers a wide berth. For example, switch to tea for your after-meal beverage.
Upping your exercise regime can benefit you in a number of ways while you’re kicking the habit. For a start, it burns calories, helping you to avoid weight gain. It can even help curb cravings and manage withdrawal symptoms – and it doesn’t have to be a heavy CrossFit session to be effective. Even gentle activity, such as walking your dog, can help.
E-CIGARETTES: YES OR NO?
Before you reach for that e-cig, consider this: electronic cigarettes are designed to replace tobacco products rather than help you stop smoking, and although it’s obviously desirable to find an alternative to smoking, too little is known about the chemical cocktail in e-cigarettes to consider them a safe option.
YOUR ANTI-ASHTRAY ARSENAL
Looking for a way to manage those cravings? Consider a nicotine replacement. Products include patches, gum and inhalers. Alternatively, ask your doctor about prescription medication, such as Zyban or Chantix.
WITH A LITTLE HELP FROM YOUR FRIENDS Dr Vinod Thomas says that behavioural therapy might be useful to help you quit. You could also try a course, like The Cancer Association of South Africa’s (CANSA) eKick Butt programme, a free online series of surveys and downloads. www.ekickbutt.org.za
2016/02/16 3:58 PM
HYPERTENSION: THE SILENT KILLER
You can feel fine and still be at risk of some very serious disease. Mandy Collins gets the low-down on hypertension
f you haven’t had your blood pressure checked recently, you could be walking around blissfully unaware that you’re ill. Hypertension (or high blood pressure) is a very common but often undiagnosed condition. Known as the silent killer, most people with hypertension have no symptoms whatsoever. ‘But that doesn’t mean there’s no cause for concern,’ says Dr Vinod Thomas, a cardiologist and cardiac electrophysiologist at Life Vincent Pallotti Hospital in Cape Town. ‘And if you just carry on without getting it under control, you put yourself at increased risk of serious problems, such as stroke, congestive heart failure, heart attack, and kidney failure.’ The Heart and Stroke Foundation South Africa estimates that about a quarter of all South Africans, 15 years and older, suffer from hypertension. But medical experts can only hazard a guess as so many people don’t have their blood pressure checked. Other statistics show that about 130 heart attacks and 240 strokes occur daily in South Africa. This means that 10 people will suffer a stroke and five will have a heart attack every hour.
WHAT IS HYPERTENSION?
I MAG ES GETTY/GALLO IMAGES, SUPPLIED
Hypertension, or high blood pressure, is a common condition in which the long-term force of the blood against your artery walls is so high that it begins to cause damage in the form of health problems. When your doctor takes a blood pressure reading, they are measuring both the amount of blood your heart pumps, and the amount of resistance to blood flow in your arteries. So the more blood your heart
MEET OUR EXPERT
pumps and the narrower your arteries, the higher your blood pressure. The problem is that there are no symptoms, which means often your blood vessels and heart are being damaged undetected for years. But the good news is that it’s easy to pick up – you simply need to get it checked regularly.
KNOW YOUR NUMBERS
‘You can ask your doctor to take your blood pressure or even pop in at your local pharmacy – many have sisters who can check your blood pressure for you and send you to a doctor if yours is high,’ says Dr Thomas. ‘Ask your doctor for a blood pressure reading at least every two years, starting at age 18. If you’re younger with a high risk of high blood pressure, or older than 40, measure it at least once yearly.’
TREATMENT AND PREVENTION
Depending on your blood pressure reading, your doctor may prescribe medication to get it under control. It’s important to note that you will have to keep taking this medication, says Dr Thomas. ‘Many patients stop taking their treatment when their blood pressure improves, but it only gets better because of the medication – you have to stay on your treatment regimen.’ However, there are some lifestyle changes you can make to support the treatment: • Eat a healthier diet with less salt • Exercise regularly • Quit smoking • Limit the amount of alcohol you drink • Maintain a healthy weight or lose weight if you’re overweight or obese.
