PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
DAILY DOSE WHEN YOU’RE PREGNANT… WHAT’S SAFE AND WHAT’S NOT
The truth about eating eggs
MAKE THIS YOUR
HEALTHIEST YEAR MANAGE stress • EAT better • KEEP fit
QUIZ: HOW WELL DO YOU DEAL WITH STRESS?
clever. simple. intuitive. Our new inhaler is so clever, it does the thinking for you. It even counts. You, simply breathe.
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ADVANCING HEALTHCARE FOR ALL
Life is… I’m always caught a little off guard when autumn arrives. The warm summer breeze has become crisp and cool, and a scarf or light cardigan is essential as I dash out the door in the morning. The cycle of loss, regeneration and regrowth that starts with autumn is comforting and clear – nothing lasts forever and despite your best-laid plans, you can’t control everything. While autumn’s beat is sure and steady, everyday stresses are hard to avoid and can easily consume your energy. Stress plays an important role in your survival, but it can be destructive to your body and soul. There are valuable lessons to be learnt about how you deal with stress and how you perceive the stressor if you take our test on page 26. As the Easter holiday approaches, you might be planning to destress with a road trip with family or friends. There’s a healthy body of research that advocates for the benefits of a holiday experience that helps people reconnect and make memories, and our magazine has some great suggestions on page 28. If the anticipation of a new season feels empowering, why not make a few changes and updates? Find out how to quit smoking and instantly improve your health on page 40, cook good, flavourful food with the recipes on page 54, and, if you’re a woman, take particular care of your heart with our tips on page 52. Enjoy the gifts and the unexpected treasures to come, and approach the challenges with confidence in your ability to thrive and forge new paths where they may not have existed before. Making life better starts right here.
IMAGE ANGIE LAZARO
A PUBLICATION BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP
EDITORIAL COMMITTEE Yvonne Motsisi, Dr Sharon Vasuthevan, Janette Joubert, Dr Trevor Frankish, Liesel van Oudenhove, Lucy Balona (CANSA), Professor Pamela Naidoo (Heart and Stroke Foundation South Africa) MANAGEMENT Managing Director Lani Carstens Business Development Director Rebecca Smeda Group Account Director Joanne Hope Account Manager Delicia Krause Production Director Nina Hendricks Financial Director Megan Paulse Human Resources Director Aashiqa Petersen
SAMANTHA PAGE EDITOR
ADVERTISING Advertising Sales Director (Johannesburg) Moyra Beeming email@example.com 011 507 9123; 082 375 4446 Advertising Sales Manager (Cape Town) Estelle Dietrich firstname.lastname@example.org 021 486 7609; 073 224 4996 PRODUCTION Production Manager Tessa Smith Reproduction Resolution Colour Printing Paarl Media Cape Life Healthcare magazine, 2nd Floor, Block A, North Side, Black River Park, Fir Street, Observatory, 7925 / PostNet Suite #2, Private Bag X11, Mowbray, 7705 Email: email@example.com Tel: 021 486 7600 Fax: 021 486 7614 www.johnbrownmedia.com For magazine-related queries, contact John Brown Media. Tel: 021 486 7600 Fax: 021 486 7614 PostNet Suite #2, Private Bag X11, Mowbray, 7705
Life Healthcare magazine is published by The Life Healthcare Group to provide patients, their families and the public with the most readable, interesting and relevant health and wellbeing journal available. Life Healthcare magazine is distributed quarterly to patients at all Life Healthcare hospitals and to privatesector doctors. It has a guaranteed print order of 90 000 per quarter, with an estimated readership of 240 000. Life Healthcare magazine can now also be read online. Visit www.lifehealthcare.co.za Disclaimer: the opinions expressed by the authors of the articles published in this magazine do not necessarily reflect the views of The Life Healthcare Group Ltd or John Brown Media. The Life Healthcare Group Ltd or John Brown Media do not accept any responsibility for information given in the articles featured in Life Healthcare magazine.
Visit our website at www.lifehealthcare.co.za to access previous issues of Life Healthcare magazine, get information about Life’s hospitals and specialists, and see all the latest Life Healthcare news. Making life better starts here.
EDITORIAL Editor Samantha Page firstname.lastname@example.org Senior Designer Anelia du Plessis Managing Editor Sharon McTavish Copy Editor Lynn Cloete Managing Editor (Life Healthcare Group) Tanya Bennetts
Whilst The Life Healthcare Group Ltd has agreed to advertise products in this magazine, the Group makes no representations or warranties as to the efficacy or use of the products. The products are advertised on condition that readers will make their own determination, including seeking advice from their medical practitioner or healthcare professional as to the suitability of the product for the intended purpose, prior to use. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of use of the advertised products.
LOOK OUT FOR LIFE PLUS BOXES IN OUR MAGAZINE FOR EXTRA INFORMATION AND HEALTH TIPS FROM OUR EXPERTS
THIS MONTH’S FOCUS: MAKING LIFE BETTER
LIFE 01 LIFE IS…
A note from the editor
04 OVER TO YOU
Letters from our readers
Medical innovations, what’s new at Life Healthcare and latest reads
12 EASING THE PAIN OF ARTHRITIS
Osteoarthritis can begin in your 40s, but there are ways to manage it. This is what you need to know By Mandy Collins
16 ‘MY WIFE GAVE ME HER KIDNEY’ Dennis and Faye Naicker have an extraordinary story to tell about their life-saving bond As told to Lynne Gidish
18 MEDICATION AND PREGNANCY
A gynaecologist/obstetrician and a pharmacist offer their expertise on which drugs are safe to take when you’re pregnant and which aren’t By Charlene Yared-West
20 THE GOOD EGG
Dietitians weigh in on the right way to eat this powerful protein By Sam Brighton
23 GOLDEN RULES OF WORKPLACE SAFETY
You spend more waking hours on the job than you do anywhere else – protect your wellbeing by learning to identify unsafe behaviours in the workplace By Samantha Page
LIFE IN THE NICU
24 TAKING CHARGE OF BIPOLAR DISORDER
Find out what causes this manic- depressive illness and brain disorder, and how you can better understand and support those who suffer from it By Gillian Warren-Brown
26 DON’T LET STRESS GET YOU DOWN Life is often busy and challenging, but it’s possible to learn how to cope with the stress of it in a healthy way. Take our quiz to see where you can improve
28 LET’S MAKE MEMORIES
South Africa offers plenty of opportunities to escape into nature for a feel-good holiday. We’ve rounded up five of our favourite destinations By Erin Coe
HEALTH 32 TAKING CARE OF LITTLE LIVES
NICU nurses tend to the tiniest and most vulnerable babies born too soon and give them a fighting chance By Glynis Horning
38 COCHLEAR IMPLANTS: BREAKING THE SILENCE
For those with profound hearing loss, a cochlear implant can be truly life-changing. Read one remarkable success story here By Carla Hüsselmann
THE JOY OF HEARING
40 BE A QUITTER!
Smoking cessation medication can help you quit the habit and improve your quality of life and health By Mandy Collins
42 JUST BREATHE
CARE 50 DON’T WAIT: VACCINATE
Life West Coast Private Hospital’s vaccination initiative By Lynne Gidish
Practical knowledge of first aid saves lives. This is why learning CPR is important – especially for parents of newborns and infants By Melanie Farrell
52 TAKE THE PRESSURE OFF
44 EVERYBODY’S TALKING ABOUT… BIRD FLU
54 TASTE OF THE MEDITERRANEAN
The recent cases of avian flu have caused some concern, but are humans at risk? These are the facts By Pippa Naudé
46 JUST A PINCH OF SALT
Cut your salt intake with tips from a dietitian at the Heart and Stroke Foundation South Africa By Raadiyah Abrahams
47 RENAL CLINICAL TECHNOLOGIST What exactly does this job entail? By Erin Coe
Women are more at risk of hypertension than you might think. Take these preventative steps By Tracy Melass This new cookbook provides a healthy and flavourful approach to food
61 LIFE HEALTHCARE HERO
Stock controller Divan Schutte from Life Rosepark Hospital As told to Melanie Farrell
62 MIND GAMES
Take a break with our puzzles and crossword
64 GIVING THE GIFT OF LIFE
A look at heart-transplant history By James-Brent Styan
OVER TO YOU We’d love to hear from you
LIFE-SAVING CARE I was admitted to Life Vincent Pallotti Hospital in November 2017 with very high blood pressure (220/149). I would like to commend Jane and Terry in the High Care ward of the hospital for their 24-hour dedication and care. I was bed-bathed, and at night a nurse sat beside me checking my blood pressure and recording it, taking my sugar reading and seeing that I had all I needed. This might not seem like much, but to me in this frightening situation it was a lifesaver. I believe it was their care and dedication that got me through those three days. I owe them my life. Amanda Pelser, Cape Town
A MOTHER’S LOVE My baby arrived a month early, and I was rushed to Life Westville Hospital. I was not a first-time mom, but this was a high-risk pregnancy and I had previously had a miscarriage, so I was terrified. I was admitted at 4am, my gynae arrived at 7am and shortly thereafter all my fears disappeared when I held my beautiful baby girl in my arms following an emergency c-section. I was blown away by the service of one nurse in particular: Pearl Catherine Pillay. She taught me to breastfeed and saw to my aches and pains, giving helpful advice to me and the other three patients in the room. I felt like my mum was there caring for me. Her excellent care subsequently led me to choose the hospital again.
WINNING LETTER FIVE-STAR TREATMENT FROM TOP TEAM
When I fetched my husband from Life Vincent Pallotti Hospital in Pinelands, Cape Town, after a five-day stay in High Care, he remarked that ‘it was like staying in a five-star hotel’. The sister in charge of the unit, Nikki Krynauw, is an outstanding nurse and a lovely person. She treated my husband, an elderly man of 75 who at the time was in a great deal of pain, calmly and made him feel like he was the most important patient in her ward. Nurse Krynauw’s support team of sisters and nurses, especially Terry, Mandla, Eunice and Janet, were all exceptionally gentle and took time to explain to my husband at all times what they were doing and why. Fortunately, we were able to have the services of two amazing doctors, Dr Martin van Liedre and Dr Adam Piorkowaski, who consulted together and both visited my husband several times each day. With their expertise and care he was able to return home a different man from the one who was rushed to the trauma unit a few days earlier. The Life Vincent Pallotti Hospital team made a very difficult and stressful time for both my husband and our family much easier, and to them we give our sincere and grateful thanks. June Alrick, Cape Town
Thomas Mashia was featured in Life Healthcare’s Summer 2017/18 issue, where patients gave inspiring accounts of not letting their disabilities limit their potential. He was delighted to be part of the feature and to share his positive experience at Life Eugene Marais Hospital. For more on Life Rehabilitation, visit www.lifehealthcare.co.za/patient-information/ patient-services/complementaryservices/life-rehabilitation
IT DIDN’T GO UNNOTICED In October last year, I was admitted to Life West Coast Private Hospital for a shoulder operation. All the staff treated me with friendliness and dignity, the food was excellent and well prepared, and the room was always clean. I will definitely recommend Life West Coast Private Hospital to anybody. Keep up your good work, Life Healthcare. It didn’t go unnoticed.
