WINTER 2016
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
• WINTER 2016
WINTER WELLNESS HEALTHY, HAPPY & FIT
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RECOVERY
AFTER INJURY
BAD TEMPER?
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2016/05/26 15:04
ED’S LETTER
IMAGE ANGIE LAZARO
LIFE IS…
sweet, but perhaps a little too sweet, according to a recent Human Sciences Research Council study reporting that, on average, South Africans consume 25kg of sugar annually. Catriona Ross discovers that kicking your habit can boost your mood and your health, and save your life too (page 20). Talking about boosting your mood, did you know that honeybush tea, indigenous to South Africa, is the perfect tea for diabetics, helps fight obesity and contains many minerals essential to human health, including iron, potassium, calcium and manganese? These are vital in fluid balance, bone growth and repair, and in the prevention of anaemia. Journey with us to the mountain slopes of the Eastern Cape where this mildly sweet tea flourishes, and find out more about its countless health benefits on page 27. There’s no denying the advantages of regular physical activity, and this season Life Healthcare magazine is asking just how much exercise kids really need. On page 42, Charlene Yared-West shares some practical ideas on how to get kids moving and maps out the World Health Organization guidelines. International Cancer Survivor’s Day is on 5 June this year, and while there is a great deal of focus on those afflicted with the disease, what support is available to cancer survivors once treatment is over and life continues? Glynis Horning has researched the available resources, chatted to survivors and compiled a comprehensive list. You’ll want to read page 32 and share the information with friends and family or tap into it yourself. As we welcome shorter days and longer nights, create moments to share wholesome meals with loved ones (page 52), choose gentle exercise to relieve chronic back pain (page 46) and get a good night’s rest (page 64), which is essential for peak performance and optimum health. Making your life good starts by turning the page… SAMANTHA PAGE, editor INTE T THE INTERES PUBLISH ED IN BY OF YOUR HEALTH
THE INTEREST OF YOUR HEALTH
EAT, PLAY, LO VE
BY LIFE HEALTHCAR
SU M M ER
E
• AUTUMN 2016
• SUMMER 2015
IPES DELI CIOUS REC SUN-SMART TIPS HOLI DAY READS
PLUS
REB OOT YOU R WOR KOUT IN 2016 UT THE FACTS ABO DIAB ETES PREGNANCY AND OVERV2
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PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
PUBLISHED IN
THE MARCH 2016 ISSUE OF LIFE HEALTHCARE MAGAZINE IS AVAILABLE AT WWW.LIFEHEALTHCARE.CO.ZA ‘MAKING LIFE BETTER STARTS HERE’
AUTUMN 2016
SUMMER / 2015
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
YOUR BETTER LIFE STARTS HERE! IMPROVE • RELATIONSHIPS • FITNESS • NUTRITION LIFE-SAVING PROCEDURE THE SKINNY ON DO GOO D, WEIGHT-LOSS SURGERY FEE L GREAT YOUR GUIDE TO GIVING
EDITORIAL Editor Samantha Page lifehealthcaremag@johnbrownmedia.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 Delicia Krause 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 tessa@tfwcc.net 021 795 0430; 082 320 0014 PRODUCTION Production Co-ordinator Tessa Smith Reproduction Resolution Colour 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: lifehealthcaremag@johnbrownmedia.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.
WHAT THE FITNESS EXPERTS WANT YOU TO KNOW
PLUS
HYPERTENSION: THE SILENT THREAT YOU MUST HEAR ABOUT
AM 3 11:31
2015/11/1
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THE FACTS ABO
LIFE PLUS
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2016/02/16 11:58 AM
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Contents SURVIVING AND THRIVING
THIS MONTH’S FOCUS…
LIFE 01 LIFE IS…
A note from the editor
04 OVER TO YOU
Letters from our readers
08 NEWS
Medical innovations, what’s new at Life Healthcare and latest reads
12 RECOVERY AFTER INJURY
A full rehabilitation and strengthening programme is essential to ensuring recovery and preventing re-injury. Read the experts’ advice By Meg de Jong
16 ‘BREAST CANCER FLICKED MY SWITCH FROM BURNT OUT TO BALANCED’ Survivor Sarah Bailey is living an ‘ecstatic existence’ having been given a second chance at life As told to Charlene Yared-West
18 BREASTFEEDING FOR BEGINNERS
What happens when nursing your baby isn’t the most natural thing in the world? A lactation specialist shares her insights By Lisa Lazarus
20 SWEET NOTHING
Reducing sugar can change your life By Catriona Ross
22 THE ABCs OF ADDICTION
Addiction is a chronic disease that can be fatal if left untreated By Vivian Warby
24 CAN YOU CONTROL YOUR TEMPER? Take Life Healthcare magazine’s quiz and evaluate the manner in which you approach and handle anger-inducing situations
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27 STEEPED IN SWEET HONEYBUSH
LIVING LIFE AFTER TREATMENT
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Journey to the home of this naturally sweet tea and learn about its countless health benefits By Keri Harvey
WINTER 2016
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HONEYBUSH: NATURE’S HEALER
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20
BREASTFEEDING HOW TO FOR NEW MOMS
CUT DOWN YOUR SUGAR INTAKE
HEALTH 32 THRIVING AFTER SURVIVING There is not just life after cancer, but a good life if you tap into the many resources now available. Life Healthcare magazine rounds them up By Glynis Horning
37 TECHNOLOGY TO HEAL YOUR HEART
Life Healthcare’s first cardiac electrophysiologist explains what electrophysiology is all about By Charlene Yared-West
40 HELP THAT MEDICINE GO DOWN
How to get the best possible result from taking chronic medication By Mandy Collins
CARE 42 GET KIDS MOVING
Is your child spending enough time being active and what are the recommended guidelines? By Charlene Yared-West
45 EVERYBODY’S TALKING ABOUT… ANTIBIOTIC RESISTANCE What you need to know about the responsible use of antibiotics By Gillian Warren-Brown
46 SOOTHE LOWER-BACK PAIN Follow these simple exercises to reduce pain and increase your flexibility
47 JOB PROFILE
What does an intensivist do? By Mandy Collins
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ADDICTION IS A CHRONIC DISEASE
50 A SORE THROAT CAN HURT YOUR HEART
What is rheumatic heart disease, who is at risk and what can you do to prevent it? By Carine Visagie
52 DELICIOUS MEMORIES
Zola Nene shares her favourite food memories and recipes from her new book Simply Delicious
57 HEALER, HELPER & NURSE
Life Healthcare celebrates the men and women who make a difference in the lives of each patient for International Nurses’ Day on 12 May By Melanie Farrell
59 I RAN FOR MY LIFE
An excerpt from musician Kabelo Mabalane’s book about his journey through the highs and lows of addiction
61 LIFE HEALTHCARE HERO OF THE MONTH
Get to know Sister Lucy de la Harpe, unit manager of the Maternity Unit at Life Wilgeheuwel Hospital
62 MIND GAMES
Take a break with our puzzles and crossword
64 PERFECT REST
Author Arianna Huffington on how sleep can transform your life
WWW.LIFEHEALTHCARE.CO.ZA
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LETTERS
OVER TO YOU We’d love to hear from you
WINNING LETTER
Healing in my heart I fell pregnant last year, and the only doctor I could see at the time was Dr Thembi Khoale. My husband and I are ardent Afrikaners, so we weren’t comfortable with this being the only choice available, but from the moment I met Dr Khoale I knew my baby and I were in the best hands possible, and I came to know and respect this incredible person. He made us feel at home every time we visited his practice, and on delivery day Dr Khoale and his team made this delivery the easiest, quickest and most comfortable ever. This was not an easy pregnancy as our unborn son was diagnosed with duodenal atresia, and later we found out that he has Down syndrome, but Dr Khoale calmed all our worries and made everything seem manageable. I’d like to thank Dr Khoale and his team at Life Rosepark Hospital in Bloemfontein for their support during my pregnancy, the smooth delivery of my son and the care and attention after I had given birth. Dr Khoale you are a very special doctor and my husband and I wish our country had more doctors like you. Nicci van der Bergh, Bloemfontein
STAR TREATMENT My mother, 88, was admitted to Life Piet Retief Hospital in the early hours of 6 October, last year. The next day she was transferred to the intensive care unit, where she was treated for about five days, and thereafter in the adult ward where she later passed away. During her hospital stay she was always treated with respect and dignity, and was neat and clean whenever we visited. The ICU staff was grateful for any improvement they could share with us, and we really felt she was in good hands. On my mom’s last day, we didn’t keep to visiting hours, but we were assured that we could stay as long as we liked. I really feel this hospital deserves a medal. Their professionalism, patience and kindness were tangible and words cannot express our appreciation. A big thank you to Dr Garcia, who was responsible for my mom’s treatment. His concern and sympathy were outstanding. Annatjie Nel and family, Mpumalanga
AN ANGEL IN DISGUISE People are quick to publish negative comments about hospitals and their staff, however, I wish to make special mention of Erica Roodt at Life Rosepark Hospital in Bloemfontein. For the last two years, our daughter Courtney has been battling a pilonidal abscess, situated on the most awkward of places. She’s been in theatre thrice, had several emergency visits to casualty, been on what seems to be a ton of antibiotics, and then this horrible ‘gogga’ recurred. Through every situation and challenge we faced as a family, Erica Roodt lovingly and caringly reassured us that all would be well. Even when we had to visit her at 6:45am for a dressing change, Erica would be ready with a smile, reassuring voice and competent, professional help. Erica, our family thanks you for being so tirelessly committed to all your patients. You make the world a far better place. The Wilbraham Family, Bloemfontein
THE CARE PROGRAMME IN ACTION I would like to say ‘big ups’ to Life Fourways Hospital, where we were treated like royalty. The service was efficient, respectful, polite and warm and we were in and out without delays. I have never seen anything like this in all the years I have lived in this country. Life Healthcare has set the bar high and I wish all government hospitals would take a page from your book. From the moment you drive on to the premises, it feels like a red carpet has been rolled out especially for you, and the doctor that assisted us was so happy to help. I highly recommend Life Healthcare because not only are they experts in their field, but they care and speak to you like a person. How many people can say that about hospitals? Keep up the great work because for a moment I even forgot I was in a hospital. I also think the Discovery Lounge is a brilliant idea. Via Hello Peter
Win an Interflora hamper valued at R1 000 Interflora is the world’s largest flower delivery service. Supported by a network of professional florists, we proudly deliver beautiful hand-crafted floral arrangements to most areas in South Africa via our same-day flower delivery service. TIP: When placing orders to a hospital, remember to include the recipient’s surname, full address of the hospital, ward name or number, as well as a contact number on the delivery information section. www.interflora.co.za | 0861 468 373 Email Life Healthcare magazine (lifehealthcaremag@johnbrownmedia.com) about how you experienced life, health and care at a Life Healthcare hospital or facility and you could win. 4
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LIFE EAT YOUR SUPERFOOD / RECOVERY AFTER INJURY / UNDERSTANDING ADDICTION / ANGER MANAGEMENT
‘ONE WAY TO GET THE MOST OUT OF LIFE IS TO LOOK UPON IT AS AN ADVENTURE.’ WILLIAM FEATHER
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NEWS
LIFE NEWS
Medical innovations and Life Healthcare news
SUPERFOOD
Quinoa
Q
Is seasonal affective disorder real?
Do the bleak winter months send you into a depression? Do you feel listless, melancholy and even irritable and weepy at the thought of another gloomy, rainy day? You may have seasonal depression, which is also referred to as seasonal affective disorder (SAD) or winter blues. Dr Gomolemo Sepeng, a psychiatrist at Life Poortview Hospital, says: ‘SAD is a subtype of major depressive disorder and bipolar disorder that presents with either depression or hypomania. Predominantly common in winter, SAD begins and ends at around the same time every year.’ Symptoms are severe and recurrent, and prevent people from performing basic functions during the season they’re affected. It takes more than one winter depression to be diagnosed with SAD. Individuals must meet certain criteria: the symptoms and remission
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of symptoms must have occurred in the last two consecutive years, and the seasonal depressive episodes must outnumber the non-seasonal depressive episodes in your lifetime. The good news is that once it’s correctly diagnosed, SAD can be treated through therapies, including biological, psychological and psychosocial. ‘Treatment depends on the severity of your symptoms and include a combination of antidepressants as well as light therapy and psychotherapy. In some cases, hospitalisation is required,’ says Dr Sepeng. While SAD is more common the farther north in the world you live, people in the south do suffer from the condition, so you should be aware of how your mood is being affected by the shorter days and longer nights. If your feeling down is interfering with normal daily life, consult a professional or visit sadag.org for more information.
Known to the Incas as ‘the mother of all grains’, quinoa is one of the few plant-based sources of complete protein. The United Nations General Assembly declared 2013 the International Year of Quinoa for ‘the part this super-grain can play in eradicating hunger, malnutrition and poverty,’ said Food and Agriculture Organization Director-General José Graziano da Silva. When cooked, it takes on a mild, nutty flavour, has a light crunch and packs an impressive protein punch (one cup contains eight grams). Since it’s gluten-free, it can be used as a substitute for pasta, rice or couscous, and in recent years it has also been milled into flour, which can be used in gluten-free baking, or as the base for pasta, cereal or bread. Quinoa is a complete protein, so it provides all nine essential amino acids necessary for good health. Since your body can’t naturally produce these nutrients, you have to get them through food. Amino acids support strong muscles and a healthy immune system.
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
(keen-wa)
WINTER 2016
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NEWS
The flu vaccine
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
TRY IT OR
56 DAYS
SKIP IT?
One of the inevitable side effects of winter is getting the flu, which usually presents with a high fever, body aches, fatigue and general malaise, though headache and chest discomfort are not uncommon. Vaccination has been proven to be the most effective way of preventing infection or a hospital admission as a result of flu complications. In South Africa, the best time to get your vaccine is before the end of April, but if you’ve missed this period, the vaccine can still be taken any time during winter and will continue to offer benefits whenever it’s taken. Just remember that it takes the body about two weeks to develop antibodies against the virus. Side effects are generally not severe and will disappear in a day or two. The most common are mild pain and redness or swelling at the injection site, as well as headache and muscle or joint pain. Each year brings new strains of the virus, so you’ll need a current one to protect you this season. The companies that develop flu shots assess flu viruses in 83 countries all over the world and come up with a vaccine that is safe and effective every year. The World Health Organisation (WHO) recommends that the following people get the vaccine: • Healthcare workers and caregivers • People who work in crowded areas • Pregnant women and small children • People who are on long-term steroids, undergoing chemotherapy, taking HIV medication • Those who have liver, lung, kidney or heart diseases • People who are over 50 IMPORTANT TO NOTE The flu vaccine contains trace amounts of egg protein, so people with an egg allergy need to take care and consult their doctor about their options.
The minimum amount of time you must wait after your last blood donation before you can donate again. More than 26% of donated blood is used for cancer patients, so donate on World Blood Donor Day on 14 June.
Did you know? The Life Healthcare Group’s water strategy aims to ensure the implementation of responsible water management processes and preventative measures in order to control, minimise or eliminate risk and impact to patients, doctors and staff. Patients and employees are also being educated on the importance of using water wisely.
THE BAR-OMETER How fast can you burn off the 233 calories in a four finger Kit-Kat? Swimming > 25 minutes Running > 27 minutes Cycling > 30 minutes Aerobics > 37 minutes
Source: Zest magazine
LIFE EXPRESS ½ Tbsp vinegar + ½ Tbsp honey × 6 times a day = natural sore throat relief WWW.LIFEHEALTHCARE.CO.ZA
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BITS & BY TES
CAN VIRTUAL REALITY COMBAT FEAR? Frightened of high rises? Why not try a virtual-reality exercise, which tricks you (or rather your brain) into thinking you’re on the top floor of a mega-high building? Could the exposure and practise help you banish your phobias? According to adweek.com, Samsung recently conducted just such an experiment to demonstrate the potential of its recently launched VR headgear. Test subjects from Germany, Russia and the United Arab Emirates underwent four weeks of training to combat their fear of heights (acrophobia) or public speaking (glossophobia) before facing real-life applications of their new skills, like speaking in front of a packed conference venue. None of the situations are real, so not in any way life threatening, but based on the feedback from the participants, the mind trick did appear to improve their fear and their outlook.