Dr Vinod Thomas began his medical career in an interesting place – with a BSc (Anatomy) in Archaeology under the tutelage of Professor Phillip Tobias at the University of Witwatersrand. He went on to study medicine and specialise in cardiology in the UK and Canada before returning to South Africa to set up his own practice.
FOR HIGH BLOOD PRESSURE • Age – the older you are, the higher the risk. • Gender – from about age 45, hypertension is more common in men. Women are more likely to develop it after age 65. • Race – high blood pressure is particularly common among black people, often developing at an earlier age than it does in white people. • Family history – it tends to run in families. • Being overweight or obese – the larger you are, the harder your heart has to work. • A sedentary lifestyle – people who are inactive tend to have higher heart rates, which means your heart has to work harder. • Smoking • Diabetes mellitus • Too much salt (sodium) in your diet • Too little potassium in your diet • Too little vitamin D in your diet • Drinking too much alcohol • High levels of stress • Certain chronic conditions
2016/02/18 9:16 AM
Good morning Start your day off right with one of these delightfully delicious breakfasts from Jamie Oliver’s new cookbook Everyday Super Food. They’re packed with nutrients for a healthier, happier you
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Baked Eggs in Popped Beans, Cherry Tomatoes, Ricotta on Toast
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Baked Eggs in Popped Beans, Cherry Tomatoes, Ricotta on Toast Mighty cannellini beans are a great source of protein, high in ﬁbre, and contain vitamin C as well as magnesium, a mineral that helps our muscles to function properly. Serves 2 250g mixed-colour ripe cherry tomatoes ½ a lemon Extra-virgin olive oil 4 sprigs of fresh basil 1 × 400g tin of cannellini beans 1 good pinch of fennel seeds 2 large free-range eggs 2 slices of seeded wholemeal bread 2 heaped teaspoons ricotta cheese Optional: thick balsamic vinegar Optional: hot chilli sauce 1. Halve the tomatoes, place in a bowl and toss with the lemon juice, 1 tablespoon of oil and a pinch of sea salt. Pick, tear and toss in the basil leaves (reserving the smaller ones for garnish), then leave aside to macerate for a few minutes. 2. Meanwhile, place a large non-stick frying pan on a high heat. Drain the beans and put into the hot pan with the
fennel seeds and a pinch of black pepper. Leave for 5 minutes, shaking occasionally – you want them to char and pop open, bursting their skins. Pour the macerated tomatoes into the pan with 100ml of water, season, then leave to bubble away vigorously for 1 minute. Crack in an egg on each side, then cover with a lid, plate or tin foil, reduce to a medium-low heat and slow-cook for 3 to 4 minutes for nice soft eggs, or longer if you prefer. Meanwhile, toast the bread. 3. Divide the ricotta and spread over the two pieces of hot toast, then serve on the side of the baked eggs in beans. Sprinkle the reserved baby basil leaves over the top and tuck right in. Nice ﬁnished with a drizzle of balsamic vinegar and/or a drizzle of hot chilli sauce. Delicious.
399kcal CALORIES 15.7g FAT 3.6g SATURATED FAT 22g PROTEIN CARBOHYDRATES 40.7g 5.8g SUGAR 12.6g FIBRE 20 minutes
Toasted Oats, Mango, Blueberries & Yoghurt Oats ﬁll us up and act as a slow-burning fuel, so are a perfect start to the day. They’re high in ﬁbre, and the minerals phosphorus and magnesium, keeping our bones strong and healthy. Serves 1 1 handful of porridge oats (50g) 1 level teaspoon fennel seeds 1 heaped teaspoon coconut flakes 2 heaped tablespoons natural yoghurt 1 small handful of blueberries Optional: rose water 1 small ripe mango ½ a banana ½ a lime Optional: manuka honey 1. Put the oats into a small frying pan on a medium heat with the fennel seeds and coconut and toast until lightly golden and smelling delicious, tossing regularly. Tip into your bowl and spoon the yoghurt on top. 2. Return the pan to the heat. Place the blueberries in with a good splash of
water and a few drips of rose water (if using), which will add an incredible perfumed ﬂavour. Simply boil for a couple of minutes until the berries burst and you have a loose sauce, then spoon over the yoghurt. 3. Slice one of the cheeks off the mango and cut a criss-cross pattern into the ﬂesh, making sure you don’t go all the way through, then turn it inside out so all the pieces pop up into a mango hedgehog (keep the rest of the mango for another day). Peel and slice the banana, then dress both mango and banana with a squeeze of lime juice. Add to your bowl and tuck right in. Great as it is, or if you like you can drizzle 1 teaspoon of honey over the top before serving.