Renalda Dalthamun, Durban
Win a Harmony II speaker valued at R1 000 The DreamWave Harmony II is an elegantly designed premium speaker that brings the music to your ears the way the artist intended. The textured cognac leather strip, unique rust-orange honeycomb mesh, and audio playing from both sides of the speaker make it a one-of-a-kind showpiece in any room. It comes with a soft velvet pouch, meaning you can take it with you and enjoy your music in the comfort of your home, office, car or even during your workout. Email email@example.com about how you experienced life, health and care at a Life Healthcare hospital or facility and you could win. Prize is non-transferable and cannot be exchanged for cash. 4
Mariana Uys, Piketberg
YOU COULD BE SOMEONEâ€™S HOPE OF LIFE The Sunflower Fund creates awareness and educates the public about the need for and the process involved in becoming blood stem cell donors. We raise funds to cover the tissue-typing costs involved in recruiting potential donors.
share. give. register
0800 12 10 82 | www.sunflowerfund.org.za
LIFE PREGNANCY AND MEDICATION / STRESS TEST / THE POWER OF EGGS
‘THERE IS SOMETHING INCREDIBLY NOSTALGIC AND SIGNIFICANT ABOUT THE ANNUAL CASCADE OF AUTUMN LEAVES.’ JOE L. WHEELER
Medical innovations and Life Healthcare news
ASKED AND ANSWERED
EATING FOR ENERGY
As the days get shorter and the weather cooler, it’s easy to start feeling sluggish and more inclined to skip your morning run or evening workout. However, you can boost your energy by eating the right combination of foods in four to six smaller meals or snacks throughout the day. Frequent meals and snacks sustain your energy and provide a constant stream of nutrients, keeping blood sugar levels even and helping you feel fuller for longer.
Water + oranges, lemons, limes, berries = FRUITY REFRESHMENT Wholewheat toast + avocado + egg = ENERGY COMBO Yoghurt + nuts + oats + stone fruits = BRILLIANT BREAKFAST
FOR YOUR GOOD HEALTH
YOUR BODY UNDER STRESS Stress is a common side effect of modern living and many people cite insomnia, weight gain and heart palpitations as some of the ways it can manifest. But there are a few other surprising and lesser-known effects you should know about. It can affect your memory In a recent study by the University of Iowa, researchers found that the brain’s prolonged exposure to the stress hormone cortisol weakens and ‘weathers’ the synapses in the brain’s prefrontal cortex (the part responsible for short-term memory). It can give you headaches The Mayo Clinic lists headache as the first of the most common effects that stress has on the body, and says that stress is the most common headache trigger. It can sabotage your sex drive Stress is one of the most common causes of a low libido. As both a psychological and physical phenomenon, stress can be all-consuming, limiting your interest in sex. 8
WHAT’S THE BEST WAY TO KEEP PREDIABETES FROM BECOMING DIABETES?
It is estimated that about 5 million South Africans have prediabetes, which means your blood sugar levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes. This condition also puts you at higher-thannormal risk of developing type 2 diabetes, heart disease and stroke, but a large body of research shows that even small lifestyle changes, such as a healthy diet combined with sensible exercise and losing as little as five percent of body weight, can make a huge difference and, in many cases, prevent progression to type 2 diabetes. Research also suggests that moderate activity can be more effective than vigorous exercise. A 2016 study at Duke University found that briskly walking 12km a week was more effective at helping the body process sugar than jogging 18km a week. Most effective, however, was combining moderate activity with a low-fat, low-kilojoule diet, researchers concluded.
IN A NUTSHELL
To do or not to do IF YOU’RE PREGNANT OR YOUR BODY IS UNDER STRAIN AND YOU’RE WONDERING WHETHER OR NOT IT’S OKAY TO EXERCISE, HERE’S A HANDY GUIDE. CONDITION
OKAY TO EXERCISE?
Always take your doctor’s advice, but it’s mostly safe to exercise throughout your pregnancy. Activities with a high risk of falling, like tennis or climbing, are not advised.
Depends on the injury
If you need physiotherapy, consult your doctor before you start any regimen.
Depends on the sickness
If you have a mild cold or the sniffles, it should be okay, but stay home and rest if you have a fever, body aches or more.
Exercise is an excellent way to combat fatigue, but if you’re concerned about the root of your fatigue, discuss it with your doctor.
It’s always good to keep your joints moving and supple to prevent them from completely seizing up, so maintain flexibility but check any additional niggles with your doctor.
Mom needs comfort too Most expectant moms ensure that their newborn has a snug blanket and comfortable clothes, even a soft toy – but new mothers need to nurture themselves too. One way to make your hospital stay cosier is by packing some of your favourite items from home. • Special music: create a playlist of your favourite tracks – and don’t forget earbuds. • Your own pillow: it might seem like a small thing but something familiar is important when everything else feels new. • Comfortable PJs: hospital gowns are practical for the delivery but the next day, after you’ve had a shower and receive your first visitors, you’ll want your own sleepwear. • Cosy socks: keep your feet warm while your hormones adjust – non-slip soles are helpful for avoiding injury on slippery hospital floors. • Aromatherapy: a scent diffuser gives your room a pleasant, calming smell, which is a quick way to relax. For more tips on what to pack for your hospital stay, visit www.lifehealthcare.co.za/patientinformation/going-into-hospital/pre-admission/ what-should-you-bring-to-hospital
WINTER IS COMING
IMPORTANT Loose and/or fungal-damaged nails need Fix-4-Nails® to recover
Recovery takes time START NOW!
When is the best time to have the flu vaccine? You should get a flu vaccine before flu begins spreading in your community. It takes about two weeks after vaccination for antibodies to develop in the body that protect against flu. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season. Source: Sanofi Pasteur
dId yOU kNOW? DID YOU KNOW?
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is the percentage of people who exercise regularly in the morning rather than later in the day. Once you’re into the habit, it seems easier to stick to an exercise regimen then. Getting an early start boosts your metabolism and keeps you burning calories all day long. Source: Health24.com
The ideal conditions created by Fix-4-Nails® under the nail is the secret of its success in ‘restoring by regrowth’ of loose and fungal-damaged nails
Available at and participating pharmacies and salons
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E-health, m-health (mobile health) or telemedicine is a means of delivering health-related information via digital channels and communication technologies such as mobile devices, computers and other innovative platforms. It could be as simple as two doctors in different locations discussing a patient’s treatment or as complex as performing a robotic surgery between facilities in different countries. At a recent health conference, James Tong, engagement manager and mobile health lead at IMS Health, reported that two out of three Americans are willing to use a device as an adjunct to their healthcare plan because telemedicine is not part of a future health landscape – it’s evolving right now.
C O M P I L E D B Y S A M A N T H A P A G E I M aA gG E sS G E T T yY / G A lL lL oO iI M A G E S , iI S T oO Cc Kk
WHAT IS TELEMEdICINE? TELEMEDICINE?
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
FIT FOR LIFE
EASING THE PAIN OF ARTHRITIS Osteoarthritis is a very common, painful condition, but it can be managed, writes Mandy Collins
ven if you don’t suffer from osteoarthritis yourself, chances are you know someone who does. We’ve all witnessed the hands of an older person slowly twisting and changing over time, with an inevitable loss of function. But it’s not just the hands that are affected. Osteoarthritis can damage any joint in your body, although it most commonly affects 12
joints in your hands, knees, hips and spine. ‘Osteoarthritis increases with age and is primarily due to degenerative changes in the cartilage,’ says Dr Cathy Spargo, a specialist physician and rheumatologist at Life Vincent Pallotti Hospital. ‘This in turn results in secondary changes in the surrounding bone, which may result in deformity of the affected area.’
Cartilage is a firm, slippery tissue that permits your joints to move with very little friction. But in osteoarthritis, that slipperiness becomes rough. And eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone – which is what makes the condition so painful. Osteoarthritis is extremely common, says Dr Spargo. As a rule of thumb, 60% of the population will have osteoarthritis by
the age of 60 years and 80% by the age of 80 years, although the site and severity will vary. Previous injury to joints will accelerate the risk and progression of the condition.
The symptoms of osteoarthritis usually develop slowly and worsen over time. Signs and symptoms include: •Y our joint might hurt during or after movement. •Y our joint might feel tender when you apply light pressure to it. •Y ou might experience joint stiffness that’s most noticeable first thing in the morning, or if you’ve been inactive for a while. •Y ou might notice that a joint isn’t as flexible as it used to be. •Y ou might hear or feel a grating sensation when you use the joint. •Y ou could develop bone spurs – which feel like hard lumps – around the affected joint.
WHO IS AFFECTED?
Dr Spargo says there are different subsets of osteoarthritis. ‘Previous injury increases the risk of osteoarthritis, and genetics plays a significant part, particularly in osteoarthritis of the hands in women. So-called double-jointed people, who have
PREPARING FOR YOUR APPOINTMENT Depending on the severity of your condition, your GP might refer you to a rheumatologist or even an orthopaedic surgeon. To prepare for your appointment, it might help to write lists of the following:
I MAG ES GETTY/GALLO IMAGES, SUPPLIED
Your symptoms. A medical history of any medical problems you’ve had. A family medical history – parents and siblings. All of the medications you take – prescription, over the counter, dietary supplements, herbal remedies, anything. Questions you have for the doctor.
hypermobile joints, will have increased risk too. Obesity is also a risk factor for osteoarthritis of weight-bearing joints such as hips or knees.’ Even injuries that occurred many years before and have seemingly healed can increase your risk, particularly if it was the kind of injury that occurred from playing sport or from an accident. And if your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
PREVENTING THE ONSET OF OSTEOARTHRITIS
There’s no cure for osteoarthritis, but you can try to prevent it, or at least slow its progression if it takes hold. ‘Strong muscles protect joints, so supervised exercise is important,’ says Dr Spargo. ‘In addition, control of other medical conditions such as diabetes is important.’ And then, she says, it’s imperative to ensure you stay at the correct weight for your height, and eat a healthy diet with a high intake of omega 3-rich foods and a low intake of red meat.