#unmaskstigma
Every 25 seconds, tuberculosis (TB) claims a life. According to the World Health Organization’s Global TB Report, TB is the world’s leading cause of death from infectious disease, killing even more people than HIV. While the disease ravages the body, many sufferers also have to deal with the external stigma, which often results in patients not finishing their course of treatment or not wearing a mask during the time they are infectious, which is generally the first two to four weeks of treatment for some strains of the disease. On 24 March, WHO launched #UnmaskStigma in an attempt to raise awareness about the disease and counter the stigma people with TB face. To join the movement or for more information, visit unmaskstigma.org
KEYHOLE HEART SURGERY
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Emoji and me There are more than a million words in the English language, but last year, Oxford Dictionaries chose the Face with Tears of Joy emoji as the Word of the Year. These little pictures we use to punctuate our tweets, posts, mails and texts are more popular than ever, but what do they reveal about human beings? Professor Vyvyan Evans, a linguistic expert from the University of Bangor, analysed texts from emojis around the world and his conclusion was that every single example included the Face with Tears of Joy emoji. ‘Globally, about 45% of emojis are happy faces, around 14% are sad faces and a little over 12% relate to hearts, including a broken heart,’ says Prof Evans. Perhaps the world and its people are happier than we think.
I M A G E S G E T T Y / G A L L O I M A G E S , D A I LY D I S PAT C H
Ever since Dr Christiaan Barnard performed the first heart transplant at Groote Schuur Hospital in Cape Town, the hospital has been at the forefront of pioneering surgeries. In March this year, their heart team did it again when they performed an open-heart aortic valve replacement through little more than a keyhole incision. The operation, which is in line with a general move in surgery that favours less invasive procedures, was performed on a patient to fix a leaking aortic valve. The operation was hailed a great success and the patient is recovering well at home. ‘This surgical procedure results in less surgical trauma and leads to faster recovery times and eventually cost savings for the hospital,’ said Dr Jacques Scherman, who led the procedure.
WINTER 2016
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BOOKS
SHELF HELP
The latest reads to nurture your mind, body and soul
I M A G E S G E T T Y / G A L L O I M A G E S , D A I LY D I S PAT C H
EDITOR’S CHOICE
HOW TO HAVE A GOOD DAY
WHEN BREATH BECOMES AIR
WHOLESOME NUTRITION FOR YOU
By Caroline Webb (Pan Macmillan) Can anyone guarantee that you will have a good day at work? Author Caroline Webb thinks she can. In her book How to Have a Good Day: Think Bigger, Feel Better and Transform Your Working Life, Webb uses a combination of psychology and neuroscience to help you have a good day at the office every single day. Some of her tips include ‘single tasking’ and no ‘email grazing’, which is a departure from what you’ve been told makes you a good worker. Webb adds that when we are stressed, we simply cannot have a satisfying, productive day and we definitely can’t think at our best. ‘Our brain diverts mental energy to mounting a stress response, which means activity in our brain’s prefrontal cortex, where most of our sophisticated thinking happens, actually drops when we’re stressed,’ says Webb. Her hope is that her book will teach readers to cultivate positivity and in so doing keep your brain happy and set you up for a more positive day.
By Paul Kalanithi (Random House) At the age of 36, neurosurgeon Paul Kalanithi is diagnosed with inoperable lung cancer. One day he was the doctor, the next, the patient, but despite the radical changes he faces, how he chooses to live during the time he has left will inspire and move you beyond measure. All of his life he had wondered about the meaning of life; and the question becomes more urgent as he faces his dire prognosis. What makes life worth living in the face of death? How does one continue to do what you love when your body fails you? Can you be a husband and father when you know you have so little time to fully realise those roles? Kalanithi answers all of those questions with eloquence, sensitivity and insight, and has, in the process, left readers with a remarkable book. Despite dying before he could finish the book (the last chapter is written by his wife), nothing has been left unsaid – you will linger over the pages and finally exhale when you’ve read the last one.
By Ian Craig and Rachel Jesson (Penguin Random House) There is no shortage of books about healthy eating, keeping fit and making meals that nourish and sustain your family. So why is this book different? The authors Ian Craig (nutritional therapist and exercise physiologist) and Rachel Jesson (health and food specialist and sports scientist) have created a book based on sound science and their vast experience in the area, and the result is a well-rounded exploration of the emotive nutrition and health topics from a scientific perspective. The information is accessible to all South Africans who care about optimum health and living well, and they offer sensible, economical ways to approach your daily dietary needs. Perhaps the best piece of advice in the book is that we are all different so there is no one-size-fits-all approach to your health and well-being. Wholesome Nutrition for You is an enjoyable and informative read.
WWW.LIFEHEALTHCARE.CO.ZA
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AFTER INJURY
Suffering an injury – whether a car accident, sports-related or medical condition such as a stroke – can leave you debilitated both physically and cognitively. Meg de Jong investigates rehabilitation and what is needed to get you back on track 12
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I MAG E GETTY/GALLO IMAGES, SUPPLIED
RECOVERY
FIT FOR LIFE
A
run-of-the-mill headache turned into a worst-case scenario for 56-year-old grandmother Leila Daubenton*, who suffered a brain haemorrhage that left her weakened on her right side and unable to speak. Luckily for Mrs Daubenton, her story does not end there. After several weeks in an acute hospital, then transferring to Life Vincent Pallotti Hospital’s acute rehabilitation unit, she was able to regain much of her strength, function and mobility, and return home to tend to her orchids and spend time with her grandchildren. On her initial admission to Life Kingsbury Hospital, Leila was unable to move herself in bed, couldn’t speak or swallow and had limited movement in her right arm and leg, recalls physiotherapist Sam Ellenberger, who formed part of her initial rehabilitation team at the hospital, along with an occupational therapist and speech therapist. Arriving at Life Vincent Pallotti Rehabilitation Unit, her intensive rehabilitation programme was specifically designed to address regaining function, along with regaining her speech and swallowing, while treating any medical problems she had, explains Dr Ed Baalbergen, rehabilitation doctor. ‘With neuro-physiotherapy, we promote neuroplasticity by helping the brain lay down new pathways around the damaged area so that patients can regain some functional ability,’ says Elmarie du Preez, physiotherapist at Life Vincent Pallotti Rehabilitation Unit. Mrs Daubenton was quick to respond to the therapy, not least because of her positive attitude and dedication to the exercises. Within a few weeks, she was making strides towards walking and talking again. This success story is one of many examples that illustrates why undergoing rehabilitation after an accident or injury is important. ‘Rehabilitation is vital as it allows patients to regain their independence and integrate back into society,’ says Ellenberger. Biokineticist Kiruben Naicker shares a similar point of view. ‘Rehabilitation helps to bridge the gap between the initial injury or incident and return to sport, work and resumption of a daily routine,’ he says.
I MAG E GETTY/GALLO IMAGES, SUPPLIED
WHAT IS REHABILITATION?
Rehabilitation is a specialised form of healthcare dedicated to restoring a patient’s function strength, mobility and endurance after an illness, injury or surgery. Rehabilitation is an ongoing journey that starts in the intensive care unit and is ongoing even with a patient back at home or back in the workplace. Life Healthcare offers acute rehabilitation – the earliest, safest intervention promoting and enhancing recovery from illness.
MEET OUR EXPERTS
Kiruben Naicker is a biokineticist with a private practice at Life Mount Edgecombe Hospital. He specialises in rehabilitating patients after injury.
Rehabilitation is vital as it allows patients to regain their independence and integrate back into society The medical team at an acute rehabilitation facility is usually made up of a comprehensive team of professionals to provide medical care and intensive daily physical, cognitive and occupational therapy.
WHEN DO YOU NEED IT?
Accidents come in many shapes and forms – from a car accident to a sporting injury, to a stroke. A patient needs rehabilitation at the earliest possible time once medically safe. Rehabilitation not only promotes recovery but is essential for the prevention of complications that arise commonly from impairment or dysfunction. Naicker explains that in the event of an injury, certain physiological changes take place in the body that can affect a patient’s strength, flexibility, balance, coordination and stamina, and more.
WHAT KIND OF THERAPY DO YOU NEED? Sam Ellenberger is a neuro-physiotherapist in private practice at Life Kingsbury Hospital.
Dr Ed Baalbergen is a rehabiliation doctor at the Life Rehabilitation Unit at Life Vincent Pallotti Hospital. He has a special interest in pressure sore management and repair using myocutaneous flaps.
This will depend on the nature of your condition. There is short-term therapy in an acute hospital to start the rehabilitation process and to ensure that you will be able to cope at home after discharge. According to the Council of Medical Schemes, you are entitled to rehabilitative care when you have suffered from a debilitating illness or have a complex condition, such as a stroke, brain injury, spinal cord injury or complex orthopaedic injuries. Therapy will continue as an outpatient to regain optimum function. ‘There are exercises to improve strength, flexibility, balance and coordination, depending on the nature of the injury and structure involved,’ explains Naicker. ‘Whether it’s muscular, a joint or a fracture will determine the type of rehabilitation exercises to be followed. For example, if it’s a muscular injury, we generally do isometric, isotonic and isokinetic exercises in that order as the patient progresses through their recovery, however, if it’s a lower-limb fracture, we start with non-weight-bearing exercises and progress to weight-bearing exercises.’ *Name has been changed.
WWW.LIFEHEALTHCARE.CO.ZA
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FIT FOR LIFE
Are you on the right track? DO
DON’T
• Always consult a professional before starting any rehabilitation exercises. • Be certain that your technique during exercise is correct. • Remember to always rest and recover between your rehabilitation sessions. • Follow a healthy eating plan. • Start early – research shows that early intervention by a multidisciplinary team results in better outcomes with fewer residual problems. • Be patient – often patients struggle with very simple tasks or exercises and they can become despondent, but every little bit helps. ‘Even when it feels like you aren’t accomplishing much, you are laying down new pathways, which will ultimately result in improved function,’ says Sam Ellenberger. • Ask your rehabilitation team to write things down. ‘Sometimes injuries can impair memory, making it difficult for patients to continue with their programmes, or they may become so overwhelmed by all the information they’re given that they can’t take it all in,’ says Ellenberger. Getting your team to write down your goals, exercises and ‘homework’ tasks makes it easier for you to remember everything. It is also helpful for family/caregivers to see what you are managing to do. • Go easy on yourself. Some days will be good and others will be a struggle. It is important to be kind to yourself on the bad days. • If you think that you need help at home once discharged, it is important that a caregiver receives training beforehand. It may be best to have an overnight ‘trial run’ before final discharge to identify any problems. The rehabilitation team can then help you solve these.
• Don’t continue if you have pain while exercising during rehabilitation. • Don’t push too hard early in the rehabilitation phase. • Don’t exclude family/caregivers – they are as affected by what has happened to the patient and will also need support and education. ‘Making them part of the process sets their mind at ease and helps with setting medium and long-term goals,’ says Ellenberger. She explains that it also facilitates the rehabilitation process for the patients as family/caregivers can encourage them to use their newly acquired skills. • Don’t neglect your emotional or psychological well-being. ‘Depression and anxiety can impede progress, so it is important to speak about how you are feeling and to get help if you are not coping. It is normal to feel overwhelmed and emotional,’ says Ellenberger, adding that most multidisciplinary teams have a social worker and/or psychologist to provide support. • Don’t isolate yourself. Fellow patients can be a huge support to you. They may have the same problems you have and you can empathise with them. Or they may have found a different way to perform a task that you haven’t thought of.
Life Healthcare has a wide range of rehabilitation facilities across the country. With 265 beds, specialised programmes are available for neurological, orthopaedic, paediatric and pulmonary conditions. Our facilities are custom designed, well-equipped and manned by teams of experienced rehabilitation professionals. For further information, contact the Life Rehabilitation national office on 011 219 9626 or email kimesha.naidoo@lifehealthcare.co.za 14
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Major illness? Stroke? Traumatic injury? Your journey of recovery starts here
Let Life Healthcare’s Acute Rehabilitation Team of dedicated experts assist you to prioritise and develop your care journey to recovery Life Rehabilitation is a specialised healthcare service dedicated to providing rehabilitation care to patients recovering from:
■ Head injury ■ Spinal cord injury ■ Severe orthopaedic injury as a result of injury on duty or car accident ■ Stroke and nerve related injury or illness that has resulted in weakness or paralysis ■ Traumatic injury, amputation and/or joint replacement
We also support:
■ Elderly patients with weakness and inability to walk ■ Unsteadiness and weakness following a severe medical illness ■ Cancer recovery ■ Post-surgery for strengthening and stabilisation
Life Rehabilitation has extensive knowledge in managing the rehabilitation requirements of our patients. Each patient has unique needs and we develop care treatment plans tailored towards the individual in collaboration with families. Our interdisciplinary team includes:
■ Rehabilitation doctors ■ Rehabilitation nurses ■ Physiotherapists ■ Occupational therapists
■ Neurocognitive psychologists ■ Speech and language therapists ■ Social workers ■ Dieticians
Will my medical aid pay for the treatment?
Most medical aids pay for acute rehabilitation to facilitate return to function and reduce complications. Life Rehabilitation offers you a global fee tariff which is inclusive of hospital, doctor and therapists costs. This ensures that patients are protected from medical savings being depleted.
What do I do next?
We can assist you in obtaining the referral to our facility to further facilitate recovery. Please contact us for further assistance. For more information please contact us on Tel: 011 219 9626 or email: Rehab.Headoffice@lifehealthcare.co.za www.lifehealthcare.co.za
FIRST PERSON
‘BREAST CANCER FLICKED MY SWITCH FROM BURNT OUT TO BALANCED’ Sarah Bailey, a Cape Town based clinical psychologist, was diagnosed with breast cancer in 2008. Today she is living a full life as a mother to six children, owner of a successful practice in Mouille Point and founder of the NGO Thandafrika
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explained that I had very dense breast tissue, which could’ve been the reason it was missed. I was thankful that I’d just rejoined a medical aid, who agreed to pay for my treatment with the drug Herceptin. My treatment began with chemotherapy to shrink and kill the tumours. About five months later, I had a full mastectomy. Yes, chemo was bad, but not as bad as dying, so I did it wholeheartedly – for my kids and myself. I love my life and it wasn’t over for me yet, so after a further eight months of Herceptin treatment, and tamoxifen for five more years (I’m in my seventh year of being treated with tamoxifen), I’m clear of cancer. Many women stop tamoxifen treatment because of the side effects, but I have had none. I believe this is because
Sarah is using her second chance to live out her dreams and make every day count I’ve focused on consuming a clean diet and making sure I keep stress levels low. I hate the terminology ‘in remission’. No way – I’m cured! However, I know it isn’t just the drugs that changed my life for the better, it’s my lifestyle too. I believe that if you can manage your cancer properly, you can die of old age, instead of cancer or related diseases. Your prognosis depends on how you work with it. Today I have six kids; three adopted. I know it sounds like a cliche, but breast cancer was a gift. It changed my life and now I like to think of myself as living an ecstatic existence.
IN HER DOCTOR’S WORDS Dr Irene Boeddinghaus explains that, if properly managed, a cure is within reach of more and more people. ‘Sarah’s story is one I wish every woman heard. Where she is now is testimony both to her inner strength – which most women have no idea they’re capable of – and the miracle that is modern medicine,’ she says. ‘Sarah was referred on diagnosis by the breast surgeon before surgery had taken place. This is an ideal time to meet the oncologist, as it allows the order of treatment to be optimised. Sarah presented with a large cancer (10cm in maximum dimension), and she had chemotherapy before surgery. She underwent a gruelling four-and-a-half months of chemo plus targeted agent administration (Herceptin), and by the time of her operation, all the cancer had died off, both in the breast and her previously affected lymph glands. She underwent a full mastectomy, but during the time on chemo she was able to investigate and plan her surgery unhurriedly, which allowed for a fantastic cosmetic result. She still needed to undergo treatments for a further sevenand-a-half months, and five to 10 years of tamoxifen. Not easy, but not unmanageable, Dr Irene Boeddinghaus and it changed her prognosis specialises in breast diseases. She from dismal to excellent. In the has a doctorate in biochemical time since her chemo we’ve endocrinology from the University refined our supportive treatof London, and did her specialist ments, meaning that curative training in the UK. She practises chemo for breast cancer is from Life Vincent Pallotti Hospital. something that almost every woman is able to cope with.’