329kcal CALORIES 8.3g FAT 3.4g SATURATED FAT 9.1g PROTEIN 53.5g CARBOHYDRATES 19.7g SUGAR 8.5g FIBRE 10 minutes
‘Healthy, nourishing food should be colourful, delicious and fun’ JAMIE OLIVER
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Toasted Oats, Mango, Blueberries & Yoghurt
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Berry Pocket Eggy Bread, Pistachios, Yoghurt, Honey & Cinnamon Crunchy pistachios are super-high in the mineral chloride, which our bodies need to make hydrochloric acid in the stomach, in turn aiding good digestion and keeping our gut happy. Serves 2 2 large free-range eggs 1 small ripe banana Ground nutmeg Ground cinnamon 2 thick slices of seeded wholemeal bread 150g raspberries Olive oil 20g shelled pistachios 4 heaped tablespoons fat-free natural yoghurt Manuka honey 1. In a blender, blitz the eggs, peeled banana, and 1 pinch each of nutmeg and cinnamon until smooth, then pour into a wide shallow bowl. Cut your bread 2½cm thick, then cut a slit into the longest side of each slice and wiggle your knife inside to make a pocket. Use your finger to stuff the raspberries inside – pack as many in as you can, but be gentle so you don’t tear the bread. Lay in the eggy mixture and gently squash the bread so it soaks up the eggs.
2. Meanwhile, put a large non-stick frying pan on a medium-low heat with 1 teaspoon of oil, then wipe it around and out with kitchen paper. Pour half the excess egg mixture into one side of the pan, then place a piece of soaked bread on top to give it a lovely pancake layer. Repeat with the rest of the mixture and the other slice alongside it. Cook for 3 to 4 minutes, or
until golden, then confidently flip over to cook for the same amount of time. Meanwhile, smash up the pistachios in a pestle and mortar – toast them first, if you like. 3. Serve the eggy bread dolloped with yoghurt, sprinkled with pistachios and an extra pinch of cinnamon and drizzled with a little honey.
344kcal CALORIES 14.4g FAT 3.1g SATURATED FAT 18.8g PROTEIN CARBOHYDRATES 38.2g 17.4g SUGAR 6.7g FIBRE 15 minutes
Everyday Super Food by Jamie Oliver is published by Penguin Random House © Jamie Oliver Enterprises Limited (2015 Everyday Super Food) Photographer: Jamie Oliver. From R390. Available at all good bookstores. 54
2016/02/17 9:01 AM
WH_Dulce Hospital A4 advert.pdf
Commitment Our smile is our welcome Thoughtful care is our commitment How we leave you feeling after your hospital experience is our legacy In our commitment to providing high quality care and personal attention we promise to: Greet you courteously â€“ with a smile Treat you with dignity, respect and without prejudice Provide you with a safe, clean and organised facility Be sensitive to your physical, emotional and psychological needs Listen and address, to the best of our ability, any concerns that you may have We appreciate your feedback Speak to us: You are welcome to discuss any requests or concerns with members of the hospital management team Respond to our survey: As a valued patient you will receive an email or sms survey after you are discharged from our hospital Email us: Customer.firstname.lastname@example.org Use the web: www.lifehealthcare.co.za â€“ follow the prompts from contact us Call us: 011 219 9111
External Governing Bodies Hospital Complaints: Department of Health Office of Health Standards Compliance
PUTTING PATIENTS FIRST Feeling cared for while in hospital is the sum of so much more than medical treatment. To remind staff how they can contribute to a patient’s overall experience, Life Healthcare Group has implemented the CARE programme. Gillian Warren-Brown asked four staff members to share their perspectives, having recently undergone CARE training
THE CARE PROGRAMME
Being in a hospital can be daunting. When you’re feeling ill, perhaps even afraid, being greeted with a smile and caring words makes the world of difference. In addition, being kept in the loop about your treatment can motivate you on your journey to recovery. As a patient, you want to know that each member of the hospital staff has your best interests at heart. The CARE programme highlights ways in which staff can demonstrate this, ensuring that quality and thoughtful care are the hallmark of every interaction they have with patients. Launched in October 2015, the programme is being rolled out nationally. It involves all 24 000 employees and stakeholders, who receive a full day’s training by CARE Champions selected from each Life Healthcare facility. Following the training, which uses a fun, interactive approach, there will be themed monthly ‘huddle’ groups (small group meetings) in each ward or department to ensure that the energy of the programme is maintained.