‘Simple analgesics should be the starting point for treating osteoarthritis, with anti-inflammatories as required,’ says Dr Spargo. It’s important to remember, though, that non-steroidal antiinflammatory drugs (NSAIDs) can cause stomach upset, cardiovascular problems, gastric bleeding, and liver and kidney damage, so ensure you take them only as prescribed, and pay heed to your pharmacist’s instructions, as some are to be taken with food and some without. ‘Joints may be injected intermittently too,’ says Dr Spargo. During this procedure your doctor will numb the area around your joint, place a needle into the space inside your joint and inject cortisone into it. You can only have this done three to four times a year at most, because cortisone can actually worsen joint damage over time.
MEET OUR EXPERT
OMEGA 3-RICH FOODS Omega 3-rich foods can help with arthritis. Here are some examples: • Oily fish like salmon, mackerel and herring • Canola oil • Flaxseed and flaxseed oil • Wild rice • Eggs • Edamame/soybeans • Walnuts
Finally, says Dr Spargo, ‘joint replacement surgery is an option for those with significant functional impairment and pain’.
LEARNING TO LIVE WITH OSTEOARTHRITIS
As Dr Spargo has pointed out, supervised exercise is important to keep your muscles strong, which supports your joints – your physiotherapist will be able to help with that. Gentle, more general exercise that you do by yourself can also help – like swimming or walking. It can also help to see an occupational therapist, who will assist you in coping with everyday tasks that have become difficult. Simple interventions like finding a toothbrush with a large grip can make life easier if you have osteoarthritis in your fingers. If your knees are the problem, a shower chair might relieve the pain of standing to shower. Osteoarthritis is painful and, as it progresses, it can be debilitating. But the good news is that there are many ways to manage it well, and live a happy, healthy life in spite of it.
Dr Cathy Spargo studied medicine at the University of Cape Town and practises from Life Vincent Pallotti Hospital. She has a special interest in rheumatoid arthritis and osteoporosis, and keeps fit by running.
â€˜MY WIFE GAVE ME
her kidneyâ€™ Husband and wife Dennis and Faye Naicker share more than love, ever since Faye decided to give Dennis one of her kidneys. As told to Lynne Gidish
I MAG ES GETTY/GALLO IMAGES, SUPPLIED
was diagnosed with type 2 diabetes about 15 years ago and when I went for my annual check-up at the beginning of 2012, my endocrinologist immediately referred me to a nephrologist as she wasn’t happy with my blood results. I thought she was over-reacting, so it was a huge shock to hear I was experiencing renal failure. ‘The doctor suggested surgery to put in a fistula and that I start dialysis as urgently as possible, but I refused to accept this. We compromised with me visiting the doctor regularly so he could closely monitor the situation, but there was no doubt that my kidney function was rapidly deteriorating. When he told us he was putting me on the organ transplant waiting list, my wife Faye asked him to test her as a possible donor. I refused. We have two children and our son was only four years old at the time, and I didn’t want to compromise her health in any way. But Faye insisted, so we started the testing process and amazingly discovered that she was a perfect match! ‘By that stage I had no choice but to start dialysis. Even though I was symptom-free, both my kidneys were failing and I was sent to the dialysis unit at Life Fourways Hospital, where I received the most wonderful care. The entire team was completely professional and made every twice-weekly session as comfortable as possible. ‘Because Faye and I were not related other than by marriage, we had to get government approval for the transplant, and for the next four months we chased the Department of Health, phoning and emailing them about the status of our request. Unfortunately these things take time and we drove people mad with our continuous pestering, but we both wanted to get this over with as quickly as possible. When the call finally came that we had their approval, I couldn’t stop crying. ‘Before I received my kidney on 5 February 2013, Faye endured further invasive tests and iron transfusions, and she never once complained. She remained extremely positive throughout, firmly believing, as I did, that this would turn out for the best. Of course we both knew that anything could happen on that operating table, but she was determined to see this through. On the morning of the transplant, when the surgeon asked her
IN FAYE’S WORDS ‘Dennis is the best husband, dad, brother and son and, when we received the diagnosis, offering my kidney was the most natural thing to do. It’s been a really difficult time for us all and going through the transplant was tough. However, seeing Dennis doing so well today and living his life to the fullest makes everything we went through completely worthwhile. We are so grateful that we were able to overcome all the challenges.’
IN THE WORDS OF REENA MOODLEY, LIFE FOURWAYS HOSPITAL ERD PRACTICE MANAGER ‘“For better, for worse; in sickness and in health”: these vows were put to the test by Dennis Naicker’s condition, but he and his wifeFaye passed the challenge with flying colours. Dennis came to our kidney unit at Life Fourways Hospital in July 2012 and received dialysis for the next seven months. Faye decided to get tested to see if she could donate her kidney, rather than wait for a possible donor which, since it’s dependent on the patient’s blood group, can take between four to eight years. If a donor is not related or lives outside our borders, the transplant needs to be approved by the Department of Health, with a waiting period of weeks. Dennis was blessed to have a supportive and loving family, and Faye’s positive energy was a big contributor to his recovery. Their commitment and love for each other has stood the test of time.’ yet again if she was sure she wanted to proceed, she responded with a firm “yes”! ‘Faye was in theatre for approximately seven hours; my surgery took about four. The care and support we received at Life Fourways Hospital and the Wits Donald Gordon Transplant Unit from every member of our medical team was incredible, and it continues to be the same every time I pop in for my regular check-ups. Our families and friends stepped in when we got home, and their help, together with support from our workplaces and local church, helped us both to make full recoveries. ‘Faye is the bravest person I have ever met. Our life together has always been a strong bond of friendship and love and there’s no doubt that this experience has brought us even closer together. During our recovery we’d sit and hold hands, and every time we did so I was convinced I could feel her kidney move in me. ‘We’ve been married for 28 years and I still can’t believe how much Faye has given me: two gorgeous children, and one of her healthy kidneys so that we can walk together until the end of time. I know I am truly blessed.’
Life Renal Dialysis has 22 units across South Africa and Botswana. Contact the national office via email@example.com or on 011 219 9720 for more information.
Clinical Practice Pharmacist at Life Eugene Marais Hospital, Kashmiri Ganas agrees. ‘During pregnancy, many medications and supplements pass via the placenta directly to the foetus,’ she says. ‘Some medications and supplements can cause harm or birth defects to the unborn child, so it is of utmost importance to consult your doctor before taking any medication or supplement. The same holds true if you are breastfeeding.’ Most medications on the market haven’t been registered for use in pregnancy – because pregnant women and their unborn babies are so vulnerable, pharmaceutical companies are unable to do trials to determine drug safety.
MEDICATION TO AVOID
There will be times in your pregnancy when you simply don’t feel well, and you’ll wonder whether or not it’s safe to take the same medication you took before you got pregnant. Charlene Yared-West investigates
n the late 1950s, the drug thalidomide was released as a nonaddictive sedative, which could also effectively treat morning sickness in pregnant women. It was distributed to 46 countries – and what followed was a medical disaster in which over 10 000 children were born with severe, debilitating malformations*. ‘That was one of the most devastatingly tragic events in medical history. However, it is rare for something like that to happen today, when women are more informed about what’s safe and what’s not – and do 18
question everything,’ says Dr Billy Joseph Jacobs, gynaecologist and obstetrician at Life The Glynnwood. ‘We encourage our patients to clear the medications they are on with us – and if they are experiencing symptoms, to check what medications are safe to take now that they are pregnant. ‘The greatest risk to the baby is in the first trimester, when all the organs are forming. Oral medication used for acne is especially dangerous then. It’s best to avoid all medication in the first trimester, unless it’s been prescribed by your doctor.’
According to Dr Jacobs, medication containing alcohol and pseudoephedrine, which is found in common cold and flu preparations, as well as aspirin and anti-inflammatory agents such as ibuprofen and diclofenac, are not safe in pregnancy and should not be taken, unless directed under the supervision of your treating doctor. ‘Each medication has a risk-factor classification associated with it and it is on an individual basis that safety is established,’ he says.
CHRONIC MEDICATION IN PREGNANCY
Kashmiri adds that it is important to inform your doctor of chronic illnesses. ‘Your doctor will then look at the riskbenefit ratio when deciding whether or not to continue treatment. ‘Conditions that require treatment, such as epilepsy and depression, must be treated adequately, as failing to do so may result in a risk to mother and baby. The doctor will review all medication taken to treat the chronic condition and establish whether it is safe to take while pregnant. If not, an alternate drug may be prescribed, or further collaboration with the physician may be required.’ Dr Jacobs agrees, adding that it’s imperative that all medication is taken as prescribed, according to the correct dose, quantity and frequency, as any deviation may harm you or your baby. ‘Always read the label and look for allergic reactions, expiry dates and warnings – and be wary of side effects. Be careful not to mix up your medications, or skip taking them.’ *Source: www.ncbi.nlm.nih.gov/pmc/ articles/PMC4737249
Dr Jacobs and pharmacist Kashmiri share their advice on how to alleviate some common pregnancy conditions from A to Z. COMMON CONDITION
MEDICATIONS AND REMEDIES GENERALLY CONSIDERED SAFE**
EXAMPLES OF PRODUCTS
Saline nasal spray
Use medication with caution – consultation with a doctor is preferred. If allergic reactions last longer than a day or two, see your doctor.
Common colds and flu
Saline nasal spray Hedera helix (ivy leaf extract) syrup Paracetamol
Salex® Prospan® Panado®
If you suspect a respiratory infection, your doctor should be consulted.
Ispaghula husk Oral macrogol-containing solution Glycerine suppositories
Fybogel® Movicol® Lennon Glycerin®
Increase fibre and fluid intake, and add dried fruit, prune juice and bran to your diet.
Oral kaolin-pectin Oral diosmectite Oral rehydration solution
Gastropect® Smecta® Rehidrat®
Contact your doctor if diarrhoea is severe, stools are bloody or symptoms continue for more than 24 hours. Replace lost fluids with a rehydration solution.
Faintness and dizziness
Prenatal vitamins Folic acid Magnesium
Pregnavit® Be-Tabs Folic Acid® Slow-Mag®
Rest, elevate feet and eat a balanced diet. If persistent, contact your doctor as this may signal low iron levels. Folic acid also helps prevent spina bifida in the baby.
Suppositories/ointment containing bismuth subgallate or witch hazel
Anusol® or Preparation H®
Constipation aggravates haemorrhoids, so increase fibre and fluid intake. Don’t delay bowel movements. Sitting in a warm bath may alleviate some symptoms.