A S TO L D TO CHAR LE N E YAR E D-WEST
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he last thing I thought about was checking my breasts. My life was too hectic, stressful and busy: I was holding down three jobs just to keep our heads above water. I was divorced with three children and stranded in a country I didn’t want to be in – far, far away from South Africa, our home and a support system of family and friends. Two weeks after arriving in Australia in 2000, with my three children then two, five and seven years old, my husband walked out on us, leaving me to fend for the four of us in a country completely new to me. Fast-forward seven years and I was 20kg lighter, burnt out and utterly exhausted. In November 2007, I remember going for a mammogram in New Zealand, where the specialists were unable to pick up anything and my breasts were declared clear. In February of the following year, my kids, then 10, 13 and 15, and I could finally move back to South Africa. In those eight years I had been living on the edge – in constant survival mode and stress, which I now know to be the perfect conditions for cancer to thrive. One night I was lying in bed, thinking of a close friend who recently died of breast cancer, when I realised that my left breast felt hard. It was more than a lump, so I went to the chemist the next day, who immediately referred me to specialist surgeon Dr Aaron Ndhluni at the Breast Clinic at Life Kingsbury Hospital. Dr Ndlhuni confirmed the worst – the lump was more than five centimetres in diameter and was in my lymph tissue. I remember howling in his office about my life being over. He told me to pull myself together, which is probably what I needed to hear, and said: ‘You’re going to live for a very long time, so stop crying!’ He then referred me to my wonderful oncologist Dr Irene Boeddinghaus at Life Vincent Pallotti, who specialises in breast diseases. I questioned why the lump hadn’t been picked up in New Zealand and Dr Boeddinghaus WINTER 2016
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11/02/2016 09:39
GR OWING LIFE
BREASTFEEDING FOR BEGINNERS
It may be the most natural thing in the world, but for many women breastfeeding doesn’t come naturally. Lisa Lazarus seeks help for new moms
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The advantages of breastfeeding include protecting babies from some of the biggest killers of infants and children in South Africa, namely diarrhoea and pneumonia. Breastfeeding is also associated with improved development and educational achievement. Bearing this in mind, Sister Hettie Grové, midwife, certified lactation consultant and author of the book, Born to Breastfeed, Born to be Breastfed, shares some of the most common concerns. Is there anything you can do before birth to prepare yourself for breastfeeding? ‘Absolutely,’ says Sr Grové. She lists two essentials: women need to attend a breastfeeding class conducted by a certified lactation expert (two hours in a childbirth class is not sufficient) and they need a breastfeeding plan, which could include what you will do in the first hours following birth, where you will get support if you need it, what you will do if the baby has special needs, and so on.
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efore I breastfed my baby, the only information I received was from the antenatal teacher. ‘Take the baby,’ she told the class of heavily pregnant women while holding up a plastic doll whose head she had twisted backwards, ‘then take your breast – tjoeps.’ As she said it, plastic baby and her breast met, a forever-happy union. But for many women, it’s not quite that simple. The United Nations Children’s Emergency Fund (UNICEF) website reports that South Africa has the ‘lowest rate of exclusive breastfeeding in the world at eight percent’. This is the result of a number of factors, including not understanding the critical benefits of breastfeeding, as well as fears of HIV transmission. UNICEF and the World Health Organization (WHO) recommend that breastfeeding starts ‘within the first hour after birth, and that all babies – regardless of the mother’s HIV status – should be exclusively breastfed for the first six months of life.’ Thereafter complementary feeding can be started, while breastfeeding can continue up to two years.
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For many new moms, breastfeeding doesn’t come naturally. What are the common problems? Sr Grové explains that problems can vary, from structural problems involving the tongue or lips of either the baby or the mother to sore nipples, difficulties with latching the baby or even low milk supply. But almost all these problems can be sorted out with better support (ideally from a certified lactation consultant) and the right advice. For latching problems, immediate action needs to be taken to find out what is wrong and how to fix it. Mothers should feel reassured to know that ‘sore nipples are not normal, although they may become tender’. Importantly, there should be a zero tolerance approach to the separation of the mother from her baby after birth. Separation causes anxiety in babies. Additionally, there should be skin-to-skin contact as soon as possible. What about diet? Don’t worry. You can follow a diet without restriction – just keep it healthy and balanced. Any gas, due to the digestion of food in the stomach and intestines, won’t reach the breast, explains Sr Grové.
World Breastfeeding Week The theme for this year is breastfeeding as a key to sustainable development. Last year’s theme was centred around working women and breastfeeding. For more information, go to worldbreastfeedingweek.org
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1–7 August 2016
MEET OUR EXPERT
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What happens when I go back to work? How do I carry on breastfeeding? ‘It’s true that this is a time when many women get derailed. I would personally like women to attend a back-to-work breastfeeding class,’ says Sr Grové. In addition, here are some tips from Sr Grové and Today’s Parent: • Don’t start pumping breastmilk before the first six weeks. This is how long your body takes to adjust to producing milk. • Most women produce 900ml breastmilk a day (though this number fluctuates between 750ml and 1 050ml). Work out how frequently your little one feeds in a 24-hour period, and then divide that number by the amount of milk you produce daily, using 900ml as the average to find out how much you should be pumping. • You don’t need to introduce bottles too early in the process – a couple of weeks before you return to work should be fine. • Talk to your employer about incorporating pumping into your work schedule to relieve full breasts. • Know the guidelines for storing milk. Milk that has been frozen loses some of its protective enzymes and antibodies. • Breastfeed ‘on demand’ on weekends and plan for more night-time nursing. How can dads get involved? Potentially, they can attend any breastfeeding classes with mothers to understand the process. They can certainly help with other baby chores too, including tummy time, burping baby, changing nappies or, of course, making moms tea or running a bath. Finally, although ‘breast is best’, as the saying goes, know that whatever you do for your baby – and some women, for whatever reason, decide breastfeeding is not for them – you need not feel ashamed or guilty. Ultimately, you will do what is best for your baby and you, and that’s all anyone can ask.
Sister Hettie Grové is a lactation specialist at Life Springs Parkland Hospital in Gauteng. She’s an internationally certified childbirth educator, lactation consultant and lecturer at Wits. Besides her private practice, she also runs childbirth and birth-basics classes with new and expectant parents.
2016/06/09 1:13 PM
NOTHING Sugar may make life sweeter, but kicking the habit (yes, it’s a habit) could boost your mood and health, and possibly save your life. By Catriona Ross
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consumption has risen from 48g a day 30 years ago to 70g daily today, according to a Credit Suisse Research Institute report. Sweet?
THE PROBLEM WITH SUGAR
‘Sugar is an empty calorie: it gives you energy but no healthy nutrition, such as vitamins, minerals and fibre,’ says Kim Hofmann, a Cape Town registered dietitian. As Bloemfontein registered dietitian Tristie van der Spuy explains, sugar is converted to glucose and fructose in your digestive tract. When you eat too much sugar, the fructose is converted to glycogen and stored in the liver, and excess glycogen is converted to fat. And when a meal or snack contains carbohydrates, your body produces insulin to regulate glucose
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s a nation, we’re on a sugar high. South Africans consume, on average, 25kg of sugar annually, according to a Human Sciences Research Council study. A Stellenbosch University study shows that our sugar consumption has increased by 33.1%, mainly via processed foods and soft drinks, since 1994. And the results are frightening: up to 70% of women and a third of men are overweight or obese, say the Heart and Stroke Foundation SA. Ten years ago, 27% of women were obese, but today it’s up to more than 39% – five percent higher than the global obesity average. And diabetes, often preventable, now causes more deaths here than HIV. We are leading a global trend in which sugar
T H E WA Y W E E A T
levels. Over time, high insulin levels may lead to insulin resistance, which can progress to type 2 diabetes. ‘Elevated insulin levels can be a leading factor for cancer, and sugar can increase inflammation, also a driver for cancer,’ warns Tristie. In addition, sugar makes blood-sugar levels spike and drop quickly, causing fatigue and cravings. The main offenders are sugary foods and sweetened drinks, including sports drinks, energy drinks and flavoured water. One can of soft drink contains up to 10 teaspoons of sugar. ‘Even fruit juice is a problem as the sugar load is too large,’ notes Kim. And ‘hidden’ sugars are found in cereals, health bars and condiments: ingredients are listed according to weight so if sugar is in the first three ingredients, it’s generally too sugary a product.
Sugar is an empty calorie: it gives you energy but no healthy nutrition, such as vitamins, minerals and fibre
MEET THE EXPERTS
Kim Hofmann is a registered dietitian with a BSc from Wits University, an honours in psychology from Unisa and an honours in dietetics from the University of Cape Town. She has a private practice in Claremont, Cape Town, and particularly enjoys working with people who want to lose weight. Kim’s an avid runner and will do anything for an animal in need.
which help decrease cravings as they keep you fuller for longer. Kim feels the safe amount is no more than four teaspoons of added sugar per day, including honey, jam and syrup – and any small treat (or any food that lists sugar in the first three ingredients) counts towards the daily allowance. To kick the habit, she believes going cold turkey is better than slow reduction, but you must eat to keep your blood sugar levels balanced throughout the day, ‘otherwise you’re relying on will power, which can only last for so long.’ However, some of her clients work on having fewer treats less often and changing how they enjoy them: sitting down and eating mindfully (not while watching TV, for example). ‘And don’t have treats on consecutive days as this is how a habit starts,’ she warns. Are sweeteners and low-sugar soft drinks good alternatives? ‘I’ve never seen a skinny person drinking diet cooldrinks,’ quips Tristie. It’s important to wean yourself off sweetness and learn to enjoy the natural flavours of foods again, says Kim; sweeteners don’t help with this. Perhaps the 20% tax on sugar-sweetened beverages coming into effect in April 2017 will!
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KICKING THE HABIT
I gave up sugar eight years ago after my chocolate habit (a slab a day at times) began giving me intense headaches. After a few days of detox discomfort, I noted my elevated energy levels, improved memory and acute sense of smell. Although I miss birthday cake and Easter eggs, I’m grateful for my youthful energy and stable mood. ‘Generally, because people eat too much sugar, their diets are high calorie and lack nutrition,’ says Kim. ‘By cutting sugar and eating more nutrient-dense foods instead, your health and energy levels will improve, and it can help with weight loss.’ Tristie adds, ‘You’ll also have fewer cravings and a decreased risk of developing diabetes and other diseases.’ ‘It’s a little bit ridiculous to cut sugar out completely; people will always be tempted to have sugar. Five percent of your total energy is adequate and realistic,’ says Tristie, who recommends slowly decreasing the sugar in your tea and coffee until you reach zero. ‘Don’t drink your calories!’ Dilute a third fruit juice with two thirds water. Instead of a full serving of sweetened yoghurt, mix half with plain yoghurt, and eat low-GI foods,
RESOURCES
Tristie van der Spuy has been a registered dietitian for 30 years. She received her BSc Dietetics degree at the University of the Free State and works with a group of dietitians at Life Rosepark Hospital, Bloemfontein. Born in Tsumeb, Namibia, she loves travelling, photography and being in the wild. She has a need for speed but has recently taken up part-time farming.
• Health and fitness guru Kayla Itsines offers tips on healthy eating on her motivational Facebook page: Facebook.com/k.itsines • That Sugar App can be downloaded from the App Store to help you track the amount of sugar in various foods and your overall diet. • Visit www.dailymail.co.uk/home/ you/article-2532775/Food-SarahWilsons-I-Quit-Sugar.html and thatsugarfilm.com/act-now/recipes to stay motivated. • Search for Jamie Oliver’s YouTube videos about sugar, including his TED talk. • The Healthy & Tasty series recipe books by Martie Hofmeyr and Janet Wiegand. • Low-GI recipe books by Gabi Steenkamp: www.gabisteenkamp.co.za • Fed Up is an investigative documentary about the US food industry and American obesity levels.
WWW.LIFEHEALTHCARE.CO.ZA
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MIND WISE
ADDICTION Addiction, like diabetes and heart disease, is a chronic disease. And, if left untreated, it can be fatal, says Vivian Warby
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WHAT MAKES AN ADDICT?
To explain it simply, Cape Town-based addiction counsellor Dana Tadmor turns to Patrick Carnes, an author best known for his work on sex and love addiction. ‘In a nutshell, Carnes believes that addiction is a combination of trauma and genetic predisposition to addiction.’
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THE ABCS OF
he came from an average family, did well at school, was in a long-term relationship and was moderately successful at work. So what drove Sharon Barkley* to the point that she had to be admitted to a rehab clinic in 2013? To the naked, untrained eye there were no predictors that could have said this 35-year-old Johannesburg woman would be an addict. ‘By the time I checked into rehab, I had hit rock bottom,’ says Barkley. ‘But it didn’t matter because I’d found the perfect cocktail for getting through a day: amphetamines (stimulant), cocaine, alcohol, tranquillisers and sleeping tablets.’ Those who lived with her could see her behaviour was becoming unsustainable. Something was going to give. First it was her relationship, then the small mess-ups at work, which she was able to cover up at first. Then the ‘crazy, soul-destroying’ behaviour ‘that made me hate myself’ and the constantly being off sick, to finally, ‘my life is in an unmanageable state. My job was threatened, my relationship was over and I just couldn’t keep up my lies any longer. I had nowhere to run. There was a line of sanity that said: “You’re going to die if you don’t stop this”.’ According to Dr Hemant Nowbath, a psychiatrist in private practice in Durban and executive member of the South African Addiction Medicine Society (SAAMS), no single factor could have predicted that Barkley would become an addict. Risk for addiction, he says, is influenced by a combination of factors. These include: • Individual biology (think the brain, genetics, psychology and personality, among others); • Social environment; and • Age or stage of development. ‘The more risk factors an individual has, the greater the chance that drugs can lead to addiction.’ It’s important to understand that addiction is a chronic, often relapsing, brain disease that causes compulsive drug seeking and use despite harmful consequences to the addicted individual and to those around him or her, says Dr Nowbath. ‘The brain changes that occur over time challenge an addicted person’s self-control and hamper his or her ability to resist intense impulses to take drugs’ (see ‘What is addiction?’).
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It is difficult to pinpoint exactly what it is in the make-up of an individual that will determine one person an addict and someone else not. Another person, even a sibling, could be exposed to exactly the same ingredients Barkley was and not become an addict. Ultimately, says Tadmor, all addictions create negative consequences to an individual’s mental
Addiction is a very destructive disease: for the user as well as those involved with the user health, physical well-being, relationships and work. And all require supportive efforts to be healed. Specialist psychiatrist, Dr Lolita Mostert from Life New Kensington Clinic says addiction may exist with a co-morbidity, such as depression, anxiety, bipolar disorder or schizophrenia. ‘Often you will find that the addict uses their drug of choice to try and self-medicate other mental illnesses they have. The chance of relapse is great if the co-morbidity is not treated too. Addiction can’t be treated on its own.’
THE STAGES OF CHANGE
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When a person is in active addiction it is very hard to get off the cycle. At this stage of their addiction they are said to be ‘Pre-contemplative’ (according to The Stages of Change Model put forward in Changing for Good [William Morrow, 1994], developed by James Prochaska and Carlo DiClimente to treat addiction), says Tadmor. This means: • They are not aware they have a problem • There is an element of denial • There is justification of the behaviour • There is a belief that they have it under control.