STAFF PERSPECTIVES Jayesh Parshotam Hospital manager, Life Fourways Hospital in Johannesburg
Successful healthcare outcomes depend on more than purely clinical interventions, says Parshotam. He sees the CARE programme as a tool to enhance the personal, caring and empathetic human elements that support clinical excellence. ‘For me, the programme has reinforced how critical it is for every member of staff to be thoughtful in their approach to patients and their families. It has also highlighted how our actions have a powerful impact on their experience,’ he says. In the training, these aspects were illustrated by the environment map, which took participants on the patient journey and underlined the key part that every role player has during a patient’s stay in hospital, says Parshotam.
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At Life Fourways Hospital, and throughout Life Healthcare, the CARE programme will be reinforced through visual reminders, such as posters, as well as the monthly ‘huddle’ sessions. Parshotam believes the success of the programme will become increasingly evident as its core message is reinforced through the refresher sessions, and as individual staff members explore how they can contribute – not just to patient satisfaction but to a positive patient experience.
Wilmaree Palmer Ward clerk, Life Isivivana Private Hospital in Humansdorp
The essence of the CARE programme is to put yourself in the patient’s shoes, says Palmer. ‘It reminds us that we each have a responsibility to create a caring environment, to treat patients with dignity and to put their needs ﬁrst.’ Adding a personal anecdote, Palmer says her father once told her that if someone made her angry, she shouldn’t upset others by having a face like a thundercloud. ‘It’s our job to be happiness providers. A smile is powerful medication; it goes a long way to help patients feel better.’ Along with treating patients with dignity and respect, Palmer says it’s important for staff to educate them mindfully about their treatment. ‘Staff who are familiar with the medication might whizz through the details quickly – one, two, three, four. But the patient might only get points one and three. In this, and every instance, it helps to put yourself in the patient’s shoes.’
It’s our job to be happiness providers. A smile is powerful medication; it goes a long way to help patients feel better Sister Nonceba Ratego Professional nurse, Kirkwood Care Centre, Life Esidimeni
advocate for her patients. ‘They trust us to do the best for them,’ she says. She intends to live by the CARE values and do everything with excellence and pride. Sister Ratego says the activity on company values was a particularly meaningful part of the training because it clariﬁed what both patients and Life Healthcare expect of her. The CARE message she would highlight to colleagues is that every staff member’s role is essential to the overall service delivered by the multidisciplinary team. Her message to patients is: ‘You are our priority.’
My CARE message for the patients is that their comfort and well-being come first Sister Debbie Lebeloane Nurse, Life Eugene Marais Hospital in Pretoria
‘The CARE programme reminds me why I am a nurse,’ says Sister Lebeloane. ‘It reminds me of the Nurses’ Pledge, which I took in 1999, particularly the part about dedication to patients and putting them ﬁrst.’ This was reinforced by a card game – one of the unusual, interactive techniques used in the training. The emphasis on multidisciplinary teamwork and the ‘total care’ of patients also struck a chord and, she says, are aspects of her work as a surgical ward sister that she’ll pay extra attention to since the CARE training. After greeting the patients, Sister Lebeloane says she and her colleagues often sing for them, which they enjoy. ‘My CARE message for the patients is that their comfort and well-being come ﬁrst.’ This is also what she would encourage her colleagues to bear in mind, along with the need for teamwork, as part of a dedicated team that provides a caring patient experience.