Stay hydrated. If not alleviated, contact your doctor, as this may be a sign of elevated blood pressure. If feverish, contact your care provider immediately.
Heartburn and indigestion
Oral product containing sodium alginate, calcium carbonate and sodium bicarbonate Antacid Oral product containing calcium carbonate and magnesium carbonate Oral product containing aluminium hydroxide, magnesium hydroxide and simeticone
Taking a warm bath can help with achy muscles.
Nausea and vomiting, morning sickness
Oral product containing dicyclomine, doxylamine and pyridoxine Syrup containing phosphoric acid
Identify foods that may trigger symptoms. Start the day with a dry, bland meal such as toast, and eat more frequent, smaller, less fatty meals throughout the day.
Mild steroid creams
Ask your pharmacist or doctor for advice. Using mild steroid creams for a day or two is safe.
Urinary tract infection (UTI)
Urinary alkalinising agent
Contact your doctor immediately if symptoms occur. Citro-Soda only provides relief from the burning sensation when urinating; it cannot cure the infection.
Vaginal yeast infection
Contact your doctor to prevent harm to the unborn baby. Use a probiotic like Inteflora when recurrent.
If not relieved by sitting or lying down, see your doctor. You may have high or low blood pressure or glucose levels, which can cause harm to the unborn baby.
Steer clear of foods that exacerbate symptoms.
I MAG ES GETTY/GALLO IMAGES, SUPPLIED
** There may be exceptions and therefore all self-medication must always be discussed with your doctor first.
MEET OUR EXPERTS
Kashmiri Ganas is a clinical practice pharmacist at Life Eugene Marais Hospital. She loves that her job allows her to work within an interdisciplinary healthcare team, and being based in ICU means she’s able to expand the reach of pharmacy while still providing quality patient care.
Dr Billy Joseph Jacobs is a specialist gynaecologist and obstetrician. He’s currently the lead obstetrician at Life The Glynnwood – here he’s responsible for implementing the Better Obs programme, which aims to improve mother-and-baby safety during pregnancy and delivery. WWW.LIFEHEALTHCARE.CO.ZA
T H E WA Y W E E A T
THE GOOD EGG
Once upon a time, the humble yet nutritious egg was cast as the evil henchman in many a dietary tale, but the narrative is changing. Life Healthcare magazine talks to two dietitians about the punch this protein powerhouse packs. By Sam Brighton
f you eat eggs, have we got good news for you. Not only are these little wonders affordable, but they are also highly nutritious and a rich protein source. Plus, some research suggests eating them can help with your satiety (feeling full and satisfied). ‘Eggs are also rich in several other nutrients including vitamins A and D, selenium, choline, a variety of the B vitamins and the antioxidants lutein and zeaxanthin,’ says Megan Lee, a registered dietitian at the Heart and Stroke Foundation South Africa (HSFSA) in Cape Town.
Let’s get this out of the way: yes, eggs are high in cholesterol. In fact, eggs are one of the richest food sources of cholesterol, containing on average seven times more cholesterol than the same amount of beef, says Megan. But dietary cholesterol is unlikely to influence your blood cholesterol level. Kelly Francis, a dietitian at Life Westville Hospital in Durban, explains that, rather than dietary cholesterol, ‘saturated fats are responsible for raising LDL (“bad”) cholesterol levels in the blood’. In other words, it’s more likely to be the bacon than the egg in your breakfast that could raise your blood cholesterol.
SIX OF ONE, HALF A DOZEN OF ANOTHER How many eggs are too many? Both Kelly and Megan advise around seven eggs a week can be eaten as part of a healthy diet. However, this number is relative to the rest of your diet. Megan elaborates: ‘Someone who regularly eats meat and has lots of eggs in addition to that, will have a higher dietary cholesterol intake. For someone who seldom eats meat, restricting eggs is less of a priority. Ideally, eggs should be used as an alternative protein to meat as part of a dish, not in addition.’
EGGspand your repertoire A variety of eggs are now readily available to offer a once-in-a-while alternative to hens’ eggs. QUAIL EGGS They may be small, but they are potent! A small quail egg contains the same energy and protein as a hen’s egg, but more than double the iron. GOOSE EGGS Higher in monounsaturated fat and cholesterol than hens’ eggs, these have 10% more protein per 100g. DUCK EGGS A duck’s egg contains more fat, folate, cholesterol and iron per 100g than the other eggs listed here. It’s a nutritional golden nugget.
I MAG ES GETTY/GALLO IMAGES, ISTOCK, SUPPLIED
The way your eggs are prepared also plays a part in ensuring your diet is balanced and healthy. ‘Eggs should be boiled, poached or scrambled rather than fried,’ Kelly advises. ‘Everyone can benefit from eggs cooked without adding butter, vegetable oil or coconut oil.’ The yolk of an egg contains 99% of its fat, which has resulted in some diets advocating egg-white-only meals. However, Megan explains that ‘the egg’s yolk and white have very different nutritional profiles where neither are “healthier” but simply provide different nutrients’. The yolk may have more fat, but it also houses many of the egg’s fat-soluble vitamins – especially vitamins A and D.
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ARE EGGS FOR EVERYONE? While eggs are a great addition to a healthy diet, there are certain cases where caution should be taken. Kelly notes that pregnant women should only eat well-cooked eggs that have been washed and checked for cracks prior to cooking. It is necessary to note that the high cholesterol content of eggs can still push up blood cholesterol in some people, which is a concern for those who are at high risk of heart disease or if blood cholesterol levels remain elevated despite treatment. So it’s important you are aware of your blood cholesterol level if eggs are part of your diet. ARE SOME EGGS BETTER? In most supermarkets you’ll be presented with the option of purchasing either free-range or organic eggs in addition to ordinary eggs. According to Megan, there is some research to suggest that free-range eggs have a higher total fat content than regular eggs – which is mostly made up of good fats. However, as Kelly explains, while free-range chickens have access to an outdoor space, they aren’t necessarily fed with organic food and may receive antibiotics and other medications, unlike those producing organic eggs. These different classifications focus mostly on the welfare of the chicken, and it’s that consideration that’s likely to influence your choice. THE RETURN OF THE EGG Have your omelettes, boiled eggs, quiches and more: the egg has pride of place in a healthy diet. Due to being rich in cholesterol, eggs were considered an occasional treat before now. But in 2015, a report by the United States Dietary Guidelines Advisory Committee (DGAC) stated: ‘Previously, the dietary guidelines
for Americans recommended that cholesterol intake be limited to no more than 300mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol. Cholesterol is not a nutrient of concern for overconsumption.’ So, let’s get cracking on breakfast.
CRACKING THE EGG Here’s a look at what’s under the shell. • A large egg weighs about 50g. • Each egg contains around 300kJ, with 75% found in the yolk. • Each egg contains around 6g of protein, with 60% found in the egg white. • A large egg contains 186mg of cholesterol. • Eggs, second only to liver, are the best dietary source of choline, which is important for brain development and muscle movement.
Megan Lee is a registered dietitian who received her Bachelor of Dietetics degree at the University of Pretoria in 2012. She works at the Heart and Stroke Foundation South Africa (HSFSA) in Cape Town, where she enjoys educating the public about prevention of cardiovascular disease.
Kelly Francis is a registered dietitian with a BSc degree in Dietetics from the University of KwaZulu-Natal. She practises independently at Life Westville Hospital, and enjoys sharing her knowledge of how good nutrition can help to maintain health, manage disease and improve quality of life.
Blood & Infusion Warmer
Highly accurate, intelligent, microprocessor-controlled device suited to all medical departments: • Blood transfusion / infusion during or after surgery • Routine blood transfusion and infusion in the clinical setting • Blood return feeds / dialysis ﬂuids • Enteral / parenteral nutrition and rinsing solutions • Infusion suitable for children and neonates
Standard infusion tube for medical ﬂuids or blood Safety features include: • Permanently run self-tests; • Double independent over-heating protections and automatic cut-off; • Visual and acoustic alarm for high / low temperature or sensor fault Big LED screen showing operating information and fault situation
Holder for warm proﬁle Visual check of the infusion ﬂow from the opening Electronic warming proﬁle controlled by sensors Cable to warming proﬁle Optimal heating up to the patient
GOLDEN RULES OF
WORKPLACE SAFETY Workers have a great responsibility to keep safe and on World Day for Safety and Health at Work on 28 April, you might want to remember these tips, says Samantha Page you harm is an important step to keeping yourself safe.
Protect your back
Back injuries are more often than not the result of minor injuries, slipped discs or arthritis, and pain can range from acute to chronic. If you work at a desk, keep your shoulders aligned with your hips, and if youâ€™re picking up things, use the correct form (bend your knees) so you take the pressure off your spine.
Take a regular breather
These days, many workers are deskbound so you need to schedule regular breaks throughout your day. Several work-related injuries and illnesses occur because employees are stressed or burnt out, so stay fresh and keep your concentration at its best at all times.
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he modern workplace has evolved dramatically over the past couple of years and according to a Gallup report, the average time worked by full-time employees has ticked up to 46.7 hours a week, which is nearly a full extra eight-hour day, reported The Washington Post. Spending more time at work means that your health and safety is more at risk, but the onus is on you to be alert and awake and constantly make your wellbeing a priority.
A successful workplace safety plan encourages employees to identify unsafe behaviours, to recognise opportunities to improve your safety and to make well-informed decisions during your daily tasks. These tips might help renew your focus.
Be aware of your surroundings
All accidents are preventable, and being keenly aware of the hazards of your workplace and any changes to your immediate environment that may cause
The abuse of alcohol and drugs in the workplace puts your colleagues and you at risk. Workers who misuse addictive substances are 2.7 times more likely than other workers to have injuryrelated absences, which could jeopardise your job security. Check your behaviour and get professional help if you suspect you have a problem.
In case of an emergency
If an accident happens at work, you need to be prepared. Make sure you know where the emergency exits are and familiarise yourself with the company or buildingâ€™s evacuation plan. You should also ensure that your HR manager has an updated list of your emergency contacts and medical aid information. The last thing you want in a crisis is unnecessary chaos.