MEET OUR EXPERTS
It is hitting rock bottom’ (which is different for everyone) that usually shifts their denial. ‘It is the point where there are no more alibis, no more excuses and the pain of using is greater than the pain of recovery.’ This leads to ‘Contemplation’, which will hopefully lead to the following stages: • Preparation/Determination • Action • Maintenance • And, sometimes, relapse. Similar to other chronic, relapsing diseases, such as diabetes, asthma or heart disease, says Dr Nowbath, drug addiction can be managed successfully with support. And, as with other chronic diseases, it’s not uncommon to relapse and begin abusing drugs again, he says. ‘Relapse, however, does not signal treatment failure – rather, it indicates that treatment should be reinstated or adjusted, or that an alternative treatment is needed to help the individual regain control and recover.’ It is important for the addict to be treated by a multidisciplinary team including a psychiatrist, psychologist, social worker and occupational therapist, says Dr Mostert. ‘Addiction is an illness and often the person cannot “just stop”. They need a lot of support as with any chronic illness.’ All say that addiction is a very destructive disease: for the user as well as those involved with the user. ‘No one is left unscathed,’ says Tadmor. Dr Mostert urges those who are close to an addict to seek support and help for themselves as well. Just like being diagnosed with diabetes is not a death sentence, so too is it not when diagnosed with the disease of addiction. There is help available ranging from medication to therapy and support groups. And there are many recovering addicts who prove that treatment does work. ‘My life is back on track today. I often look back at that time in my life as my “girl-interrupted” phase,’ says Barkley. ‘But I never make light of it. It was hell and destroyed my fibre and I have to be constantly vigilant. I am lucky to be alive.’
What is addiction? Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviours. Addiction is characterised by inability to consistently abstain, impairment in behavioural control, craving, diminished recognition of significant problems with your behaviours and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, there are cycles of relapse and remission. Without treatment or recovery activities, addiction is progressive and can result in disability or premature death. The American Society of Addiction Medicine (ASAM)
*Name has been changed.
Dr Hemant Nowbath is a psychiatrist in private practice in Durban. He is an executive member of the South African Addiction Medicine Society (SAAMS). He qualified at the University of the Witwatersrand and specialised in KwaZulu-Natal.
Dr Lolita Mostert is a psychiatrist at Life New Kensington Clinic in Gauteng. She is currently working on MMED research on Dual Diagnosis (substance abuse with co-morbid psychiatric pathology). WWW.LIFEHEALTHCARE.CO.ZA
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YOUR TEMPER?
Does your anger manifest in unhealthy ways? Anger is a powerful emotion that can lead to serious problems in your relationships and career if left unbridled. Learn more about your ability to manage it by taking this test
1. I complain about past situations or events that still bother me to this day. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me 2. I nitpick about things that others would consider minor. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me 3. If I have an issue with someone I will fight relentlessly until the issue is resolved to my satisfaction. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me 4. You have just come out of the gym and are heading home after a long day. You’re really looking forward to a relaxing evening – until you see your car. Two other parked cars have boxed it in, and there is no way you can pull out of the parking spot without causing damage. How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious 5. Your friend persuades you to hire her cousin for a moving job. The guy turns out to be pretty clumsy – he even manages to drop a box
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labelled ‘Fragile’, shattering your valuable wine glasses into hundreds of pieces. How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious 6. You have agreed to pick up some friends at the train station. They are coming to stay with you for a month, and they are not light travellers. You’ve arranged with your partner to have the car for the day. You are about to leave the house when you realise the car is outside but your partner has gone to work with the keys! How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious 7. At a karaoke night with friends, your partner pokes fun at your singing in front of everyone. You thought your voice was pretty good, but it looks like your so-called better half thinks you deserve two thumbs down. How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious 8. On your way home from work you stop at the bank to deposit a cheque. As you’re standing in line patiently
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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
CAN YOU CONTROL
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.
QUIZ
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
waiting your turn, you notice a little kid with a chocolate running around screaming. His mom seems to have no problem with it; she’s actually beaming with pride. Next thing you know, the kid decides to run over to you and give you a big hug, smearing little chocolate handprints all over your pants. How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious
progresses. How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious
S C O R IN G YO U R S E LF QUESTION 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
A 10 10 10 0 0 0 0 0 0 0
B 8 8 8 2 2 2 2 2 2 2
C 5 5 5 4 4 4 4 4 4 4
D 2 2 2 6 6 6 6 6 6 6
E 0 0 0 8 8 8 8 8 8 8
F
10 10 10 10 10 10 10
9. You decide to catch a weekend matinee with a friend. You’re getting drawn into the story but the guy behind you keeps bumping the back of your seat whenever he changes position ... and he seems to be getting more and more restless as the movie
10. You have a late afternoon appointment at your doctor’s office so you take the afternoon off from work. When you arrive at the office, you find out that the appointment has been rescheduled. The doctor is in and seeing patients but was overbooked. Apparently, the receptionist left a last-minute message which you didn’t get because you were already on your way. How angry does that make you feel? A I don’t feel angry at all B I feel slightly annoyed C I feel a little angry D I feel moderately angry E I feel very angry F I feel furious
0–30
31–50
51–70
71–100
It would take more than a few minor annoyances or inconveniences to anger you. You are quite skilled at coping with potential anger-inducing situations. Under circumstances where many people would lose their temper, you are able to stay calm and composed. Few people are able to attain this degree of emotional control – your Zen-like attitude allows you to take situations in your stride and let them go. Just make sure that you are not bottling up your emotions or denying your true feelings. Repressing anger can sometimes be as harmful as becoming outright angry. Remember, there is nothing wrong with feeling angry sometimes, as long as you express it in a healthy way.
You will get angry when certain people push your buttons or try your patience, but you certainly don’t blow up every time you are faced with annoying circumstances. You seem to have found a balance between accepting the occasional flash of temper and not letting yourself get worked up over minor issues – and probably even a few major issues. You realise that sometimes it’s just not worth the headache, and that the feeling will pass if you step back and look at the situation objectively. This is generally a healthy way to deal with anger: Suppressing it can make you feel worse, but so can letting yourself get swept away by this powerful emotion. Fortunately, you are not one to allow your temper to get out of hand.
There are some annoyances that barely cause a blip on your anger radar … and then there are some that really get your temper boiling. It’s not always easy for you to maintain your poise in frustrating situations, especially when it seems like people are purposely going out of their way to push your buttons or disrespect you. It can also be hard to take a step back from a situation and put it in perspective when all you really want to do is tell someone off. But you need to remind yourself that not all annoyances are worth getting worked-up over. When someone gets a rise out of you, ask yourself whether it’s worth your time, and whether it will matter to you tomorrow, next week, next year, or in five years.
It’s not like you start your day just waiting for someone to step out of line and anger you, but the situations described on this test did seem to get a rise out of you. When someone inconveniences you or doesn’t treat you with respect you will not take it lightly, and this is understandable. However, before letting your anger out (or repressing it, which can also be unhealthy), ask yourself whether the situation or person who has angered you is worth your time and energy. This isn’t to say anger is unhealthy, but if you express it in unhealthy ways (yelling, taking your frustration out on someone else, throwing and breaking things), this is what gets you into trouble. Sometimes, for the sake of your well-being, you just have to let certain issues go.
Anger is a product of our perception of an event, not the event itself. For example, if you perceive that someone’s comment was purposefully hurtful, this will most likely incite a response in you, whether it’s sadness, anger, etc. In reality, however, the event (the comment) may not have been intended to hurt you – it is only your perception that it was. Anger is separate from the reaction it prompts. Although we may feel angry, how we react to it is a completely different matter.
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QuatroFlora KEEPS THE COLON HEALTHY
ALL PROBIOTICS ARE NOT THE SAME
❖Benefi cialNOT bacteria the gutgut areare known to:to: ALL PROBIOTICS ARE THE SAME Beneficial bacteriain in the known
Gastro-intestinal affect all all of of us us at some time or or Gastro-intestinalproblems problems affect at some time another. Diarrhoea, constipation, bloating and the like are another. Diarrhea, constipation, bloating and the like areoften often One of the greatest challenges for human caused or or eating something thatthat doesn’t causedbybyover-indulgence over-indulgence eating something doesn’t wellbeing in the 21st century will be to focus agree clear upup of of their own accord. agreewith withus,us,and andquickly quickly clear their own accord. on the advantage of having a healthy colon and Distressing and unpleasant conditions such as these can, Distressing and unpleasant conditions such as these therefore a good immune system – this is where however, become chronicchronic – and –that caused by a by can however become andcan thatbecan be caused probiotics can play a significant role. bacterial imbalance in the a bacterial imbalance in intestines. the intestines. Some groups of bacteria can cause acute or chronic Some groups ofare bacteria can cause acute or digestion chronic Probiotics critical for normal illness, but another group of bacteria offers protective and illness, butfor another group of bacteria infection. offers protective and and defence against nutritive properties. Imbalances between the two can lead to a nutritive properties. Imbalances Bacteria in the gut are between known the to: two can lead number of unpleasant conditions such as diarrhoea, constipa• Stimulate the immune system to a number of unpleasant conditions such as diarrhea, tion, bloating, IBS, allergies, poor digestion and poor nutrient • Enhance the mucosal barrier constipation, bloating, IBS, allergies, poor absorption. In laboratory investigations, somedigestion strains ofand LAB •nutrient Aid digestion and break down toxins poor absorption. In laboratory investigations, (Lactobacillus bulgaricus) have demonstrated anti-mutagenic Inhibit adherence of pathogens some•thought strains of bulgaricus) effects to of beLAB due (Lactobacillus to their ability to bind with have heterocylic demonstrated anti-mutagenic effects thought to be amines, which are carcinogenic substances formed in due burnt to their ability to bind with heterocyclic amines, which are red meat. Tel: 041 3781189 carcinogenic substances formed in burnt red meat. The two most important groups of friendly intestinal flora, sales@betapharm.co.za The two are mostLactobacilli important groups friendly or probiotics, – foundofmainly in intestinal the small flora, or probiotics, aredobacteria Lactobacilli – found mainly in colon. the small www.betapharm.co.za intestine, and Bifi – found mainly in the intestine, and Bifidobacteria – found mainly in the colon. Probiotics are live micro-organisms that, when consumed Probiotics are livehave micro-organisms which,ts.when conin adequate amounts, strong health benefi sumed in adequate amounts, have strong health benefits.
Beta 041378 - 378 1189 Beta Pharmaceutical Pharmaceutical 041 1189
• Prevent diarrhea or constipation • prevent and and stopstop diarrhoea or constipation A probiotic can be beneficial in the • digestion Aidgood digestion • aid and and breakbreak downdown toxinstoxins following ailments: • Produce vitamins B12Kand K • produce vitamins B12 and • Diarrhoea or constipation • stimulate the immune system. • Stimulate the immune system • Bad breath, gas &same, bloating Just all all probiotics areare notnot the Justasasallallhumans humansarearenotnotthethe same, probiotics • Allergies, rhinitis, lactose intolerance ® clinical documentation same. Insist on QuatroFlora®, with the same. Insist on QuatroFlora with clinical documentation • Gastroenteritis and playschool diseases in available benefi ts of of thethe strains it contains. availableonyoung onthethehealth health benefits strains it contains. children
QuatroFlora™ capsules contain the following strains of probiotic bacteria for improving gastro-intestinal health and well-being: Bifidobacterium, BB-12®, Lactobacillus acidophilus, LA-5®, Lactobacillus bulgaricus, LBY-27, Streptococcus thermophilus, STY-31
Thisproduct productisisnot notintended intendedtotodiagnose, diagnose,cure cureororprevent preventany anydisease. disease. This Clinicaldocumentation documentationavailable availableononrequest. request. Clinical This product has not been evaluated by the MCC.
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JOURNEY
STEEPED IN SWEET
honeybush Honeybush is indigenous to the Cape South Coast and is found nowhere else on Earth. The dried leaves make a naturally sweet and fruity tea, which has a virtual bushel of potent health benefits. Keri Harvey reads the leaves and shares the tea’s secrets
I
t’s early morning in the Langkloof and slivers of cloud slip down the mountainside into fields of flowers. Waving gently in the breeze are plumes of honeybush blooms, butter yellow and beautiful. We’re just inland from Jeffreys Bay in the Eastern Cape, and as far as the eye can see there is wild honeybush. It’s a vast natural garden of health. Honeybush (Cyclopia spp) belongs to the fynbos family and local tribes have long known its medicinal properties.
A gentle herb, it is even perfectly safe for pregnant women and is said to assist breast milk production in nursing moms, while curbing colic in babies. For diabetics, particularly, it is believed to help regulate sugar levels. In addition, according to a Cancer Association of South Africa (CANSA) fact sheet, research shows it lowers cholesterol, relieves some menopausal symptoms and has a range of essential minerals so as not to inhibit vitamin uptake in the body. Potassium, calcium, magnesium, copper, sodium, iron,
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JOURNEY
manganese and zinc are all present in the plant. Honeybush is said to prevent colds and allergies, and acts as a natural expectorant for coughing. Plus, it strengthens a weak liver and is anti-spasmodic – so it eases stomach aches, cramps and bloating. Add to this that it is rich in antioxidants and has anti-inflammatory and anti-viral properties, and the health benefits are enormous for this caffeine-free plant naturally low in tannins.
Honeybush is a true wonder plant and a powerful health potion
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HONEYBUSH IS
THE NEW GREEN TEA BECAUSE:
• It tastes better. • It needs minimal processing so antioxidants are not destroyed. • It’s caffeine-free so can safely be consumed just before bedtime.
• It’s safe for pregnant and nursing women and even children. • If brewed or boiled for more than 10 minutes, the antioxidant activity becomes much higher.
MAIN IMAGE Cyclopia spp is endemic to the Western and Eastern Cape regions of South Africa and, though it is widely referred to as tea, honeybush is in fact a herb ABOVE, FROM TOP In the Eastern Cape the plants get fresh water from the peaks and the cool mists from the Southern Indian Ocean; the shrub has distinct trifoliate tapering leaves and bright yellow flowers; lady bugs – nature’s very own fertiliser; honeybush is hand harvested with care
I M A G E S COU RTESY OF H E I G HTS TEA ESTATE
Now research is underway to establish whether honeybush has anti-cancer properties. In short, it’s the high content of antioxidants, vitamins and minerals in balance that would prevent cancers caused by free radicals. Honeybush is a true wonder plant and a powerful health potion. Dr Koch Visser from the Department of Biochemistry at Stellenbosch University says: ‘We found that Cyclopia extracts prevent the oestrogen-induced growth of breast cancer cells by targeting and inhibiting oestrogen receptor sub-types that promote the growth of these cells. There’s a possibility that this research could offer respite to women who may be diagnosed with breast cancer.’ When in bloom, honeybush is easy to spot as it glows with fragrant yellow flowers. It’s a large, sturdy plant too, with tapered leaves that are sweet smelling like honey. Because the plant is part of the fynbos biome, it’s protected by law, so picking or removing the plant is illegal. For this reason, honeybush is being sustainably cultivated for harvest in its natural mountainous reaches of the Western and Eastern Cape – the whole Garden Route stretch is its indigenous home. In order to preserve its medicinal properties, the plant is hand harvested with care, and the leaves are then cured, usually in an oven, before being sorted and sent for packaging. After a morning walk through fields of gold under indigo blue skies, we turn to head home. It’s a short distance back to Port Elizabeth and en route we stop to buy honeybush tea at a farm stall. Immediately we open the packet and for the one-hour drive back we savour the sweet, fruity aroma of the tea leaves. As soon as we arrive, we will brew a pot of honeybush to see its rich red-amber colour and taste its delicate natural sweetness – no milk or sugar added is best. Some drinkers say the tea is reminiscent of hot apricot jam, others say its aroma is of fresh mixed fruit. For us, it’s a sip of South Africa’s rarest natural herbal tea, packed with health and the delicate taste of wild honey – a natural sweet treat. Support sustainable honeybush production and curb unscrupulous harvesting by only buying products from certified sustainable plantations.