‘Delivering quality care in everything we do, including the way we greet, treat and interact with the patients…’ For Sister Ratego, this is the basic message of the CARE programme. Underpinning this, she believes, is having a real passion for your work in the healthcare profession. Sister Ratego has been a professional nurse since 2011 and top-quality care has always been her priority. However, after the CARE training she is more conscious of being an 58
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THE SEED THIEF The Seed Thief, by author Jacqui L’Ange, follows Maddy Bellani from Cape Town to Brazil in a richly woven tale of love, ancient history and the journeys we must all take
t felt more like a pageant than a religious ceremony. But after about an hour, it started to make sense. I began to recognise the shift in rhythm that heralded the arrival of each new orixá. Before the costume changes, before the colour shifts, even before the drawing inward of a dancer, when a new spirit was about to take over a corporeal son or daughter and spin a new story, I sensed it in the drum beat. The drumming was relentless and hypnotic. Each change in tempo was also a change in energy and personality, taken in, communally, by all the participants in the ceremony, whether initiate, elder, local, tourist, or ‘other’, like me.
I sat in the women’s section, which faced the men’s along one side of the barracão. Towards the front of the hall, where the stage would have been if there was one, a door led to a mysterious space from which plates of food and costumed figures emerged at irregular intervals. There were two sets of entrance doors at the back of the hall. Men and women streamed in and out, separately, to and from the dark, cooling night. Against the long walls, cement benches tiered from floor to ceiling. I arrived late, but found a place in the body crush about three tiers up from the floor. A group of excitable blonde tourists, speaking too loudly, sat a bit further along the bench. I distanced myself from them mentally, focusing instead on a row of little girls standing in front of me.
Every so often the girl would break off her candy negotiation, close her eyes and immerse herself unselfconsciously in the rhythm. She couldn’t have been more than seven or eight years old, but she flicked and rotated her skinny hips in a manner way beyond her years, opening a window to the sensuality I was sure she would one day practice with more self-conscious skill. She was not just pulsing with the beat, not performing an obvious parody of what she must have seen her mother, and countless other women, do as part of their birth right. She had surrendered herself to it, utterly.
The children were small and nimble, and preoccupied with sharing out a packet of colourful sweets – the candy-coated chocolate button kind.
So had the spinning women on the floor, dervishes whose long skirts flared out, stiffened by motion and layers of white petticoats. One was decked out in ornate gold brocade, with rivers of seemingly precious gold chains and trinkets, even though they were probably made of painted plastic. She held a hand mirror, preening and spinning and reflecting and weaving, like water.
The little girl directly in front of me had dark hair tightly braided with white ribbons at the end of each cord – her only concession to white. Most people in the hall wore white; a sign of respect to the spirits being honoured here. But this little girl wore a pink and white striped T-shirt over a frilled and faded red skirt. I imagined the rules were different for children.
Facing them, from her two tiers up, the young girl jiggled and swayed, gyrating to the pulse she had taken inside her, eyes closed, fist closed around a handful of the sweets. When she opened her eyes and hand and looked down, they had run into rivulets of colour that coalesced in the centre of her palm like a chocolaty stigmata. She shoved the congealed mess into her
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mouth, throwing a look of bliss and triumph at her small neighbour, who had long since finished her own handful.
over the terreiro. He was on the far edge of the group, head tilted to keep an eye on his fellow drummers. Except that his eye was tethered to me.
I felt my face crease into a smile, but when the child turned around, I looked away – I had shared this intimacy without permission.
My watcher’s left hand palmed slow time, while in his right, he flicked a stick that teased the skin of his drum. He didn’t smile. He just looked. And played. I wasn’t sure if he was even seeing me.
That was when I noticed that I was being watched.