TAKING CHARGE OF BIPOLAR DISORDER
Extreme highs and lows characterise bipolar mood disorder. It can affect anyone and makes it difficult for them to carry out daily tasks. However, with the right treatment and support, it can be managed, writes Gillian Warren-Brown
ursts of energy and goal-driven activity with very little need for sleep sounds like a recipe for go-getter success. But when it’s accompanied by inflated self-esteem and irrational decisions and, after a few weeks, a mood swing to the other end of the spectrum, it’s time to get help. ‘These extremes of a manic or hypomanic high followed by a depressive low represent the two poles of bipolar mood disorder, formerly called manic depression,’ says Dr Theshenthree (Shen) Govender, a specialist psychiatrist based at Life Entabeni Hospital and Life St Joseph’s in Durban. It is a mental illness, not a character flaw, she emphasises. ‘The brain is an organ and, like any other organ in the body, it can malfunction.’ Bipolar disorder can affect anyone, inhibiting their ability to function. In particular, for those with a genetic predisposition, psychological and environmental stressors – even something positive such as the birth of a child – could precipitate the onset of symptoms. Although it can’t be cured, the disorder can be managed. According to the South African Depression and Anxiety Group (SADAG), one percent of South Africans are affected by bipolar disorder, which is in line with the World Health Organization (WHO) statistic for global prevalence.
The type of disorder depends on the symptoms. Bipolar I: manic highs and depressive lows. From being euphoric, invincible and energetic, a patient sinks into despair, feeling useless and unable to manage life. The manic phase can lead to psychosis. 24
What is ELECTROCONVULSIVE THERAPY? While electroconvulsive therapy (ECT) is controversial due to perceptions based on the old-fashioned technique, it is now safe, effective and done in a theatre with an anaesthetist, says Dr Govender. Small electrical currents are passed through the brain, triggering a brief seizure, which changes the brain chemistry and controls symptoms. A possible side effect is short-term memory loss. ECT may be used for patients who can’t take medication (such as pregnant women), if the standard treatment isn’t working, or if a patient is manic and highly suicidal or severely depressed and catatonic, says Dr Govender. Bipolar II: hypomania, and usually more depressive episodes. Hypomania is more subtle than mania and doesn’t lead to psychosis. Cyclothymia: hypomanic and depressive cycles occur over a two-year period, but the symptoms are not full-blown.
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Dr Theshenthree (Shen) Govender is a specialist psychiatrist in private practice. She is based at Life Entabeni Hospital and Life St Joseph’s and is on the executive committee of the SA Society of Psychiatrists.
A clinical diagnosis is made by a psychiatrist, based on symptoms, history and genetic predisposition. Dr Govender says it’s essential to rule out that symptoms are being caused by a medical condition such as a brain tumour or stroke, medication prescribed for other illnesses, or drug abuse. Dr Rani Samuel, a clinical psychologist who consults at Life St Joseph’s, says when the symptoms are tracked back, it’s usually clear that there’s been ‘a persistent emotional unravelling’ for at least a few weeks. ‘Anyone can have mild mood fluctuations, but in bipolar disorder the mood changes are quite marked,’ she says. ‘A proper diagnosis by a skilled clinician is necessary. Input from family about the patient’s mood swings and behaviour changes can also be helpful in this regard.’ I MAG ES GETTY/GALLO IMAGES, SUPPLIED
The type of bipolar disorder and the phase a patient is in dictate the appropriate treatment. ‘If a patient is in a manic episode, there’s a risk of suicide, so we need to stabilise them. If they’re psychotic, sedation might be necessary,’ says Dr Govender. If a patient is in a depressive phase, a picture of behaviour over time is key because if depression is diagnosed and antidepressants are prescribed, these could precipitate a manic episode.
Long term, a mood stabiliser is the mainstay for managing and controlling the disorder. ‘The medications are optimised according to clinical response, so monitoring, patient compliance and follow-up is essential,’ says Dr Govender. ‘If a patient defaults prescribed medication and relapses, they are more likely to have an extended episode with increasing episode frequency that becomes progressively destructive,’ she adds. Dr Samuel says that alongside medication, psychotherapy for bipolar mood disorder is fundamental to managing the condition. Nurse Grace Maleka, Clinic Manager at Life Carstenview, advises that family members of those affected by bipolar seek out help too. ‘While a patient is still in hospital, it’s important for an interdisciplinary team to start educating and working with the patient and their family. It helps everyone understand and cope with the illness, and the family learns how they can best support their loved one,’ she says.
Dr Rani Samuel is a clinical psychologist in private practice and consults at Life St Joseph’s. She does crisis-intervention work and longer-term intensive psychotherapy, and is the author of three books.
Nurse Grace Maleka is the clinic manager at Life Carstenview in Midrand. She holds a master’s degree in Mental Health and completed her research on the topic of electroconvulsive therapy (ECT).
Life Mental Health has nine units around the country: Eastern Cape • Life Hunterscraig Private Hospital, Central, Port Elizabeth: 041 586 2664 • Life St Mark’s Clinic, Southernwood, East London: 043 707 4400 Gauteng • Life Glynnview, Benoni: 011 741 5462 • Life Poortview, Roodepoort: 011 952 3000 • Life Riverfield Lodge, near Fourways, Sandton: 086 074 8373 • Life Carstenview, Midrand: 011 655 5791 • Life New Kensington, Kensington: 011 538 4700 KwaZulu-Natal • Life St Joseph’s, Berea, Durban: 031 204 1300 Western Cape • Life St Vincent’s, Pinelands, Cape Town: 021 506 5360
DON’T LET STRESS
Life is stressful! However, what matters is not the number of stressful situations we are exposed to, or the amount of stress we have to withstand, but rather how we deal with and perceive stress. Take our test to find out if you cope with stress in a healthy way
GET YOU DOWN Read every statement carefully and indicate which option applies best to you, answering with your typical behaviour in mind. After finishing the test, you can add up your points using the scoring table and view the relevant results for you. WHEN THERE’S A GREAT DEAL OF STRESS IN MY LIFE… 1. I try to think of ways I can change my situation to make it better. A Exactly like me B A lot like me 26
C Somewhat like me D A little like me E Not at all like me 2. I try to find people who can offer me information or otherwise help me with my problem. 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. I seek out emotional support from others. 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. I remind myself to focus on the good things in my life instead of the bad. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
6. I seek out more leisure activities to occupy my thoughts and time. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
5. I find an outlet to express my emotions (writing in a journal or blog, playing some music, drawing or painting, exercise, etc.). A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
7. I throw myself into reckless behaviour (for example, bingedrinking, impulsive spending, physically dangerous activities). A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
8. I try to think about how lucky I am when compared with those who have even more difficult problems. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me 9. I take time to relax. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
I M A G E S G ET TY/GALLO I MAG ES TE ST COPYR I G HT 2018 – WWW.QU E E N DOM.COM
10. I find reasons to laugh. A Exactly like me B A lot like me C Somewhat like me D A little like me E Not at all like me
S C O R IN G YO U R S E LF QUESTION 1 2 3 4 5 6 7 8 9 10
A 10 10 10 10 10 10 0 10 10 10
B 8 8 8 8 8 8 2 8 8 8
C 5 5 5 5 5 5 5 5 5 5
D 2 2 2 2 2 2 8 2 2 2
E 0 0 0 0 0 0 10 0 0 0
Your coping skills could use some working on, as you don’t seem to be employing very healthy techniques to deal with stress in your life. The good news is that coping skills, like many other skills, can be improved. When you are feeling stressed, evaluate the source of it. Is it something you can control or is it out of your hands? It’s important to gauge the level of control you have over the problem so you can use the best strategy. If the problem is something that you can change, then seek out information online or from a professional to help you resolve the problem. If it seems out of your hands, however, it may be better to learn to live with the stressful situation by seeking social support, changing the way you think about the problem, or finding ways to express what you’re feeling. By being aware of what is stressing you out and why, you will be much better equipped to handle it effectively.
While you may not always be at your best when dealing with stress, you do appear to be using some good techniques to cope with it. There is still some room for growth, however. It seems you either don’t use your positive strategies consistently, or you occasionally fall into negative habits. Although it can be difficult to come up with a coping strategy when you’re under pressure, there are some simple, effective ways to help you calm down and put a difficult situation into perspective. Deep breathing techniques, getting some fresh air for a few moments, or repeating some calming words to yourself are quick strategies that can be used when you are in the heat of the moment. Even a little change, like giving yourself an extra 15 minutes in the morning so that you can take your time getting ready, can make a significant difference. This calmer start will place you in a good mindset and establish a more positive tone for the day.
Everyone experiences stress of some kind, but some people deal with it better than others. You are someone who copes with hardship in a healthy and positive way. You are resilient, adaptable, and have adopted constructive strategies to help you get through difficult situations, allowing you to maintain a positive outlook and take good care of yourself during stressful periods in your life. While you may not always be able to control or change a stressful situation, there are methods you can use to at least improve your outlook and deal with any emotions that arise as a result of your circumstances. For example, consider the benefits of joining a support group when dealing with a particularly difficult issue, or the value of daily exercise, eating well, meditation and even owning a pet. Continue to improve and seek out good coping strategies to handle stress, as these are indispensable skills that can be used at work and in everyday life.
Stress is part of life. A death in the family, the birth of a baby, moving, taking a vacation, getting a job promotion, arguing… All of these common occurrences are stressful. Since stress can’t be excised from the life experience, it is very important to learn how to deal with it. We should view stress in much the same way as we view the weather. Although we might not be pleased with a rainy day, there is not much that can be done about it. We continue to go about our business in full acceptance of the rain. To deal with it we take an umbrella, wear a raincoat and maybe even rubber boots. Maybe we change our plans a little so as to spend less time outdoors. The best way to battle stress is to take a similar approach. Instead of trying to master stressful situations or make them go away, the better bet is to learn how to work around them.
LET’S MAKE MEMORIES Create beautiful experiences in nature with your family when you visit any of these five local destinations. By Erin Coe
rom stargazing in Sutherland to sleeping in treehouses along the Garden Route, South Africa has an abundance of stunning destinations that offer a holiday and an experience. For your next getaway, we suggest you pick a place that’ll enchant the adults and the kids, but remember that it’s not about staying in the fanciest hotels or investing in expensive gadgets to keep everyone entertained: it’s about creating memories that will last a lifetime.