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LE SUITAB HOLE W E FOR TH MILY FA
Breathe easy with Dried Ivy Leaf Extract
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Dried Ivy Leaf Extract: 1 Helps soothe the symptoms associated ciated with productive and painful coughing ghing Can be taken with other medications ions Pleasant cherry flavour Alcohol and sugar free Reference: 1. Ivylix Package Insert. Ivylix Cough Syrup. Each ml contains dried ivy leaf extract (Hedera helix) 7 mg. Accord Healthcare (Pty) Ltd (Reg. No./Nr.: 2004/011257/07) Tuscany Office Park, 6 Coombe Place, Rivonia, Gauteng, South Africa. frica. Customer Care No.: +27 11 234 5950 medinfo@accordhealth.co.za
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HEALTH THRIVING AFTER CANCER / KIDS AND EXERCISE / ANTIBIOTIC RESISTANCE / RELIEF FOR BACK PAIN
‘SLEEP IS THAT GOLDEN CHAIN THAT TIES HEALTH AND OUR BODIES TOGETHER.’ THOMAS DEKKER
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THRIVING Increasingly, there is not just life after cancer, but a good life – if you tap into the many resources now available. Learn about them, spread the word, and help make International Cancer Survivors’ Day on 5 June a day to celebrate. By Glynis Horning
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COVER FEATURE
H
ard as it is to hear the words ‘You’ve got cancer,’ and handle the treatment that follows, from surgery to chemotherapy and radiation, the period afterwards can be almost as difficult to deal with. ‘When the drama and trauma are in full swing, you go through it almost as though you’re in a dream, moving from step to step as the doctors dictate, with family and friends rallying around and keeping you up, bringing meals, sending wishes, pulling you through,’ says Johanna Francis, 54, of Ennerdale, who has survived two bouts of breast cancer. But after the final treatment, when you’re left to recuperate, the fuss
in grade 8 and has settled happily at high school. But it’s not easy. Counselling has helped me deal with the worry and the anger you feel at times. But today there’s lots of help out there. And for me, among the biggest has simply been talking with the moms of other children with cancer.’
1 REACH OUT
Every person’s cancer experience is unique. It’s normal for you and those who love you to have reactions and needs that may differ, says Lucy Balona, spokeswoman for the Cancer Association of SA (CANSA). ‘Research shows, however, that those who seek support, individually
line can also reassure others that yes, they will regain their hair, their strength, their lives. Depression is a common side-effect of chemotherapy and radiation therapy, and it’s important to watch for signs – withdrawing, struggling to eat or sleep, feeling low and unable to focus. A psychiatrist or psychologist can then help you deal with the many contributing issues. After cancer, these can range from uncertainty and fear about the future (‘Will I live? Can I resume my career; my responsibility as a breadwinner, spouse, parent?’) to anger (‘Why me?’), guilt (blaming yourself for the cancer because of bad lifestyle choices, or the universe, if you
AFTER
SURVIVING
dies, and you can feel alone with a myriad fears – from acceptance of your changed appearance after certain surgeries, to a new awareness of death and fear of a recurrence. When Colleen Eddles’ son Robert finished his last course of chemotherapy and lumbar punctures in 2011 for acute lymphocytic leukaemia diagnosed five years earlier when he was just six, there was huge relief. All that remained were his six-monthly check-ups. But as Colleen says, ‘Strangely, that was almost as hard for us as Robert’s treatment. A security blanket had been pulled away – the routine reassurances of the tests, and of the doctors and nurses who become like family. Sometimes Robert would ask, “Can I get cancer again?” And I’d tell him, “Robs, we can never say never.” In the dead of night you still worry.’ In 2014, her worst nightmare played out and the cancer reemerged, requiring even more aggressive chemo. He is now in remission again, and on the registry for a bone marrow transplant. ‘Robbie’s a survivor; so positive! He’s
or within groups, cope better and learn to find balance.’ Your past experience in handling crises will shape how you cope with cancer and afterwards, and consciously adopting a positive approach is key. ‘Many patients form their own support groups when they go for chemo, people they can vent with who truly understand,’ says Dr Avisha Chunilal, a psychiatrist at Life Mount Edgecombe Hospital. Survivors further down the
Survivors further down the line can also reassure others that yes, they will regain their hair, their strength, their lives
made good ones), financial worries (‘Will my medical aid cover me if the cancer comes back?’) and fear of rejection because of the changes you may have undergone, from loss of body integrity or libido to infertility.
2 RELEASE STRESS
Without help, continuous stress not only brings depression, it lowers your immune system, which has already taken a beating from both cancer and treatment. ‘Patients are often not in a mindset to meditate when they’re anxious, but even small things like consciously focusing on your breathing for 10 minutes at a time, or practising mindfulness – noticing things in your surrounds, like light on leaves – can really help,’ says Dr Chunilal. ‘Whatever works for you.’ It’s also important to set goals and make plans for the future, to reaffirm or finally find your purpose in life and stay motivated. Johanna is one of many survivors who has found this in helping others. She fought back from her double bout with breast cancer by joining CANSA, doing educational work and
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now managing the CANSA Keurboom Care Home in Johannesburg. ‘Supporting others, and the support you receive in turn, has helped me most – along with my family’s love and a sense of humour,’ she says. ‘My husband and children were very supportive, but my mother-in-law was not well-informed about cancer and tried to shut me out (some people still fear it’s contagious). When she saw me after I finished my treatment, her perception changed. Through CANSA, I’ve educated my extended family and others. And do we laugh. My mom and I still joke about when I lost my hair from chemo – even down there. I shouted it to her from the loo and we cracked up together. I’ve been clear 13 years now and I feel great. I asked God to spare me to see my first grandchild, and I’ve just seen my fourth!’
3 EAT WELL
Natalie Bowden, 32, had the best possible motivation to move forward positively after her cancer: a three-year-old daughter. And as a registered dietitian, she knew the
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importance of proper nutrition to give herself the best chance against the cancer. It had begun in her breast, but was already at stage four and spread to her liver by the time she was diagnosed in 2014. ‘It seemed ironic, even unfair, because I’ve always eaten healthily. But apart from still having lots of fresh fruit, veg and wholegrains, I’ve moved to more fish, white meat and olive oil, and I’ve begun growing spinach and kale. My daughter loves pottering with me in the veggie garden – it’s therapeutic in itself!’ Claire McMahon, a registered dietitian at Life Kingsbury Hospital in Cape Town, agrees. ‘There’s no need for expensive so-called “superfoods”. Rather eat more of the affordable alternatives – peppers, tomatoes or strawberries instead of over-hyped goji berries; linseed instead of chia; broccoli instead of kale (it’s a lot nicer too).’ It’s also important to avoid potentially harmful foods: ‘In excess, some have been linked to increased risk of cancer – such as red meat (especially when it’s processed or cured and cooked at high temperatures) and saturated fats. It’s
popular now to have a high protein, high fat diet, but it’s been associated with raised risk of breast and colon cancers, while plenty of fibre has been associated with a lower risk of colorectal cancer.’ According to the World Health Organization, eating 50g of processed meat (equivalent to two sausages or three rashers of bacon) every day raises the risk of colorectal cancer by about 18%. A rather small risk, however, when considering that people who smoke are 25 times more likely to develop lung cancer. As for supplements: ‘A multivitamin can’t hurt, but its far better to get your antioxidants and vitamins from your food,’ McMahon says. ‘We still don’t fully understand their interactions and studies in the last 15 years suggest taking mega-doses can actually promote the growth of cancer cells. And some herbal preparations can work against cancer drugs, so always discuss them with a doctor.’ Bottom line? ‘Accept that there are no magic bullets. I had a colon cancer patient aged 33, who spent thousands
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MEDICAL AID WORRIES
Natalie Bowden (pictured here with her husband and would give her the best chance of survival and keep daughter) believed that proper nutrition her healthy during her recovery
of rands on vitamin supplements rather than change his diet and lifestyle. He died before he turned 40.’
4 GET MOVING
‘Exercise has been as important for me as diet,’ says Yoliswa Fatima Sherazi, 36, of Vanderbijlpark. While waiting for the biopsy result from a lump in her breast two years ago, she discovered she was pregnant with the baby she and her husband had been desperately trying for. Doctors advised her to have an abortion, but she refused. ‘After my mastectomy and before radiation started, Muso was delivered by C-section – four weeks early, but perfectly healthy. I’ve had to get in shape after cancer for him.’
We do strengthening exercises, but we’re also there for them if they break down and need to talk SAM BAILEY, PHYSIOTHERAPIST, LIFE ENTABENI HOSPITAL
Money worries can be as distressing as health worries for cancer survivors. Most medical schemes have a cancer benefit (or oncology benefit), usually fixed at around R100 000 to R400 000 on a comprehensive scheme. If you exceed this, and your cancer is a prescribed minimum benefit (PMB), your medical aid will continue to pay. Cancer is a PMB when it’s of a solid organ (such as the liver), provided it can be treated (loosely defined as not having done incurable damage to the organ or spread to other organs). Some non-solid organ cancers are also PMBs (lymphoma, myeloma and leukaemia) – check with your scheme. If your cancer is a PMB, your scheme will cover, radiology, surgery, consultations, pathology and chemotherapy with certain service providers. If it’s considered non-treatable, your oncology limit will cover all oncology-related diseases that result from a non-PMB cancer. Should you exceed your oncology limit, most schemes will continue to pay, but may request a co-payment. If you become terminally ill, most schemes provide for hospice care by rand value or number of days. Check with yours. Some patients fear that if cancer recurs their premiums will increase, but this is not the case, says Dr Elsabé Conradie, GM of stakeholder relations of the Council for Medical Schemes. For more information, contact 012 431 0437 or information@ medicalschemes.com, or visit www.medicalschemes.com
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strengthening exercises, but we’re also there for them if they break down and need to talk. We motivate and give them hope that they can make it and conquer cancer. We also support the family and
can help them at home to adapt and cope with the changes,’ says Naiker. ‘A holistic approach is the best. Not only to cancer, but to a full, balanced life. You can survive cancer and thrive!’
USEFUL RESOURCES • CANSA offers support at more than 30 Care Centres and clinics in 500 communities, with 5 000 volunteers. • A new online iSurvivor programme sends brief weekly emails to guide and help you cope, says CANSA’s Lucy Balona. Visit www.isurvivor.co.za • You can also collect a CancerCare Coping Kit or booklet with practical advice at any of CANSA’s 30 Care Centres. Call 0800 22 66 22 or visit www.cansa.org.za • CANSA’s 11 care homes provide individual counselling, support groups, accommodation and transport for out-of-town patients having treatment, stoma care, and the loan of medical equipment and devices, such as wheelchairs and wigs. • CANSA Relay For Life is a celebration of survivorship and hope through community events. www.relayforlife.org.za • Smart Patients is an online community where cancer survivors and caregivers can learn from each other, research the latest treatments, find clinical trials and share stories of hope. www.smartpatients.com • Cancer Dojo aims to empower survivors and build resilience with a positive mindset. www.cancerdojo.org • Emily McDowell makes delightfully candid, non-kitsch greeting cards for people surviving illnesses. www.emilymcdowell.com • Campaigning For Cancer is an advocacy organisation that helps cancer patients through treatment by providing them with valuable info and tools to make it easier. www.campaign4cancer.co.za
I M A G E S G E T T Y / G A L L O I M A G E S , C A N C E R D O J O . C O M , E M I LY M C D O W E L L . C O M
From being a ‘couch madumbe’, Yoliswa began exercising in preparation for her mastectomy, with a supervised fitness programme at the gym. ‘I started with a treadmill and graduated to aerobics classes. Muso’s three, and running around after him, I’ve never been in better shape!’ Cancer patients need to be as active as they possibly can, given the type of cancer they had, says Kiruben Naicker, a biokineticist at Life Mount Edgecombe Hospital and Life Chatsmed Garden Hospital in Durban. ‘You need to start slowly with a professional. If you have discomfort, perhaps using an arm after breast cancer surgery, a physiotherapist can help. Alternatively, visit a biokineticist, who will devise an exercise programme to rebuild stamina, endurance, muscle strength, flexibility and balance lost through the cancer or its treatment.’ A biokineticist, physiotherapist or massage therapist can also do therapeutic massage, which he recommends to help counter stress. ‘It’s generally safer than going to a spa, where someone with less training could exert excessive pressure where a lymph node has been removed and cause lymphoedema.’ ‘We are here to get patients out of bed and teach them to walk and do the daily activities to become as independent as possible,’ says Sam Bailey, physiotherapist at Life Entabeni Hospital. ‘Patients often enter a depressed state if they stay in bed too long – we get them moving to prevent deep vein thrombosis. We do
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I N N O VA T I O N
Technology TO HEAL YOUR HEART
Life Vincent Pallotti Hospital in Cape Town now offers cardiac electrophysiology services. Charlene Yared-West finds out what it’s all about
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ife Healthcare prides itself on being one of the best healthcare providers in South Africa. When it comes to a healthy heart, the Group has added another member to its arsenal of medical specialists – Dr Vinod Thomas (www.cardiorhythm. co.za), Life Healthcare’s first cardiac electrophysiologist. The practice of cardiac electrophysiology diagnoses, manages and treats heart rhythm disorders by installing cardiac devices into the heart or using catheters to
discern healthy heart tissue from tissue that needs to be destroyed. Dr Thomas also works as a general cardiologist who has experience in coronary interventions and can prescribe medication for certain heart conditions, however, he prefers electrophysiology over drug prescriptions in most patients he meets. Life Healthcare magazine meets the doctor behind the technology at Life Vincent Pallotti Hospital in Pinelands, Cape Town, and finds out more about the innovation.
WHAT IS AN ELECTROPHYSIOLOGY STUDY?
‘If you’re experiencing symptoms of dizziness or heart palpitations, loss of consciousness and chest pains, it is time to seek out a cardiologist,’ says Dr Thomas. ‘When there’s abnormality in the beating of a heart, known as arrhythmia, an electrophysiology study can be conducted to test the electrical activity of the heart. The study is an additional test that shows where the arrhythmia is coming from and can
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help to plot a course of action; in other words, does the patient need medicine, a catheter ablation or an installation of a cardiac device? These answers are provided by the study.’ Dr Thomas says that the high success rate for ablations and installations as opposed to prescription medicine is something to be noted. ‘Prescription drugs for heart health maintenance can be avoided in many instances – and what could be better than undergoing the surgery and/or ablation and feeling 100% better after the procedure?’ he says.
Prescription drugs for heart health maintenance can be avoided in many instances WHAT HAPPENS DURING THE ELECTROPHYSIOLOGY STUDY? According to Dr Thomas, medication is intravenously administered to the patient to help them feel relaxed. The groin area is then shaved and cleaned with a sterile solution and anesthetised, and only then will the cardiologist insert several catheters into a vein, which will be guided to the heart. ‘The catheters work by picking up the electrical impulses in the heart. They allow your cardiologist to assess and treat the condition of your heart. Throughout the electrophysiology test, your blood pressure and heart rhythm will be monitored. You will be monitored by a number of machines,’ he adds.
HOW DOES THE HEART WORK? Dr Vinod Thomas explains… The heart is made up of four chambers – the right and left atria above and the larger right and left ventricles below. The atria pumps blood into the ventricles, while the ventricles pump blood throughout the body. The right side of the heart pumps blood to the lungs so that they have access to oxygen, and the left side pumps blood to the body and brain. When the heart is functioning normally, the atria pump blood to the ventricles before the ventricles pump blood to the body, so the atria and ventricles work in sequence. To make sure that the chambers are all in sequence, and to control the speed at which the heart beats, it has an electrical timing system. Small cells in the sinus node at the top of the heart send an electrical impulse out 60 to 80 times per minute, which means the normal rate at which the heart beats is between 60 to 80 times a minute,
with an increase during exercise. The impulse moves across the atria from right to left, causing the cells of the atria to contract. An insulated wall separates the atria and ventricles from each other. When the electrical wave reaches the wall, it ends and the cells wait for the next electrical impulse from the sinus node. The atria are connected to the ventricles by the atrioventricular node and bundle branches, which act as electrical paths through which the electrical waves can spread, causing the ventricles to contract. When an electrical wave is sent, it moves from the top to the bottom of the heart before it dies out until the next impulse is sent. When the heart’s electrical timing system is not working correctly, the normal rhythm of the heart is upset. These abnormal heart rhythms are often referred to as arrhythmia. These irregular electrical signals are known as atrial fibrillation.
Normal
Atrial fibrillation
Right atrium
Left atrium
‘Ablation is another word for “burn”,’ explains Dr Thomas. Catheter ablation describes when a small tube – a catheter – is placed inside the heart and delivers radio-frequency energy to parts of the heart through a small metal tip, which identifies parts (and particular cells) which need to be destroyed. ‘This technique is also used in atrial fibrillation (entire areas of tissue), which occurs when the heart’s electrical timing system 38
Sinoatrial node (pacemaker)
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WHAT IS A CATHETER ABLATION?