Author Jacqui L’Ange
The drummer held my line of sight and didn’t falter in the rhythm he was beating out on his tall, carved drum, even as he saw me register him. There were about ten drummers in the drum pit, directly in front of the women’s section. They were grouped with their backs to us and turned slightly towards one another, so that a nod or a glance could initiate a change in beat, as they weaved their percussive spell
I felt my own lips pull into a tentative arc. He was nodding his head – to me, to the beat? – swaying slightly with the rhythm, stroking, beating, nodding. I found myself swaying and nodding, too. The little girl in front of me turned again to look at me, then looked back at the man. She elbowed her friend and said something I couldn’t hear. The friend also turned to look. Senhorita Magdalena? The Seed Thief is published by Umuzi and is available at all good bookstores.
Influenza is a serious threat…
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2016/02/18 9:12 AM
HERO OF THE MONTH
ELIZABETH MZIWABANTU Determination and a positive attitude ensure this seamstress overcomes challenges one step at a time. By Melanie Farrell
ealing with obstacles head on is just part of daily life for this month’s hero, Elizabeth Mziwabantu, who works in the sewing room at Life Beacon Bay Hospital. Despite contracting polio at the age of six months, which left her with partial paralysis in her left leg, Elizabeth has refused to allow it to slow her down. She wears a brace but doesn’t see it as a handicap. ‘When I was younger, my mother said I should apply for a disability grant but I said no. I don’t see myself as disabled,’ Elizabeth says. ‘I had to start school a year later than all my friends because there were no schools for disabled children where I lived in Ngcobo, a rural area in the Eastern Cape. It was difﬁcult. ‘I convinced my mother to let me go to a mainstream school a year after my friends. I completed grade 12 and then I wanted to study further. Despite my mom pleading with me not to go, I headed for East London. ‘I started working at Life East London Private Hospital as a laundry assistant, occasionally helping in the wards as a general assistant.’
I am looking forward to all the new adventures still waiting for me
Elizabeth has never let her disability hold her back
Elizabeth now works in the sewing room (linked to the laundry) at Life Beacon Bay Hospital, where she is a whizz on the sewing machine and also captures data for daily reports. ‘My supervisor and manager started mentoring me in 2012 and taught me how to use a computer. This was an amazing moment for me. ‘Last year was an incredible year for me. In March, I moved into my newly built home, had my ﬁrst driving lesson, did a ﬁve-kilometre fun-run with my workmates, and celebrated not only my 50th birthday but also 25 years of working for Life Healthcare.’ Elizabeth has a can-do personality, so it’s only natural that she took part in the fun-run with her colleagues despite her having a leg brace. ‘But I’m not ﬁnished!’ she says with a broad smile. ‘I have so many other goals I am working on. My eyes are ﬁxed on the horizon and I am looking forward to all the new adventures still waiting for me.’ Elizabeth is a ﬁrm believer in focusing on her ability to get the job done and participating fully in what life has to offer. Just don’t tell her that she can’t do something. She’ll only want to prove you wrong.
2016/02/17 9:19 AM
PUZZLE THIS... Test your mental agility with our brain-teasers
1 CROSSWORD PUZZLE 2 SUDOKU
1 Bill 4 Garden intruder 8 Cougar 12 Exist 13 Bullets and such 14 Unyielding 15 Meadow 16 Country quaintness 18 Yuletide rendition 20 A billion years 21 Conks on the noggin’ 24 Halos 28 Poison level 62
32 Witty one 33 Mess up 34 Gold measure 36 Cowboy’s sweetie 37 Bound 39 Great joy 41 Trustworthy 43 Shed tears 44 Shelter 46 In a stunned state 50 Means of betrayal 55 ‘__’ Got a Secret 56 Needle case 57 Sharpen
58 Fresh 59 Flex 60 On the __ (unfriendly) 61 See 43-Across DOWN
1 Body powder 2 Vicinity 3 Tolerate 4 Spelling whiz? 5 Ostrich’s kin 6 Ambulance abbr. 7 Love not wisely but too well
8 Park outing 9 Swiss canton 10 Witticism 11 Whatever amount 17 Charged bit 19 Kimono closer 2 Chanteuse Edith 23 Scatter about 25 Creche trio 26 Unruly kid 27 Without doing anything 28 Reveal 29 Sandwich treat 30 Picture of health?