1. TENIQUA TREETOPS, SEDGEFIELD
Want to score some brownie points with the kids? Tell them you’re spending a night in a treehouse. But this isn’t just any treehouse. Think queen-sized bed, fully equipped kitchen and a family-sized bath. That’s what you’ll get if you visit Teniqua Treetops, located along the Garden Route just outside Sedgefield. It’s this luxury combined with the natural beauty of the area that makes this accommodation so captivating. Waking up to the sound of birdsong, walking through the forest looking for reptiles and birds, or falling asleep to the sounds of unseen animals
5 3 in their natural habitat – all of these are experiences you won’t soon forget. www.teniquatreetops.co.za/ familytreehouses
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2. STARGAZING, SUTHERLAND
Located 120km north of Matjiesfontein, with a population of just 2 841, Sutherland is, quite literally, in the middle of nowhere. And the middle of nowhere is an excellent place to stargaze. Away from city lights, Sutherland’s night sky is velvety black, offering a clear view of the Milky Way. This lack of light, combined with the area’s semi-desert climate and high altitude, results in clear night skies nearly all year round. And if you need more reason to visit, Sutherland is also home to the South African Astronomical Observatory and SALT, the largest optical telescope in the southern hemisphere. Now you can tick that off your bucket list too. Whether you pitch a tent in the garden of your B&B or you join a tour, swapping the smoggy cityscape for the clear starry night will be a magical experience for the whole family. www.saao.ac.za/about/visting/ sutherland
3. BUSHBABIES MONKEY SANCTUARY, HARTBEESPOORT
In one of the many kloofs of the Magaliesberg mountain range lies the Bushbabies Monkey Sanctuary. Here, among waterfalls, lush vegetation and natural springs, orphaned and abused primates are given a second chance at life. Because of its natural diversity, this area provides the perfect environment for monkeys from around the world, and you will be able to see squirrel, spider and capuchin monkeys, as well as bushbabies and lemurs. Talk about adorable. www.monkeysanctuary.co.za
4. CANGO CAVES, OUDTSHOORN
Stalagmites, roof crystals, tunnels and chambers – there is something quite mesmerising about the Cango Caves. Located 29km from Oudtshoorn, this underground wonder is South Africa’s oldest tourist attraction. History abounds in these caves: they used to shelter Khoisan about 10 000 years ago, and the limestone belt they’re situated on was formed about 750 million years ago. If that doesn’t spark your imagination, then perhaps the rumour of a ghost in
one of the tunnels will. So, bring along your explorers and ghost hunters, and set off on an expedition deep underground. www.cango-caves.co.za
5. WEST COAST FOSSIL PARK, LANGEBAANWEG
Five million years ago our country’s West Coast looked a little different. It was lush and green and there were animals everywhere. These creatures included saber-toothed cats, shortnecked giraffes and African bears. We know this because of the fossils found in the area. The first fossils – an elephant’s tooth and a short-necked giraffe’s ankle bone – were found in 1958 when the area was still a working mine. Now, 60 years later, there have been many more discoveries. In fact, the West Coast Fossil Park contains the greatest diversity of five-million-year-old fossils in the world. To date there is a total of 80m2 of fossil bone bed available to the public for viewing. So, take a walk back in time and enjoy a guided tour – you won’t be disappointed. www.fossilpark.org.za
PRETTY. DEADLY. When Chinese Lanterns, also known as Sky Lanterns, are released from beaches, they are often mistaken for emergency distress flares. NSRI volunteers then launch rescue boats and spend hours looking for people in difficulty.
Chinese Lanterns are also harmful to the environment and are a fire hazard.
HEALTH NICU NURSES / MEDICATION TO HELP YOU QUIT SMOKING / LIFE-SAVING CPR
‘WHEN IT COMES TO HEALTH AND WELLBEING, REGULAR EXERCISE IS ABOUT AS CLOSE TO A MAGIC POTION AS YOU CAN GET.’ THICH NHAT HANH
of little lives To celebrate International Nurses Day on 12 May, Glynis Horning turns our attention to those in one of Life Healthcare’s busy neonatal intensive care units who work tirelessly to save babies born prematurely or with health problems. These NICU nurses ensure that their tiny charges are able to leave hospital with a better chance in life
ore and more babies are starting life in neonatal intensive care units (NICUs) as medical advances support previously unviable pregnancies, and as diseases of lifestyle (diabetes, high blood pressure, etc.) and the use of fertility treatment (to offset our delaying having babies) result in more premature births – that is, birth before 37 weeks. ‘These high-risk babies are often born via c-section due to maternal complications,’ says Mariana Scheepers, programme manager at Life College of Learning and board member of the Neonatal Nurses Association of SA. The nurses in these special units are, as one puts it proudly, ‘a scarce species’, dealing with life at its most fragile yet fierce. ‘If adults were as sick as these babies, most wouldn’t make it,’ says Wilna Becker, a nurse based at the Life Wilgers Hospital NICU in Pretoria.
‘Newborn babies have tremendous fighting spirit – they’re in full survival mode. You look at this tiny creature born three months early, the size of your hand, or a full-term baby born battling to breathe, and you think: they won’t last the night. But with the interventions and equipment available today in good hospitals, at the end of the day – or sometimes a number of months – you send them home with their exhausted but happy parents. It’s why we love our jobs.’ Wilna, 44, has been a neonatal nurse for 21 years. Like many, she started with a stint in general nursing, then specialised. ‘With newborns you become God’s hands, caring for them and interceding between them, their paediatricians and their parents.’ The personal qualities this calls for go beyond the skills taught in their training (a registered nursing qualification, plus
a post-basic diploma in neonatology, says Mariana). ‘You need great attention to detail and powers of observation to be able to identify problems very early,’ says Marianne Basson, 53, manager of the Life Wilgers Hospital NICU, which employs 20 neonatal nurses. ‘Your patients can’t tell you what’s wrong or where they hurt, and many are too premature or ill to signal in the usual ways. You have to be alert to the slightest change in colour, movement, response … and to react fast, without panicking already stressed parents.’ Any birth is a life-changing moment, and when a little one is at risk and parents are in unfamiliar, high-tech surrounds, they can feel alienated and anxious. Fear often mingles with disappointment and a sense of guilt, however misplaced, for not delivering a full-term, healthy child.
participate in basic care of their baby and given emotional support through communication that builds trust and confidence. This is the challenging job of neonatal nurses. ‘It’s not so much a job as an emotional journey, looking after babies and their parents,’ says Marianne. ‘We assess the babies every one to three hours. We l ta pi os ilgers H U at Life W do feeds, sometimes IC N e th in months through nasogastric ent over five sp ah ic M Little tubes, record weights, change nappies, administer medication and, as soon as it’s possible, we help mothers breastfeed and bath their babies. We encourage as much contact with their babies as the situation allows.’ For a micro preemie, such as one currently in the Life Wilgers Hospital unit – born at 24 weeks and weighing just 440g – it may mean parents simply offering a sterile finger to gently touch their baby, taking care not to over-stimulate their fragile skin. ‘As soon as she’s stable, we’ll encourage kangaroo care, where she’ll be laid on a parent’s chest.’ Marianne has 28 years’ experience in neonatal nursing, and marvels at the advances in Micah is now a thriving two-year-old – one of the many technology and clinical care. success stories of the Life Wilgers Hospital unit ‘Everything’s now far less invasive. For example, we mostly provide ventilator Hilary Barlow, a lecturer in the support with nasal prongs in baby’s Department of Nursing and Midwifery nostrils, instead of a tube inserted into at Stellenbosch University, who their lungs through their vocal cords.’ supervised research on mothers’ Newer neonatal nurses, such as experience of their pre-term infants Laurelle Johnson, 32, who started at in a NICU, puts it this way: ‘Parents Life Wilgers Hospital’s NICU three years can feel like intruders in the foreign, ago, take for granted such methods, overwhelming NICU world… On the one along with the new generation of closed hand, they’re happy about the birth, incubators. ‘They have humidifiers and but on the other, they can experience create a warm, moist, quiet, dark space extreme grief over an uncertain future.’ for baby as close as possible to a womb,’ Parents need to be prepared for what to Laurelle explains. expect in the neonatal unit, she says. The NICU nurses cheerfully shrug off They should be involved in informed the physical challenges of their work, decision-making, encouraged to which include long shifts on their feet 34
and constantly bending over incubators. ‘It’s the emotional challenges and the relationships we develop with parents that make neonatal nursing so demanding and so worthwhile,’ Laurelle says. ‘You need to be caring and compassionate, yet stay professional and objective. It’s hard at first.’ She vividly recalls her first case in the NICU, caring for premature twins born to a surrogate mom for a single dad. They were delivered at 26 weeks and weighed just 600g each. ‘The baby girl was ready to go home after three months, but the boy needed a heart operation and struggled with weak lungs. It was overwhelming for me, but you learn and grow from the experience. The twins are two years old now, and the dad brings them in to show us. They’re bright and so energetic – the boy is giving his father grey hairs!’
It’s the emotional challenges and the relationships we develop with parents that make neonatal nursing so demanding and so worthwhile Her colleagues have similar stories. Marianne fondly recalls a preemie brought in in an ice-cream tub: ‘We called her Ola! She’s now 18 months old and toddling – her grandmother brings her to see us.’ One of Marianne’s longest relationships is with the parents of a ‘very ill baby’ who is now a strapping 17-year-old in Australia. ‘He’s just got a licence for a quad bike. His parents, like many, send us pictures each year. We love seeing them, and I display them in a frame to encourage other parents.’
We were thrown into a world of medical terms and high-tech machines... Thankfully the nurses and doctors were patient, kind and accommodating ‘We need all the encouragement we can get,’ says one mom, Pretoria graphic design business owner Lia Nascimento, 30, whose son Micah (see page 34) was born at just 26-and-a-half weeks, weighing 500g. ‘Among other issues, he wasn’t getting enough blood through my umbilical cord, so I had to have an emergency c-section. When I was first wheeled into the NICU all the preemies seemed so tiny, and Micah was a third of their size – I was shocked! He needed oxygen, lots of
different medicines and several blood transfusions. He was in an incubator, and his tiny body was covered with tubes and cables. ‘We were thrown into a world of medical terms and high-tech machines that made different noises, and alarms would go off all the time. It was daunting. Thankfully the nurses and doctors were patient, kind and accommodating and talked us through everything. Micah was in the NICU for 171 days and taking him home was the best day of our lives. He turned two in December 2017 and is now a normal little boy. We are so grateful for all the NICU nurses and doctors for the love and care they gave our son.’ Most NICU patients go on to thrive, but some are diagnosed with life-threatening conditions, and a few don’t survive. ‘That’s the biggest heartbreak,’ says Marianne. ‘All you can do is be there for the parents and support them. Then you need to tell yourself “I’ve done my job” and step back. ‘I went to a funeral once, but never again. You realise that only you and the parents knew this baby. It feels like you’re burying your own child. Luckily I have two teens at home to hug, and my husband has a good shoulder to cry on. There are times I still use it.’
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Mariana Scheepers is programme manager at Life College of Learning. She has a BCur and MCur qualification and is a PhD candidate.
Marianne Basson is the unit manager of NICU and PICU at Life Wilgers Hospital. She’s currently completing her BCur degree.