Atrioventricular node
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I N N O VA T I O N
is not working properly and the normal heart rhythm is disturbed,’ he says. Dr Thomas also performs complex atrial fibrillation ablation in selected patients. Technically complex, this procedure is also a first for the Life Healthcare Group. The first atrial fibrillation ablation was performed by Dr Thomas in January this year.
WHAT IS A CARDIAC DEVICE?
‘As a cardiac electrophysiologist, we also insert cardiac devices, such as pacemakers, defibrillators, and cardiac resynchronisation devices. These devices are connected to wires that stretch through the veins to the heart, and are inserted under the skin in the upper chest. These devices are used for sensing, pacing and delivering shock impulses,’ says Dr Thomas. ‘The main function of a pacemaker is to monitor and control the heartbeat. Electrodes in the wires identify the heart’s electrical activity and send data to the computerised generator. If there is an irregularity in the heartbeat, the generator sends electrical pulses through the wires to the heart.’
ELECTROPHYSIOLOGY STUDIES IN SOUTH AFRICA
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‘In South Africa, especially, electrophysiology is a new field of development in medicine and patients who have arrhthymia will benefit from an electrophysiology cardiologist opinion,’ says Dr Thomas. ‘Given the cure rates with the intervention procedures, it would be ideal for everyone to have access to this type of medicine. It is not completely out of reach and is charged at medical aid rates in my practice.’
MEET OUR EXPERT
SUCCESS STORIES Theresa Booysens
As a child, I had a hole in the atria of my heart but had it fixed. Then, in 1988 and in 1998, I underwent two open heart surgeries for atrial septal defect, a heart defect in which blood flows between the atria (upper chambers) of the heart, where, normally, these would be separated by a dividing wall called the interatrial septum. Two years ago, I fell ill again and was diagnosed with atrial fibrillation and a complex atrial flutter. I was placed on multiple medications (up to six) but nothing made me feel better – I still experienced all the symptoms. About six months ago, my heart rate suddenly became very high. My cardiologist referred me to Dr Thomas, who performed a complex atrial fibrillation/ atrial flutter mapping and ablation procedure, which was a huge success. It was amazing – my life has completely changed and I am off all my medication and doing very well. My family are so happy and have said it is like having a new person around because, before, I would sleep through most of the day. I feel free to take on big projects, even painting the house, and I am not as tired as I used to be. I am getting stronger and stronger each day. I cannot recommend Dr Thomas and his technology any higher – it has been a life-changing experience.
Christelle Mouton
I was a very active person and went to the gym regularly. Six months ago – in December – I started feeling very tired and short of breath when I tried to do anything physical. I would wake up feeling energetic, but by 2pm I needed to take a two to three hour nap. I was sleeping a lot. I thought I was just overworked and overtired and that I needed to take time off from work, which I believed was making me stressed and tired. I developed a tummy bug and after a visit to my GP, who picked up my very low heart rate, I was referred to Dr Thomas. I was diagnosed with multiple extra beats from my ventricle, and my ventricular function was deteriorating. I tried medication initially, but I experienced very bad side effects. We then decided to do an electrophysiological study, complex mapping and a ventricular tachycardia ablation (also a first for Life Healthcare), which was successful. Now I am back to where I was before and I am doing so well. My heart is in tip-top condition and I feel so good. My husband and two boys, 14 and 11, are very happy to have me back to normal – it was scary for them to see me so unwell. I am thankful that I met Dr Thomas when I did; I am sure I would be in a very different place if it wasn’t for the professionalism and care he took with my case.
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 at Life Vincent Pallotti Hospital.
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HELP THAT
MEDICINE GO DOWN
A
n unfortunate side effect of growing older is that you’re far more likely to be on chronic medication of some sort – particularly if you’ve not been paying any attention to your doctor’s constant admonitions to live a healthier lifestyle. But there are a variety of other reasons you might be on chronic medicine too – it’s not just for older people with high blood pressure and cholesterol. Children may be on medication for attention deficit hyperactivity disorder (ADHD), for example, or perhaps you suffer from
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depression or need help with pain management. Whatever the reason, it’s important you understand how to get the best results from your chronic medication and avoid the pitfalls. Jolet Cloete, a pharmacist at Life Wilgers Hospital in Pretoria, says that if you are on chronic medication, your relationship with your pharmacist is vital. ‘Don’t jump from pharmacy to pharmacy,’ she advises. ‘Stay at one where the pharmacist can see what’s on the chronic prescription and the other medications you are taking. There are various things to consider, for example, interactions with other medicines you’re taking.
‘It’s also important that you know how to take the medicine – some need to be taken at the same time every day. Others must be taken with food, or on an empty stomach. It’s vital you understand your condition, as well as what you need to take, and when.’ An important issue regarding chronic medication is compliance. Cloete quotes cases of clients who decide that they only need their hypertension medication during the week because they think they don’t need them when their stress levels are lower on the weekend. ‘Or I see patients who are on Warfarin
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Whether you’re new to chronic medication or have been taking it for some time, it’s important to understand how to get the best possible result from your treatment. By Mandy Collins
GOOD MEDICINE
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It’s vital you understand your condition, as well as what you need to take, and when and they’re not having their regular blood tests,’ she says. ‘Seeing one pharmacist who has your full history can help with all of that.’ Also, if you’re taking medication for high cholesterol, for instance, and your cholesterol levels have come down, don’t just decide to stop the treatment. Most chronic medication is about managing your condition, not curing it. Your cholesterol has come down because of the medication. If you stop taking it, your cholesterol will go up again. Your doctor might adjust the dose, but you shouldn’t just stop. If your child is on chronic medication (for ADHD or depression, for example), you will need to work with the school if he or she needs medication during the day. ‘Usually, teachers are very happy to assist in giving children’s medication correctly during school hours because this helps them if the child has ADHD and is able to concentrate in class,’ says Cloete. Finally, she cautions against sharing medication – something she sees quite often among older patients. ‘It’s not okay!’ she says. ‘It can be downright dangerous. You should only be taking medicine that has been prescribed for you, and it should not be shared with anyone else.’
Pain medication and the risk of addiction One of the biggest pitfalls of chronic medication for pain is that people misuse their medication, and many become addicted to it. So says Hannes Venter, a clinical psychologist at Life Riverfield Lodge in Johannesburg. ‘Opioids are not bad medications,’ he says, ‘but patients do need to use them as prescribed. If you start to use more than the prescribed dose, you can end up with rebound pain syndrome – where your body starts to “manufacture” pain in order to get more of the medication. You start to develop a tolerance for the drugs, and you need more and more.’ He says there are behavioural techniques for pain management, which are very important. ‘Mindfulness is a wonderful tool – you learn how to work around the pain,’ he says. ‘Unfortunately, human beings are wired to focus on pain, and when you focus on it, it becomes more intense.’ Venter also warns that if you’re taking pain medication and you have a psychiatric illness, you do need to be careful. ‘With depression, for example, if you don’t take care, the link soon forms that you can numb your emotional pain by numbing your physical pain.’ Codeine is of particular concern, because you can still buy it over the counter. In many countries overseas, this is not the case, and you would need a prescription to buy a pain medication containing codeine. ‘Codeine is supposed to be better regulated,’ says Venter, ‘and codeine addiction is rife, but it’s quite hidden. The problem with it being an over-the-counter medication is that people don’t think of it as being harmful – but it is highly addictive.’
MEET OUR EXPERT
Hannes Venter works primarily in the clinical field as a diagnostician, clinician, neuropsychologist and therapist. His primary interest is psychiatric rehabilitation, and he has designed and manages a psychiatric/psychology call system at Life Riverfield Lodge.
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GET KIDS
MOVING Unplug yourself from social media, get your trainers on and get the kids moving, says Charlene Yared-West
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However, modern-day children have become more sedentary, opting to spend their free time connected to the internet, where it is accessible, and exercising no more than their thumbs on small screens. South African children have poor physical activity levels according to the Healthy Active Kids South Africa Report Card 2014, and
as adults we have a responsibility to inspire our youngsters to move more for better health and longevity.
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hysical activity is vital for a child’s development and lays the foundation for a healthy and active life. In South Africa, every school-going child should get at least 90 minutes of physical activity per week, within the prescribed school curriculum.
A BLEAK FUTURE WITHOUT EXERCISE
Dr Claire Nicholson, founder of the healthy, active-living initiative Move-It, Moving Matters™
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THE BABY FILES
programme (movingmatters.co.za), points out a sad trajectory into adult life for children who do not exercise. ‘Without change, we can expect to see obese adults with a lifespan shorter than their parents,’ she says. Dr Nicholson heads up the programme, and Life Healthcare, who is committed to quality supporting interventions, is one of its funding partners. The Move-It, Moving Matters™ programme continues to gain momentum and respect, nationally and internationally. It’s a powerful, educational collection of programmes, which stimulate positive engagements with activity for life. Currently, 30 000 children in public schools across South Africa are participants. ‘Our aim is to educate adults and children about the value of physical activity and to make it a fun alternative so that they go out there and just do it!’ says Dr Nicholson.
MAKE EXERCISE FUN AND MEANINGFUL
Show your kids you care and give them the gift of your time when you set out for physical activity, says Tracy Clifford Statt, hypnosis practitioner for the motivational exercise programme hypnocize.co.za. ‘The fun factor is very important and children prefer short bursts of activity. Also, avoid nagging and negative language and be sensitive to insecurities like being overweight or uncoordinated. Choose appropriate activities that won’t embarrass the participants,’ she says. ‘It is also very helpful to set daily goals for activity with your children. Begin with short 10-minute bursts and work up to 30-minute play sessions.’
Avoid nagging and negative language and be sensitive to insecurities like being overweight or uncoordinated change is made,’ he says. ‘Children need encouragement and support, and good examples to follow, and parents play a big role in this. Whether it is washing the car together on a Sunday afternoon, taking a walk on the beach or showing them it’s a healthier choice to take the stairs instead of the lift, it’s vital they see the importance of movement. Choose age-appropriate activities and the sky’s the limit!’
BE INTERESTED IN THEIR INTERESTS
‘Children should be overjoyed by their own joy and parents should partake by showing an interest in their children’s interests,’ says Dr Nicholson. ‘So, even if that interest is in building Lego blocks, parents should get on to the floor and play. This can be built upon and taken
outdoors where it can become a more physical activity, such as building with bricks, for example. Pay attention to what they’re drawn to for clues to what they possibly would enjoy.’
INVEST IN THEIR LIVES
According to Andrew Wyllie, who is personal trainer and the owner of personalsublime.co.za, encouraging movement in children is an investment in their lives. ‘Exercise builds confidence, encourages teamwork and social skills, helps build physical development and maturity, and also inspires creativity,’ he says. ‘The bottom line is that children need to discover and explore that side of their own development and be in awe of their amazingly agile and strong bodies.’
YOU’VE GOT TO MOVE IT, MOVE IT You don’t need a gym membership to move, explains Kiruben Naicker. Always ask yourself the question: ‘How can I get my child to be more active?’ Here are some ideas to get you started: • Play catch in the backyard. • Take a morning family stroll in nature. • Go bicycle riding together. • Grab a towel and go to the beach. • Take the stairs instead of a lift. • Take a walk instead of a drive. • Go for a swim as a family.
• Ban technology for a day, then be ready to engage children in an activity, such as Twister. • Take it outside – indoor activity is sweaty and stifling. • Plan for rainy days – a novel activity like blowing up balloons and chasing them around the room.
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ENCOURAGEMENT AND SUPPORT ARE KEY
Kiruben Naicker, a biokineticist at Life Mount Edgecombe Hospital in KwaZulu-Natal, notes that he is seeing more children with obesity in his practice, from as young as seven or eight years old. ‘Parents often think their children will grow out of their baby-fat … until they see their kids have, in fact, grown into obesity. Obese children can easily become obese adults unless a lifestyle
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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
HOT TOPIC
EVERYBODY’S TALKING ABOUT…
ANTIBIOTIC RESISTANCE
They’re life-saving drugs, yet antibiotics have lost their clout against an increasing number of ‘superbugs’. Gillian Warren-Brown researches the implications
W
hen illness strikes, a quick fix is an attractive option. Life, work and school demands don’t let up and society expects us to bounce back within a couple of days. The upshot? We turn to antibiotics. No longer. Antibiotic resistance is necessitating a change in mindset.
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WHAT IS ANTIBIOTIC RESISTANCE?
Antibiotics are designed to neutralise or kill bacteria. In a classic example of survival of the fittest, some bacteria mutate in order to foil the search-anddestroy mission mounted by an antibiotic. Bacteria can be naturally resistant to certain types of antibiotics, says Dr Juno Thomas, a consultant clinical microbiologist in Life Healthcare Group’s Clinical Directorate. ‘More important,
if bacteria are exposed to antibiotics over a prolonged period of time, some can develop mutations that make them resistant.’ These then replicate and are transmitted between people and in the environment – especially where there’s continual use of antibiotics, both in the community and in hospitals. Essentially, the antibiotics quickly kill non-resistant bacteria, which leaves more room and resources for the resistant ones to thrive.
HEALTH IMPLICATIONS
Highly resistant bacteria, often called ‘superbugs’, are difficult to treat and more people die from them as a result, says National Infection Control Risk Manager Joy Cleghorn. Globally, we have a limited number of antibiotics to treat serious infections. Due to cost, and lengthy research and development time, few are on the horizon. This, and the fact that there is already a range of drug-resistant bacteria, including those of serious concern worldwide, such as tuberculosis (TB), means we’re already facing a crisis that threatens to catapult us into a time comparable to pre-penicillin days. Responding to this, the World Health Organization (WHO) has made it a priority to develop novel treatments, such as phage therapy, and to expand the use of vaccines in an effort to prevent infections.
LIFE PLUS ANTIBIOTIC USE: WHAT YOU NEED TO KNOW
Antibiotics are not always the answer, says Michelle Gijzelaar, national clinical pharmacy specialist at Life Healthcare head office. She highlights six smart facts to consider: 1. Antibiotics are life-saving drugs Using antibiotics wisely and sparingly is the best way to preserve their effectiveness for future use. If they are necessary, ensure that you take them as prescribed and complete the whole course. 2. Antibiotics only treat bacterial infections If you or your child has a common cold, it is usually caused by a viral infection. Gijzelaar suggests you talk to a doctor or pharmacist about symptom relief. This may include over-the-counter medicine, a humidifier or warm liquids. 3. Some ear infections DO NOT require an antibiotic It’s important for a doctor to identify the type of ear infection and whether antibiotics will help. Based on a thorough assessment, he or she may elect to wait a couple of days before prescribing antibiotics to see if the infection will clear without them. 4. Most sore throats DO NOT require an antibiotic In only one in five children seen by a doctor, a sore throat is caused by a bacterial infection, which should be treated with an antibiotic. This infection can only be confirmed by running a test. 5. Green coloured mucus is NOT necessarily a sign that an antibiotic is needed As the body’s immune system fights off an infection, mucus can change colour. This is normal and does not mean an antibiotic is required. 6. There are potential risks when taking any prescription drugs Antibiotics can cause side effects, ranging from an upset stomach to a serious allergic reaction, warns Gijzelaar. Your doctor will weigh up the risks and benefits before prescribing an antibiotic.
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POWER OF FIVE
SOOTHE LOWER-BACK PAIN It’s very common and affects many South Africans every year, but exercise can reduce lower-back pain and, in some cases, prevent it from recurring. Do these simple exercises as part of your normal routine or at home
• Kneel on to all fours, keeping your hands and knees shoulder width apart. • Your hips should be directly above your knees and at a 90˚ angle, with your shoulders directly above your hands. • Slowly move your hips backwards to get your buttocks to your heels. • Hold the stretching position for 10–15 seconds.
3
LUMBAR ROTATION STRETCH (3–4 repetitions on each side, daily)
• Lie on your back with knees bent and arms stretched out. • Keeping your knees together, lower them to the floor as far as you can on one side, and hold the stretch for a couple of seconds. • Return to the starting position and repeat on the other side.