31 Eli’s campus 35 1960s T-shirt patterns 38 Wan 40 Bookkeeper (Abbr.) 42 Mainlander’s memento 45 Vocal come-back 47 Galvinising matter 48 Eternally 49 Moist, in the morning 50 Society newbie 51 Multi-purpose truck 52 Bit of wordplay 53 Debtor’s letters 54 Stick with a kick
2016/02/17 9:21 AM
I L L U S T R AT I O N T O B Y N E W S O M E , 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
Difficulty level ***
3 WORD SLEUTH
Find the hidden words in the diagram. They run in all directions
For each of the words below, replace one letter with the tile after the plus sign. Then rearrange the letters to spell something that is often sharp
Boots Cleats Ladder Outsole Plow
Rake Shoes Shovel Skid Skies
Spikes Tiller Tires Tread Wheels
ANSWERS DAGGER, NEEDLE, SWORD, TONGUE
I L L U S T R AT I O N T O B Y N E W S O M E , 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
2016/02/17 9:21 AM
BEING PRESENT A
n enormous benefit of mindfulness is that you get a free ticket to that rare destination: the present. Okay, I hear you say, ‘What’s so great about being in the present moment? What if I don’t want to stare at a butterfly wing or hear the single ting of a windchime? I have places to go, people to meet.’ Being present can’t be understood through cognition, it’s a felt experience; you feel through your senses, not through your thoughts. Simply to sit with your eyes closed and breathe probably seems like the last thing on earth you’d need, or have time, to do. You might think that by the time you’ve flossed your gums, done some ab crunches, taken a shower, moisturised, toasted toast, had sex with your boyfriend (notice I didn’t say husband; later in life, you can skip that bit) you’ve used up half your day and it hasn’t even started yet. So when people speak of being mindful or present, it’s usually thought of as being pretty low down in the hierarchy of needs. On the face of it it seems that nothing is really useful about being in the present, so we don’t visit it much. We don’t really know how to be present except when something out of the ordinary happens, for example, your house is on fire or a seagull lands on your head. Sometimes we find ourselves having an ‘aha’ moment when we wake from the daydream and have a sudden insight, a revelation, when the doors of perception are thrown open for a blip in time. No one really knows how to make an ‘aha’ moment, but you know an ‘aha’ moment when you have one.
We don’t really know how to be present except when something out of the ordinary happens, for example, your house is on fire or a seagull lands on your head
MBCT [Mindfulness-based Cognitive Therapy] teaches you to be able to come into the present when you choose to, which is no easy feat. Try it now? See? You’re all over the place, probably not even reading my book; sometimes even I’m not concentrating now, writing it: I’m looking out of the window, thinking about things like I have to call my friend Dagmar Stewart who I haven’t spoken to since kindergarten . . . then suddenly I have no idea what I’m typing. And yet the present is where everyone wants to be. If you don’t believe me, let me point out that the reason you plan a holiday or an event for months in advance is to experience it ‘in the moment’. But when you get to your dream hotel or tent, your mind will probably be on something else: ‘Why did I spend all this money? Why didn’t I go on a diet? I look like Moby Dick. I forgot to feed the hamster. This isn’t as good as I thought it would be. I bet it’s better someplace else.’ You spend a fortune on a wine that costs more than the annual GDP of Bolivia to relish its woody undertones but your mind is somewhere else so you miss the whole experience, and now you’re urinating it out without having tasted it. So much of what we do in our everyday lives is to achieve an experience, a taste, smell, sight or sound in the moment. So when people say, ‘I don’t really care about being present,’ remind them how much money and time they’re spending to get there. If, when you’re asked what’s the best time of your life, you can answer, ‘Now,’ you’ve arrived. I’m going to finish this chapter with a quote from Stephen Attain, a teenage cancer victim who said, ‘You have 86,400 seconds today. Don’t waste a single one.’ Extracted from A Mindfulness Guide for the Frazzled (Viking)
Witty, smart and accessible mindfulness advice for relationships, parents, children and teenagers from legendary comedian Ruby Wax
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2016/02/17 9:23 AM
Your better life starts here!