Laurelle Johnson has a four-year nursing qualification, plus a post-basic NICU qualification. She began practising as a professional nurse in NICU in 2014. 36
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Wilna Becker is a registered nurse and has been part of the neonatal team at Life Wilgers Hospital since 1999.
5 reasons to visit our new website We’ve launched our new website and we’d like to introduce you to some of its features www.lifehealthcare.co.za has been designed with you, the patient, in mind. It’s fast, easy to navigate and offers an enhanced experience on your mobile device. You can:
#2 Download a pre-admission form
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If you know you are going to be in hospital overnight – or a little longer – it is helpful to have all you need to make your stay as comfortable as possible.
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For those battling with the isolation of hearing loss, a cochlear implant can break through the silence. Thanks to the expertise of Life Kingsbury Hospital’s ear, nose and throat specialist Dr Gary Kroukamp and his team, Aloshay Arendse can finally enjoy her childhood. By Carla Hüsselmann
Breaking the silence 38
loshay Arendse is an effervescent eight-year-old who loves ballet, riding her bike and dressing up in a sari to watch Bollywood movies on TV. It’s hard to believe that this vibrant girl was so sick that she nearly lost her life and lived shut off in a world of silence. Diagnosed with a rare disease called biliary atresia that damaged her bile ducts and liver irreparably, Aloshay underwent a liver transplant when she was only one year and seven months old. ‘Although the transplant seemed a success, Aloshay had to remain in hospital for 11 months as her body reacted badly to the medication needed to accept the new organ,’ relates Aloshay’s mom, Candice Isaacs, from their home in Kraaifontein in the Western Cape. Imagine Candice’s devastation then when her baby was diagnosed with haemophagocytic lymphohistiocytosis (HLH), a rare condition where white blood cells attack other blood cells, damaging bone marrow, the liver and spleen. ‘Forty weeks of chemotherapy was her only hope of beating the disease,’ says Candice. ‘It was a miracle when she only needed 28 weeks of it and could come home.’ Although Aloshay was born with normal hearing, her life-saving chemo treatment came at a cost: profound hearing loss. ‘Certain medications called ototoxic medications can damage the ear – they include those used to treat serious infections and cancer,’ explains Dr Gary Kroukamp, an ear, nose and throat specialist at Life Kingsbury Hospital in Claremont, Cape Town. ‘Aloshay was given hearing aids to help her hear again, but when I first saw her in April last year, they weren’t proving useful any more. Her options were either learning sign
I N N O VA T I O N
language, or getting an electronic hearing device called a cochlear implant (CI).’ On 9 June 2017, Dr Kroukamp and his team surgically inserted a CI for Aloshay, giving her the gift of hearing again. Candice says her daughter is finally able to enjoy her childhood. ‘Six weeks after the operation, I took Alo to the park and she asked me what the new sound was that she was hearing. I nearly cried because I realised she could hear birds chirping.’
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WHAT IS A COCHLEAR IMPLANT?
Over 5% of the world’s population – 328 million adults and 32 million children – have disabling hearing loss, according to the World Health Organization (WHO). Research by the 2011 Census shows that 2.9% of the South African population older than five (1 251 907 people) have mild to moderate difficulty in hearing, while 0.7% (288 369 people) have severe hearing loss, says Dr Kroukamp. ‘It’s estimated that about 7.5% of South African schoolchildren suffer from varying degrees of hearing loss,’ he adds. Many suffer hearing loss because hair cells in their inner ear, or cochlea, are damaged. ‘You can either be born deaf, or lose your hearing from external causes such as ototoxic medication and diseases like meningitis and mumps, or have a genetic condition where you lose your hearing over time,’ explains Dr Kroukamp. A high-tech CI provides a last resort for profound hearing loss in children and adults by replacing the function of the damaged cochlea. ‘It bypasses the cochlea’s damaged parts by electrically stimulating the hearing nerve, which then sends a signal to the brain where it’s interpreted as sound. Unlike hearing aids, which make sounds louder, CIs do the work of the cochlea’s damaged parts to provide signals to the brain. They don’t restore hearing completely, but they do help the severely hard of hearing or deaf to perceive the sensation of sound once again,’ he says. The CI device has an external component with a sound processor, which is inserted behind the ear like a hearing aid. A transmitting coil, connected to the processor, is attached to the side of the head with a magnet that then connects to the internal component. This external component picks up sound and converts it to a digital signal that’s then transmitted
to the internal component. ‘This internal component processes the sound, sending it down an electrode array, which has 22 electrodes on a silicon wire and is inserted directly into the cochlea,’ explains Dr Kroukamp. The primary benefits of CIs are spoken language acquisition as well as improved speech intelligibility, reading comprehension and high-frequency hearing, says Dr Kroukamp. ‘It also drastically improves quality of life, allowing recipients to communicate and socially interact with the world again.’
sound again, which it hasn’t done for a while – this’ll take time and require more mapping sessions,’ says Dr Kroukamp. ‘She’ll eventually enjoy near-normal volume of hearing, but she won’t get completely natural quality of hearing.’ Aloshay is now able to hear the TV thanks to the CI, which has been inserted behind her right ear, enthuses Candice. ‘She’s so much more confident these days – she used to sit at the back of her class at the Carel Du Toit Centre and not interact much with her peers, but now she’s at the front of the class and very outspoken!’
BREAKING THE SILENCE WITH SURGERY
*Some medical aids cover cochlear implant procedures.
Candice admits her world crumbled when she found out it would cost approximately R250 000* for the entire CI procedure, which includes pre-operative assessments, surgery, post-operative care and a device. ‘I realised I’d never be able to afford it, but then I received a surprise phone call telling me it was all going to be sponsored, thanks to a pro bono collaboration between Dr Kroukamp and his interdisciplinary team from the Tygerberg Hospital – University of Stellenbosch Cochlear Implant Unit, Life Kingsbury Hospital anaesthetist Dr Nick Meyersfield and the Red Cross War Memorial Children’s Hospital, as well as the Bidvest Hear for Life Trust that sponsored the CI device. We couldn’t believe so many wonderful people were willing to work together to make Alo’s life easier!’ All went smoothly on the day of the two-hour operation, which was a fairly complex surgery where Dr Kroukamp had to drill into Aloshay’s skull behind the ear and into the cochlea to insert the CI. Thankfully Aloshay’s recovery was a relatively pain-free one, says Candice. Three weeks after the op, audiologist Lida Müller switched on the CI and began conducting regular ‘mapping’ sessions to programme the device to Aloshay’s individual specifications and needs. ‘Aloshay’s brain is learning how to process
TOP Dr Kroukamp and his team performing the intricate surgery ABOVE Mom Candice whispering reassuring words to Aloshay
Dr Gary Kroukamp is an ENT specialist practising from Life Kingsbury Hospital. Dr Kroukamp’s ENT interests include ENT conditions in children, nasal allergy, sinusitis and sinus surgery, snoring, ear diseases, hearing loss and cochlear implantation, voice problems, surfer’s ear surgery and vertigo/balance disorders.
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BE A QUITTER! Smoking tobacco is one of the unhealthiest habits you can form. The good news, however, is that it’s never too late to quit, and there are medications that can help to reduce withdrawal and cravings as you take steps towards a smoke-free life. By Mandy Collins
ou can resist the evidence all you like, but the fact remains that tobacco is a killer. People who smoke it or use it in other forms, such as chewing tobacco, have a much higher risk of developing serious diseases and dying prematurely than those who abstain. We all know of someone who chainsmoked their way through life and died of old age in their 90s, but those people are few and far between. If you want to be healthier, and you smoke, one of the best things you can do is quit. It sounds simple, but of course that doesn’t mean that it’s easy. Most people don’t succeed the first time they try to quit. You might need to try more than once, but you can stop smoking – especially given the medications available today that support quitting. Fagmie Solomon, a pharmacist at Life Kingsbury Hospital in Cape Town, says that medicines available for smoking cessation are broadly available in two classes: nicotine replacement therapy (NRT) and non-nicotine replacement therapy (NNRT). ‘NRT comes in various forms, like nicotine patches, gum and oral sprays,’ says Fagmie, ‘but the most popular types in South Africa are nicotine patches and gum. These over-the-counter medications release nicotine at a controlled rate into the bloodstream. They reduce the cravings during the first weeks of quitting 40
smoking by providing the body with the nicotine it previously obtained from cigarettes, without the other harmful chemicals found in cigarettes such as arsenic, benzene, carbon monoxide and lead, to name just a few.’ But there are also two prescription medications indicated for smoking cessation, he says: varenicline and bupropion. These medications do not contain any nicotine.
Varenicline reduces withdrawal symptoms and cravings by binding to specific nicotinic receptors in the brain. This binding process activates the central nervous mesolimbic dopamine system, which ultimately provides the same experience of reward that smoking does, but to a lesser extent. When varenicline binds to the nicotinic receptors, nicotine from cigarette smoke is unable to do the same – meaning smoking won’t provide full stimulation of the central nervous mesolimbic dopamine system if you’re on varenicline treatment. Adds Fagmie:
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‘Studies show that using varenicline as part of your smoking cessation programme can increase your chances of quitting by two to three times.’ He says it’s usually started a week before your quit date, and continues for at least 12 weeks. ‘You are allowed to smoke in the first week of taking the drug, but after that you should stop,’ says Fagmie. ‘As the drug levels start increasing in your body, if you do smoke it will not be as satisfying.’ Common side effects include: • nausea and vomiting; • indigestion and gas; • headaches; • unusual dreams and insomnia; and • changes in mood and behaviour. Varenicline should not be used if you: • are pregnant; • are younger than 18 years old; • have an allergy to varenicline; • are using NRT (using the two together will not increase your likelihood of quitting); • have mental health problems; or • have kidney problems.
Fagmie Solomon holds a B.Pharm degree from the University of the Western Cape. He is a clinical practice manager and has been working at Life Kingsbury Hospital in Claremont, Cape Town, for the past five years.
‘Consult your prescribing doctor immediately if you notice changes in your mood or behaviour, if you get depressed or have any suicidal thoughts,’ says Fagmie.