2
STRETCHING FLEXION
(3–4 repetitions on each side, daily)
PAIN RELIEF
• Lie on your back with your legs straight and your back in a neutral position (slightly arched). • Lift your leg towards your chest, bending at the knee. Hold the position with your hands as far as possible or until a gentle stretch is felt. • Keep the stretch for 10–15 seconds and slowly return to your original position.
4
PELVIC TILTS
(5–10 repetitions, daily)
• If you can’t lie on your back, you can do this one in a supported, reclined sitting position.
• Lie on your back with your knees bent. Get your lower
stomach muscles working by gently pulling your belly button towards your spine. Keep your breathing steady while tilting your pelvis and flattening your back to the ground. • Hold for five seconds. • Return slowly to your original position and repeat.
NOTE: Keep your shoulders on the ground during the exercise.
5
CAT STRETCH (5–10 repetitions, daily)
• Support yourself on all fours. • Keep your back straight and head in line with your body.
• Arch your back upwards. • Let your spine arch downwards. • Return to the starting position and repeat.
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LIFE PLUS
You shouldn’t feel pain when you carry out these exercises. If you do feel pain, talk to your GP or physiotherapist. They’ll be able to make sure you’re doing them correctly or may suggest different exercises.
I L L U S T R AT I O N S M O N I Q U E M O U I S S I E S O U R C E W W W. B U PA H E A LT H . C O . U K
1
FLEXION (3–4 repetitions, daily)
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JOB PROFILE
WHAT IS AN INTENSIVIST? Dr Lliam Brannigan ‘If you are not resilient and calm under pressure, this job is probably not for you’
Dr Lliam Brannigan is an intensivist at Life The Glynnwood Hospital in Gauteng, where he provides round-the-clock care for the critically ill in ICU. It’s a super speciality, one with which many people aren’t familiar. Mandy Collins asks Dr Brannigan what his job is all about
What is an intensivist?
First you become a qualified medical doctor, then complete your internship and community service, and specialise in an area of medicine (usually internal medicine or anaesthesia). After that you need to complete a two-year fellowship. I specialised first as an anaesthetist and my training took a total of 14 years.
patients in the cardiothoracic ICU and the hospital’s two high-care units. All patients are managed by the multidisciplinary team in a cooperative and patient-first approach. We are a practice of 10 specialists who run the unit on a rotatory basis. In my unit, referring clinicians are expected to guide elements of care for which they would be considered experts. For example, I’m not an orthopaedic surgeon, so for me to comment on an orthopaedic-specific issue would be ludicrous. When done properly, in a respectful and congenial manner, the modern ICU functions like the Starship Enterprise – many highly trained people all working together to get a complicated and emotionally stressful machine working for the good of our patients.
Is this a new specialty?
What are the challenges of your job?
An intensivist or critical-care specialist manages and treats patients with life-threatening pathology in the intensive care unit (ICU) or high care environment. He or she is responsible for delivering complex and difficult care to these patients, and coordinating the multidisciplinary clinical teams needed to extract a successful outcome for the patient.
How do you qualify as an intensivist?
It’s not new, but over the last 30 years or so there has been an increasing acknowledgement that the ICU environment is highly complex, stressful and requires specific training. As all areas of medicine increase in complexity, and as patients get older and society demands better outcomes, doctors are ever more specialised. Believe it or not, there are such entities as specialist neuro-intensivists, for example, who only manage neuro critical-care patients. Lastly, the days of single practitioners offering patients best care on their own are fading, if not gone. Patients have better outcomes, and care is safer, more efficient and more cost-effective when multidisciplinary teams of clinicians use their unique expertise to manage care.
IMAGE SUPPLIED
Who are the other members of your medical team?
ICUs are often sub-categorised by the types of patients they manage. So you might encounter a cardiothoracic ICU, a post-operative ICU, a coronary care unit, an oncology ICU and so on. We run a large general ICU with 13 beds and see
The technical aspects of delivery of care are difficult to master because the technology is highly complex, and patients are the sickest and most complex in the hospital. For patients and families, a trip to the ICU is extremely stressful and emotionally challenging. Possibly the most important part of my job is dealing with that and making sure they are cared for and communicated to in a humane and dignified way. The hours are long and time away from family is tough, but luckily I have an extremely supportive spouse and family.
What kind of personality do you need to be able to cope with the demands of the job?
Ideally, you must be intelligent and hard-working, not mind long hours and be a good communicator. If you have compassion, that goes a long way too. I have met very good intensivists who fulfil the entire gambit of human personality and they do well, but one thing is for sure: if you are not resilient and calm under pressure, this job is probably not for you.
WWW.LIFEHEALTHCARE.CO.ZA
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A SORE THROAT CAN
HURT YOUR HEART
Pay close attention to a sore throat. A dangerous disease with devastating effects on the heart could be at work. By Carine Visagie
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HOW RHEUMATIC FEVER CAN LEAD TO RHEUMATIC HEART DISEASE
A link between a sore throat and heart disease may seem unlikely, but it all comes down to inflammation in the body and an ongoing, damaging immune response. When a sore throat caused by group A streptococcus bacteria is left untreated, the ongoing inflammation can set off an ‘immune cascade’ in the body, explains Dr Liesl Zühlke, paediatric cardiologist at the Red Cross War Memorial Children’s Hospital in Cape Town. Your antibodies start to repeatedly attack other organs and tissues, and the heart, joints, skin and central nervous system may be affected. This is called acute rheumatic fever (ARF), or simply ‘rheumatic
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M
ost people accept the occasional sore throat as a normal part of life. After all, it’s one of those bothersome symptoms that often accompany a harmless cold. But if a sore throat is caused by a specific group of bacteria, heart damage may follow. Rheumatic fever, the inflammatory disease that may develop after so-called ‘strep throat’, can cause rheumatic heart disease – a deadly condition that kills more than 1 000 people worldwide every day. In South Africa, it’s the leading cause of acquired heart disease in children and young adults, and the sixth highest cause of death due to heart disease. Could you or your child be at risk? Brush up on the facts.
MY HEALTH
fever’, and occurs about one to six weeks after the strep throat infection. When the heart is affected, you’re said to have rheumatic heart disease (RHD) – a chronic condition that causes thickening and scarring of the heart valves, often to such an extent that the valves, which are like doors in the heart, start to leak or can’t open. Heart failure, stroke and premature death may follow. Up to 60% of people with rheumatic fever go on to develop rheumatic heart disease. If you have RHD, you may experience shortness of breath (especially when exercising or lying down), fatigue and/or chest pain. But some people display no obvious symptoms. Interestingly, the condition is often picked up during pregnancy, when the added pressure on the heart makes symptoms more apparent.
Interestingly, the condition is often picked up during pregnancy, when the added pressure on the heart makes symptoms more apparent
The third step is to spread awareness. According to the Heart and Stroke Foundation of SA, rheumatic fever and rheumatic heart disease remain ‘neglected diseases’ that don’t get enough airtime. As such, very few parents and caregivers know of the connection between a sore throat and heart disease in children, notes Prof Bongani Mayosi from Groote Schuur Hospital and the University of Cape Town. Word of mouth is an important way of spreading the prevention message in communities across South Africa.
HOW IS RHEUMATIC HEART DISEASE TREATED?
If you have severe rheumatic heart disease, you’ll most likely require surgical intervention, either in the form of heart-valve repair or heart-valve replacement. However, if you take your prescribed medication and have regular follow-ups, the chances are less likely that this will be required. Children and teenagers often need repeated valve surgery as they grow older and their bodies change. Unfortunately, the surgery is expensive, risky and not always successful, which is why it’s important to act swiftly. If a strep throat is successfully treated, rheumatic fever and rheumatic heart disease are both 100% preventable. Visit RHDAction.org for more information on rheumatic heart disease.
WHO IS MOST AT RISK?
Overcrowding, poverty, undernutrition and lack of access to healthcare all contribute to high rates of rheumatic fever and RHD in developing countries, such as South Africa. The streptococcus bacteria spreads easily where people live, work and play in close proximity to each other, while poor nutrition impacts immunity, making an exposed person more susceptible to infection. When a sick child, teen or adult isn’t treated with antibiotics to clear up the strep infection, rheumatic fever may follow. Children and teens are most at risk. In developing countries, approximately 20–50 per 100 000 children between the ages of five and 15 contract rheumatic fever. But this doesn’t mean that adults, younger children or people living in more affluent communities aren’t at risk – anyone can get rheumatic fever.
I MAG ES GETTY/GALLO IMAGES, ISTOCK
HOW TO PREVENT RHEUMATIC HEART DISEASE
The first step towards prevention is to always pay close attention to a sore throat. When it’s accompanied by a high fever, painful joints and/or a rash, strep throat should be suspected and you should see a doctor. Interestingly, a runny nose is indicative of a viral infection, says Dr Zühlke – a sign that you don’t have strep throat. The next step is to get treatment in the form of antibiotics and to religiously stick to your prescription, which may last up to 10 days. This will help prevent the progression from strep throat to rheumatic fever to RHD. If you already have rheumatic fever, your doctor will most likely prescribe ongoing antibiotic treatment (usually in the form of monthly penicillin injections) to thwart further strep infections and heart damage. If you’ve had rheumatic fever before, you’re at high risk of another attack.
RESOURCES • Rheumatic heart disease fact sheet. World Heart Federation, 2012. Download from: www.world-heart-federation.org/ heart-facts/fact-sheets/rheumatic-heart-disease • New action plan against rheumatic heart disease. The Heart and Stroke Foundation of SA. View on: www.heartfoundation.co.za/media-releases/newaction-plan-against-rheumatic-heart-disease • Zühlke, L.J. (2011) ‘Rheumatic heart disease and the ASAP programme: fresh insights into an old disease’, Continuing Medical Education, Vol 29. No 11/12.
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COOK’S CORNER
Delicious memories ‘Food has always been a huge part of my life; important occasions were always marked with a feast of some sort,’ laughs cookbook author Zola Nene who shares her favourite stories and recipes in her new book, Simply Delicious. Here are three mouth-watering meals to try
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Roast Leg of Lamb Christmas is the biggest indulgence in the Nene house; we literally eat our body weight in food during the festive season. My mom spends the entire day cooking no fewer than eight side dishes to accompany the six roasts that we always have … Don’t judge us, it’s Christmas! Our collective favourite being the lamb roast, even with the abundance of food, we still sometimes fight over the last few pieces of lamb. This is my favourite way to prepare roast lamb. Serves 6–8 2 kg leg of lamb, bone in Salt and freshly ground black pepper, to taste 4 cloves garlic, crushed 2 sprigs fresh rosemary, chopped A large handful of fresh mint, chopped Zest and juice of 1 lemon 60 ml olive oil 1. Preheat the oven to 200°C. 2. Place the lamb into a large roasting dish and season generously with salt and pepper. 3. Mix the garlic, rosemary, mint, lemon zest, lemon juice and olive oil and rub this all over the surface of the lamb. 4. Roast the lamb, uncovered, for 1 hour and 15 minutes. If you like your lamb a little more well done, leave it in for an extra 20–30 minutes. 5. Leave the lamb to rest, wrapped in foil, for at least 20 minutes before carving.
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COOK’S CORNER
Oven-roasted Sweet Potatoes with a Blue Cheese Dip My family loves sweet potatoes – we eat them untouched, just boiled. My grandparents grew sweet potatoes in Durban. We’d prepare them by boiling them in their skins and then peeling them. Their sweet potatoes had a completely different texture to the ones we find today – they were denser and drier. You felt full after eating just a few. The sweet potatoes readily available to us now are a little moister and end up tasting very bland if boiled. Nowadays I prefer to roast my sweet potatoes to bring out more flavour. Serves 4 6 large sweet potatoes, washed, skin on 10 ml salt 5 ml dried chilli flakes 2.5 ml smoked paprika 30 ml olive oil For the Blue Cheese Dip 100 g blue cheese 250 ml sour cream 2 spring onions, finely chopped Juice and zest of 1 lemon Salt and freshly ground black pepper, to taste 1. Preheat the oven to 200°C.
3. Sprinkle over the salt, chilli flakes and paprika and drizzle over the oil. 4. Toss the potato wedges to coat, then place the tray in the oven and bake for 30–40 minutes until the potatoes are golden and tender. 5. To make the dip, mash the blue cheese in a bowl and mix in the sour cream, spring onions, lemon juice and zest. Season to taste and serve alongside the hot potato wedges.
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I M A G E S © P E N G U I N R A N D O M H O U S E S T R U I K ( P T Y ) LT D / D AW I E V E R W E Y
2. Cut each sweet potato into eight wedges and place them on a baking tray.
I M A G E S © P E N G U I N R A N D O M H O U S E S T R U I K ( P T Y ) LT D / D AW I E V E R W E Y
COOK’S CORNER
Granadilla Fridge Tart There’s no way I can reminisce about my school days without featuring a fridge tart. This is my favourite flavour.
250 g cream cheese, at room temperature 385 g can condensed milk Pulp of 4 granadillas
Serves 8
1. Mix the crushed biscuits and butter, press into a 23 cm tart tin and refrigerate.
200 g coconut biscuits, crushed 100 g butter, melted 40 g granadilla jelly powder 250 ml boiling water
2. Dissolve the jelly powder in the boiling water and set aside to cool.
3. Combine the cream cheese and condensed milk in a bowl and then add the cooled jelly. 4. Pour the mixture into the chilled tart base and allow to set in the fridge. 5. Slice the tart and spoon some granadilla pulp over each helping.
Extracted from Simply Delicious by Zola Nene (Struik Lifestyle). From R250 at select bookstores. WWW.LIFEHEALTHCARE.CO.ZA
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Walk without pain Don’t let joint pain rule your life
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REACH OUT
HEALER, HELPER & NURSE
In honour of International Nurses’ Day on 12 May, Life Healthcare celebrates its excellent nurses around the country and poses the question: What makes a good nurse? By Melanie Farrell
O
nce the lights are turned low on the ward at night, it’s just you and your nurses in your own self-contained world. You can hear the gentle hum of their conversation at the nursing station, and when it’s time for your medication your nurse is there, helping you sit up, plumping up pillows and checking your charts. The vital work of nurses is celebrated around the world, every year, on International Nurses’ Day on 12 May, the anniversary of world-renowned 19th century nurse Florence Nightingale’s birth. Life Healthcare magazine caught up with Group Nursing and Quality Executive at the Life Healthcare Group, Dr Sharon Vasuthevan, about a career in nursing, the national shortage of nurses
and what Life Healthcare Group is doing to alleviate the situation.
DR SHARON VASUTHEVAN
WE NEED MORE NURSES
With the country facing a national shortage of nurses, Life Healthcare offers its nursing staff regular opportunities to upskill and ensure that they are practising the best quality care. The Group Nursing and Quality Executive says that after qualifying, nurses are encouraged to specialise. ‘Nursing has evolved over the years and a research culture has developed
with many of our nurses achieving undergraduate and postgraduate degrees, and representing the Group at scientific conferences nationally and internationally. The specialisation of healthcare has led to a greater need for specialist nurses. ‘The areas of specialisation include critical care, primary healthcare, operating theatre nursing, occupational health, education and management,’ explains Dr Vasuthevan.
What makes a good nurse? ‘They must have the ability to show empathy and compassion, be critical thinkers, problem solvers and natural carers. Nurses have the opportunity to become leaders, so great leadership qualities also come into play.’
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REACH OUT
We’d like to introduce you to some of the outstanding nurses at Life Healthcare hospitals. Award-winner Sister Mavis Mwale from Life Springs Parkland Hospital and one of SA’s first male midwives (or midmaster), now nursing operations manager at Life Healthcare’s head office, Fasie Smith, talk about careers in nursing and their view on what makes a good nurse.
SISTER MAVIS MWALE
EXCELLENCE AWARD
Sister Mavis Mwale, 53, was recently recognised for her top-notch nursing skills when she received the annual Discovery Sister Mavis during her Excellence Award two-week exchange for Nurses in 2015. programme in Boston She was chosen from 150 nurses around the country. ‘I was selected to attend a two-week exchange programme that focused on leadership for nurses in Boston, USA. I was delighted because I’ve continued attending different workshops and training courses during my career to improve the care women and children receive.’ Sister Mwale joined Life Healthcare as a nurse and midwife in 2008 and she has nursed women and newborns with passion and commitment.
Nursing is a calling that must be practised with empathy and full commitment irrespective of colour, race, age and religious values What makes a good nurse? ‘I believe in putting my patients first and nursing them with compassion. 58
Nursing is a calling that must be practised with empathy and full commitment irrespective of colour, race, age and religious values. A patient is a human being who has a right to dignity.’
FASIE SMITH
PATIENT’S POINT OF VIEW
GROUNDBREAKING NURSE
Fasie Smith, 58, has worked his way up from the nursing floor to where he is today: Life Heathcare nursing operations manager. ‘I became a nurse by accident. My mother was a nurse but couldn’t afford to send me to university, so I enrolled in a nursing course. In those days there weren’t many men training in nursing.’ In 1983, Fasie became a midmaster (the male version of a midwife) Now he is working on completing his master’s. ‘Working as a midmaster was one of the most rewarding years of my career. There are more men studying nursing now – when I qualified as a nurse in 1980 only 3% of registered nurses were men. Now 9% of the nurses registered with the SA Nursing Council are men. In countries such as the UK and the USA there is, on average, a 50/50 split between male and female nurses.’ As nursing operations manager, Fasie’s focus is nursing practice. ‘Your focus always has to be the patient in the bed’, says Fasie. ‘I tell nurses that they need to treat their patients in the same
Pensioner Kevin Gallagher, who recently had surgery at Life Kingsbury Hospital, believes that good nurses give people the assurance that they don’t have to feel scared when they are in hospital. ‘The nurses who looked after me impressed me very much,’ he says. ‘All of them were very polite, caring and helpful. In order to have these qualities they need to be happy, cheerful and understanding. They provide tender love and care.’
way as they would care for one of their own relatives.’
What makes a good nurse? ‘Firstly, they need the necessary skills and knowledge, attributes of kindness, a gentle approach and the ability to be patient with everyone who crosses their path. It’s the easiest thing on earth to hang up a drip, but being caring is difficult. People who aren’t kind should not be there. If you can identify that early on, you can advise them that nursing isn’t going to be for them.’
What is Life College of Learning? Life Healthcare is committed to contributing to the national pool of skills, especially in the fields of nursing and health sciences. The Life College of Learning was established by the Group in 1998 and has been registered as a Private Higher Education Institution with the Department of Higher Education and Training since 2008. The College is also accredited with the South African Nursing College. • The College offers both nursing courses and health science courses. • There are seven learning centres and three classrooms around the country. • The College has, on average, 1 200 students a year across all its courses, and a high pass rate.
• The role of the college is to produce nurses of world-class quality who can add value to the business. • For more information, contact Luke Cheketri on 011 219 9885 or luke.cheketri@lifehealthcare.co.za
I M A G E S SU PPLI E D, FLATICON
NURSING SUCCESS
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SHORT STORY
I RAN FOR MY LIFE
Multiplatinum-selling musician Kabelo Mabalane tells his story of the highs and lows of drug addiction and how he found hope in running I AM THE MONSTER Maybe I am contributing to that myth of famous people who always get away with c**p. When the Jub Jub thing came out I was very slow to point fingers, because I knew, without a shadow of a doubt, that it could have been me. Even Oscar Pistorius – every time I watched that case, my heart broke. That could also have been me, on so many levels. My temper, mixed with the drugs I was taking. Uncalculating, but angry. I hit a woman once. It was when I was stone-cold sober, had been off drugs for a couple of months. It was the most frustrated I had ever been. I don’t know if, even now, I am ready to talk about this. These men we see as monsters, it’s also something that can be closer than you know. You can be the monster. You just got lucky that you didn’t get caught.
INSPIRING READ
The first step of the Twelve-step programme is to admit that you are powerless over your addiction, and that your life has become unmanageable. Before then, my life was unmanageable. I could not manage my life. If I could, I wouldn’t have been there, in that place. And it was flipping hard work. It hurt. It required real bravery to go through that process. I actually understand why a lot of people stay the way they are. I went into rehab, as planned, on 1 November, and I came out on 13 December. Two days after that I had a gig – it was something that had been planned a lot earlier, before I even went into rehab. I remember getting on stage and the crowd going berserk. I was really appreciative of getting a second chance. I felt like I had got my self-respect back. That people would start respecting me for being honest about what I was going through. I had been like this villain, and all of a sudden I was made to feel like I was a hero. But there were people who weren’t happy with my sobriety. It said more about where they were at. I was accused of doing it as a publicity stunt, of being a media whore. Often by people who were in active addiction. For the first second, when you find out, it hurts deeply. But I had to rise above it. Everyone is entitled to their own opinion. I can’t force someone to think about me in a certain way. If an orange tree says it’s an orange tree, then you’ve got to give it time to bear some oranges. If harvest time comes and it bears apples, you will know who the imposter is. You will know me by my fruit. My mother came to visit me at the rehab centre every weekend. She was always there for me. She didn’t have to say anything; she was known by her actions. The addict goes in, but, parallel to that, the family goes through their own counselling. When I saw my mom give herself over to that, try to understand me, I knew that she was really there for me. One of the things you have to do as part of a Twelve-step programme is write your own life story. See what kind of a p***k you actually were. You have to travel down that road, start writing down all this
stuff. For me, that is part of what spurs an addict on to sobriety: jeez, I did that? I didn’t sign up to be this person. Then, of course, after a few weeks you have to read your story out loud, to your group. When you learn about other people’s c**p, you hear their stories week after week, it slowly becomes a safe environment for you to share yours. When you see someone else become transparent, it encourages you to become transparent. When I finally read out my story, there were proud moments – because of the good stuff I had achieved – but also embarrassing moments, humbling moments. If anything, rehab humbled me. It made me realise that the sun didn’t shine out of my bum, and that when I drive around at night the moon is not following me. So there was pride, and there was regret. Regret because … if I had paid more attention and not missed so many things, I would be much further in life. As much as you pat yourself on the back after rehab, because you came out clean, you did it, part of that process is also realising how many opportunities you missed because of your addiction. The first day I arrived at H******n H***e, I was shown around, told where to go, and then thrown straight into ‘group’. There were WWW.LIFEHEALTHCARE.CO.ZA
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SHORT STORY
plastic chairs placed in a circle. I sat down with this kind of ‘Do you know who I am?’ attitude. I folded my arms – I was completely arrogant, even though by that time I was already clean; or maybe it was because of that – and I just sat and looked at these people, pretended to listen to them. Maybe I was hearing what they said, but I wasn’t really listening. This one girl was sharing her story with the group. Like I said, you share where you have been so that people can identify with you and find strength in where you have been. It’s kind of a sacred space. It requires a huge amount of trust. So, she was sharing her stuff. And I decided to just chip in. I gave her advice: I think you should do this, and you should do that. This is so embarrassing when I think of it now – not just me thinking that I obviously knew better than everyone else, but just the complete disrespect, like I was stomping all over the stuff she was sharing. I think everyone in the group was completely horrified at my behaviour. Worse, still, I carried on acting like that for another week or so. That story about me made the rounds. And my mistake ultimately wound up being the beginning of my healing process, and me understanding what I was there to do. A week later, when the group met and got to confront each other, or confront another addict for their conduct, or applaud someone – it didn’t have to be negative – I remember basically the whole room just gunning for me. ‘We don’t know who you
think you are. This is not the music industry. You are so arrogant…’ They really let me have it. I had always had ‘yes people’ surrounding me – there were very few people who challenged who I was, or what I did. For the first time in my life that I could remember, there were all these people in this room, and they were all telling me where to get off. It was the first time that the penny dropped: that I had come there to change. They didn’t just tell me what they thought about my behaviour. People told me how I made them feel. Nobody with a conscience would want to give off what I was giving off. And that’s when I started putting in the work. At the end of five weeks, the reports about me had changed. People thanked me for taking to heart what they had said about me. But it wasn’t just what they’d said about me that caused that change. My headspace started to shift when I started hearing their stories, really hearing them. When you hear someone else’s life story, it gives you the ability to put everything in a different context. You start to understand people more, you’re able to empathise with them. The fact that some people made my mountains look like molehills … it made me want to understand people more. I Ran for My Life by Kabelo Mabalane is published by Pan Macmillan and available from leading bookstores at an RRP of R260.
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OUR HERO
HERO OF THE MONTH
SISTER LUCY DE LA HARPE This energetic maternity unit head gives new parents a dinner date to remember. By Melanie Farrell
T
his month’s hero, Sister Lucy de la Harpe, the unit manager of the Maternity Unit at Life Wilgeheuwel Hospital in Radiokop, Johannesburg, eases parents into the shock of going home alone with their newborn by treating them to a dinner date. ‘Going home with a new baby can be challenging,’ says Sister Lucy. ‘I was thinking about how to make everything easier on parents, and I had the idea of introducing a date night on their last night in maternity.’ No couple can really prepare for the ripple-effect of a baby, and when first-time parents leave the safe confines of the hospital, they may find themselves reeling from the shock of night feeds and lack of sleep. Although it sounds extreme, Cathy O’Neill, co-author of Babyproofing your Marriage, says, ‘Having a baby is like throwing a hand grenade into your marriage’. It’s a joyous and exciting occasion, but it can also be daunting and exhausting. Recognising this, everyone in the maternity unit works together on date night to ensure couples can enjoy a quiet dinner without any disturbances during their meal. Candles are lit on the tables in the maternity courtyard, and while maternity nurses take care of the babies, the parents are served their food. ‘Many of them sit and enjoy the date for an hour or so, quietly chatting and making the most of their undisturbed time alone,’ says Sister Lucy.
Sister Lucy says first-time parents deserve a date night
I’m probably the most positive person you will ever come across
‘The date night dinner has become so popular,’ Sister Lucy explains. ‘Returning parents often talk about it when they come back for subsequent deliveries. One of the first things that they ask when they come to the unit is, “Do you still do date night?” and they’re so pleased when we tell them we do.’ When asked what makes a great maternity nurse, Sister Lucy’s answer is: ‘A strong, passionate, loving and caring individual with loads and loads of empathy. They also need to be able to work well in a team. ‘I have the best team that any unit manager could possibly ask for, and once a team comes together as one, success is almost inevitable. ‘My job involves talking and building quality, caring relationships with all those around me. I’m probably the most positive person you will ever come across. ‘I’ve been working in maternity units for 36 wonderful years and I’m a young 58 and fit as a fiddle,’ says Sister Lucy, who happily goes the extra mile for the moms and dads she meets. ‘Working in a maternity unit is so special. From the moms to the newborn babies, to dads, to visitors and everything in between,’ she enthuses. ‘Her staff adore her,’ one of her colleagues tells me. ‘Her date night idea is just one example of how she does so much more than help to deliver babies.’
WWW.LIFEHEALTHCARE.CO.ZA
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PUZZLE THIS... Test your mental agility with our brain-teasers
1 CROSSWORD PUZZLE 2 SUDOKU
Arabian Nights hero 26 Scoot 28 Rub the wrong way 32 Exclamation point 34 Conger or moray 36 ____podrida 37 Battle verbally 39 Afternoon affair 41 Fleur-de-_____ 42 Succumb to gravity 44 Thing 46 Baton wielder 50 Journal 51 Pinnacle
ACROSS
1 Feathery neckpiece 4 Weevil invader 8 Diplomacy 12 Puncturing tool 13 Reed instrument 14 Petri-dish matter 15 Giving permission 17 Entice 18 Online address 19 Exhibition setting 21 Sweeny Todd, eg 24 Deposit 25 With 21-down, 62
52 Soothing 56 Fit of peevishness 57 Annie actress Cameron 58 Teachers’ org. 59 Towel marking 60 A handful 61 Sailor DOWN
1 Sheepish remark? 2 Hooter 3 Sexy 4 Alley athlete 5 ____-Wan Kenobi
6 Protracted 7 Constitutional 8 Hunter’s cry 9 Chills and fever 10 Singer Vikki 11 Deuce beater 16 Scepter topper 20 Fond du ___, Wis. 21 See 25-across 22 Winged 23 Regret 27 Trawler prop 29 Making a claim 30 Gendarme
31 Bridge position 33 Fabric inserts 35 Author Buscaglia 38 Pack away 40 Burning 43 Alumni 45 Comic Behar 46 Hawk-eye’s sitcom 47 Dermatology subject 48 Ottoman potentate 49 Hodge-podge 53 Hasty escape 54 Ultra-modern 55 Tie up the phone
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I M A G E I S T O C K P U Z Z L E S P R E S S / M A G A Z I N E F E AT U R E S ( P T Y ) LT D
Difficulty level ***
MIND GAMES
3 WORD SLEUTH
4 BANANAGRAMS!
Find the hidden words in the diagram. They run in all directions
Each of the two-letter groups below may be extended on both the right and the left to form a six-letter word. Use the tiles directly above each group to ďŹ ll in the blanks
Breeze Clouds Kite Parachute Parasail
Sails Sand dune Snowdrift Spinnaker Weather vane
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SOLUTIONS ANSWERS LINEAR, BIOPSY, CHORUS
1
2
3 Spring:
I M A G E I S T O C K P U Z Z L E S P R E S S / M A G A Z I N E F E AT U R E S ( P T Y ) LT D
4 WWW.LIFEHEALTHCARE.CO.ZA
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SOUL FOOD
PERFECT REST
Can the nightly nourishment of restful sleep transform your life? Arianna Huffington encourages sweet slumber
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It would actually be better for business if employees called in tired, got a little more sleep, and then came in a bit late, rather than call in sick a few days later
And even when it doesn’t kill us, sleep deprivation makes us dangerously less healthy. Dr. Carol Ash, the director of sleep medicine at Meridian Health, points out that even losing an hour of sleep per week – which many of us do without a moment’s thought – can lead to a higher risk of heart attack. By weakening our immune system, sleep deprivation also makes us more susceptible to garden-variety illnesses, like the common cold. It would actually be better for business if employees called in tired, got a little more sleep, and then came in a bit late, rather than call in sick a few days later or, worse, show up sick, dragging themselves through the day while infecting others. A lack of sleep also has a major impact on our ability to regulate our weight. In a study by the Mayo Clinic, sleep-restricted subjects gained more weight than their well-rested counterparts over the course of a week, consuming an average of 559 extra calories a day. People who get six hours of sleep per night are 23 percent more likely to be overweight. Get less than four hours of sleep per night and the increased likelihood of being overweight climbs to a staggering 73 percent. The bottom line? When we’re not well rested, we’re not as healthy. And it shows. In a Swedish study, untrained participants were asked to look at photos of both sleep-deprived and well-rested people. In other words, we wear our lack of sleep on our faces. Extracted from The Sleep Revolution by Arianna Huffington (Penguin Random House) RRP R320
IMAGE SUPPLIED
D
eath from overwork has its own word in Japanese (karoshi), in Chinese (guolaosi), and in Korean (gwarosa). No such word exists in English, but the casualties are all around us. It is a specter haunting the industrialised world. Simply put: we don’t get enough sleep. And it’s a much bigger problem – with much higher stakes – than many of us realise. Both our daytime hours and our nighttime hours are under assault as never before. As the amount of things we need to cram into each day has increased, the value of our awake time has skyrocketed. Scientists are resoundingly confirming what our ancestors knew instinctively: that our sleep is not empty time. Sleep is a time of intense neurological activity – a rich time of renewal, memory consolidation, brain and neurochemical cleansing, and cognitive maintenance. Properly appraised, our sleeping time is as valuable a commodity as the time we are awake. In fact, getting the right amount of sleep enhances the quality of every minute we spend with our eyes open. The incidence of death from all causes goes up by 15 percent when we sleep five hours or less per night. A 2015 CNN.com article based on the latest findings by the American Academy of Sleep Medicine, provocatively titled “Sleep or Die,” discussed the connection between lack of sleep and an increased risk of heart attack, stroke, diabetes, and obesity. In other words, getting enough sleep really is a matter of life and death.
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