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Bupropion is another medication available on prescription, which helps to reduce withdrawal and cravings. ‘Its mechanism of action in smoking cessation is not well known but it’s believed to alter chemicals in the brain that are related to nicotine addiction and craving,’ says Fagmie. ‘Bupropion can double your chances of quitting. ‘When taken as directed, bupropion can reduce anxiety, cravings and unhappy feelings that are usually associated with nicotine withdrawal. To build up the amount of drug in the body, bupropion can be started two weeks before quitting, and continued for seven to 12 weeks.’ Common side effects include: • insomnia; • dry mouth; • shaking; and • irritability. Bupropion should not be used if you: • have an allergy to bupropion; • suffer from seizures; • are pregnant; • are younger than 18 years old; • are taking a class of medication called monoamine oxidase inhibitors; • are taking medication that can increase your risk of seizures; or • have kidney or liver problems. ‘With any medication there are side effects, but these need to be weighed against the positive outcomes that can be achieved when using the medication,’ says Fagmie. ‘The benefits of using varenicline or bupropion outweigh the risks of not using it – because of the huge positive impact on your health when you give up smoking.’ Finally, remember that nicotine addiction is not just about your body physically craving a drug – there’s a psychological element too. Smoking is often a way for people to de-stress, as well as a big part of their social lives. So while the medication helps with the physical dependence and withdrawals, you will need help and support as you quit – it’s a vital component of being a successful quitter!
HELPFUL RESOURCES WEBSITES: • www.ekickbutt.org.za • www.smokenders.co.za (endorsed by CANSA) • www.allencarr.co.za BOOKS: •T he Only Way to Stop Smoking Permanently by Allen Carr (e-book) •T he Easiest Way to Stop Smoking by Heath Dingwell APPS: • LIVESTRONG MyQuit Coach (for iPhone, free) •Q uit Smoking (Android, free with in-app purchases) •Q uitNow! Quit smoking (Android, free with in-app purchases)
Just breathe Before babies are discharged from neonatal intensive care at Life Flora Hospital, their parents are now being offered basic training in infant CPR. Melanie Farrell finds out more
hat would you do if your baby stopped breathing? Would you know how to administer cardiopulmonary resuscitation (CPR)? It’s not an easy question to answer because nobody really knows how they’ll cope in a medical emergency. However, learning basic CPR skills can give you the confidence to take action in an emergency, rather than doing nothing due to panic. This is why Life Flora Hospital in Johannesburg has introduced a Baby Basics programme in its neonatal intensive care unit (NICU), to teach parents the fundamentals of infant CPR. 42
‘We believe in empowering parents so that they feel confident about taking care of their baby, by teaching them how to administer CPR to their little one before they leave the hospital,’ says Nurse Asha Jagaesar Roy, manager of NICU at Life Flora Hospital. Nurse Asha explains, ‘When a baby is in NICU the parents know that, in an emergency, the specialist skills are always there. But often they feel helpless after their child has been discharged. Parents question themselves and lack confidence regarding emergency situations. ‘Many of the babies in NICU are premature and therefore there is prolonged hospitalisation. This has
The best thing you can do ... is to stay calm. If you have some basic skills to deal with a crisis, you will cope a lot better than someone who hasn’t had training
THE BABY FILES
an impact on bonding due to limited handling of the baby, and parents need reassurance, training and education to prepare them for their baby’s discharge.’
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Darren van Zyl, a paramedic registered with the Resuscitation Council of Southern Africa (RCSA), explains the significance of the training. ‘The Baby Basics programme was developed in conjunction with the RCSA in an effort to fulfil a need to train as many parents as possible in the life-saving skills of CPR and relief of choking,’ he says. The best thing you can do in an emergency situation is to stay calm and, if you have some basic skills to deal with a crisis, you will cope a lot better than someone who hasn’t had training. ‘The steps involved in CPR are the same for everyone regardless of their age,’ says Ryan. ‘However, there is a greater emphasis on providing breaths to babies and children than for adults.’ Adds Nurse Asha: ‘Babies’ physiology is slightly different to adults because they are small: their heart and breathing rates are faster to accommodate their faster metabolic rate for growth.’ Life Flora Hospital has a team of eight Basic Life Support instructors registered with the RCSA who conduct and oversee the training, which has received much positive feedback from parents since being introduced. ‘The Baby Basics CPR programme is not a certification course but rather a demonstration (with some opportunity to practise) of what to do in an emergency,’ says Ryan. The pioneering initiative goes to show that at Life Healthcare, the emphasis is on ‘care’, even after you and your baby are discharged from hospital.
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WHAT IS THE BABY BASICS PROGRAMME? This basic infant CPR training can take place anywhere and is currently being rolled out in the NICU at Life Flora Hospital in Johannesburg.
Baby Basics CPR Here’s what to do in the event of your baby needing CPR. 1. Tap the infant’s feet firmly and check for a response. If the infant does not respond and is not breathing, place him or her on a firm, flat surface and call for help. 2. Place two fingers in the centre of the infant’s chest and begin 30 chest compressions. 3. Cover the infant’s nose and mouth with your mouth and give two breaths until you see the chest rise. Repeat 30 chest compressions, alternating with two breaths.
Source: Baby CPR Kit Find the Resuscitation Council of Southern Africa online at www.resus.co.za Visit the Facebook page on www.facebook.com/ResusCouncilSA
Darren van Zyl is an Advanced Life Support paramedic and a member of the Resuscitation Council of Southern Africa’s faculty team.
The programme was designed to be portable and flexible and consists of a pack containing: • A DVD with a full demonstration (this can be used as a recap or to show other family members or carers). • A laminated card explaining what to do in the event of choking or a baby needing CPR. This can attach to a nappy bag. • A laminated poster. The pack is sufficient as a stand-alone or as part of hands-on training, which takes 40–60 minutes (including demonstration and practice). WHAT DOES IT COST? The package and training cost R150 per person. Currently this is only available to parents of NICU babies at Life Flora Hospital.
Nurse Asha Jagaesar Roy is the unit manager of the neonatal intensive care unit (NICU) at Life Flora Hospital in Johannesburg, where the Baby Basics programme is being run.
The ‘H’ and ‘N’ refer to two types of proteins found on the surface of the virus, and are used to name and identify different strains of the disease.
Since June 2017, a highly contagious outbreak of bird flu has spread through South Africa. Fortunately for us, it’s not a variety that has been documented to infect humans. Pippa Naudé explains
vian influenza, also known as bird flu, is an infectious viral disease that affects birds – both food-producing varieties like chicken and ostrich, as well as pet birds and those found in the wild. Most strains are not transmitted to humans. The most famous exception is the Asian bird flu outbreak that occurred in 1997, and re-emerged in 2003-4 when it spread into Europe and Africa. According to the World Health Organization (WHO), since 2003 this strain (H5N1) has caused a reported 860 cases of human infection and 454 deaths in Asia and North Africa. Heather Macfarlane, a pharmacist at Life Wilgeheuwel Hospital, says, ‘The symptoms of bird flu in humans range from relatively asymptomatic to mild, flu-like symptoms including cough, runny nose, diarrhoea, body aches and headache. More severe infection includes fever, pneumonia, acute respiratory distress syndrome 44
and multi-organ failure which can lead to death.’ HIGHLY PATHOGENIC – FOR BIRDS ‘There are many different avian influenza viral sub-groups, with varying degrees of pathogenicity,’ says Heather. Fortunately, the recent epidemic in SA is a different variety to Asian bird flu. Jo McAnerney, an epidemiologist at the National Institute for Communicable Diseases (NICD), confirms the strain we’re currently dealing with is H5N8. ‘It’s transmissible to birds but not humans,’ she says. ‘Globally, H5N8 has not been documented to cause human infection.’
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Is it BIRD FLU? If you are experiencing flu-like symptoms and have been in close contact with infected birds, you should seek medical attention to rule out bird flu. Heather says, ‘A doctor will collect a nasal and/ or throat swab. It will be sent for testing to distinguish it from other seasonal flu viruses. In the highly unlikely event that treatment is needed, it is available.’ If you see dead birds anywhere, the NICD recommends you don’t touch them and that you contact your nearest veterinary service. For more information on bird flu, visit www.nicd.ac.za
Heather Macfarlane holds a B.Pharm degree and has been a pharmacist at Life Wilgeheuwel Hospital for 15 years. She has an interest in antimicrobial stewardship and clinical pharmacy, and is completing her master’s degree in Clinical Pharmacy.
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EVERYBODY’S TALKING ABOUT…
DAMAGE CONTROL At the time of writing this, the South African Poultry Association estimated that 4 million chickens had been culled. Some farms have been quarantined and the situation is being closely monitored. As a precaution, poultry farm workers at high risk of infection and who presented with symptoms were tested for the virus. All received a clean bill of health. The Department of Agriculture, Forestry and Fisheries has reassured the public that all bird meat products on supermarket shelves are safe to eat. The only difference might be that they cost more and are in short supply, as a direct result of the outbreak.
POWER OF FIVE
JUST A PINCH OF SALT Most South Africans are eating too much salt; more than the recommended amount of less than five grams per day. This can lead to increased blood pressure, in turn resulting in strokes and heart attacks later in life. Lower your intake with the following tips from Gabriel Eksteen, a registered dietitian and exercise physiologist at the Heart and Stroke Foundation South Africa
Humans become desensitised to the taste of salt with chronic high exposure, so give your body and taste buds time to adjust. If you’re still adding salt at the table, start by cutting down there. Convenience meals and takeaways never need any extra salt – a standard burger or pizza delivers two to three times the daily limit. 46
BE MINDFUL OF QUANTITIES
Give some thought to how much salt you’re adding to a dish while cooking, as well as the amount of salt that’s already in the processed foods and ingredients you’re using. There’s often no need to double up on salty ingredients – choose either a stock cube or a sprinkling of chicken spice to stir into your stew, rather than adding both.
BECOME LABEL SAVVY
Food labels display the level of sodium (in milligrams) contained in a product, which is salt together with chloride. To convert to salt in grams, use the following calculation: salt (in grams) = sodium (in milligrams) x 2.5 ÷ 1 000. Or avoid the maths and simply compare likefor-like products when shopping, choosing the low-sodium options.
DON’T COMPROMISE ON FLAVOUR
As you lower your intake of salt, your taste buds will become more attuned to subtle flavours other than just saltiness. In the meantime, add punchy elements to your food like garlic, ginger, lemon, paprika and thyme to help with the transition. In time you won’t miss the salt, and you’ll need much less of it.
EAT THE RIGHT STUFF
Make sure you include plenty of vegetables, fruit, wholegrains and legumes in your diet. You need to manage more than simply your salt intake if you want to lower your blood pressure. Eating enough potassium and magnesium works synergistically with lowering your salt levels to make even bigger improvements to your health.
C O M P I L E D BY R AADIYAH AB R AHAMS I M A G E S G ET TY/GALLO I MAG ES
CUT DOWN GRADUALLY
WHAT IS A RENAL CLINICAL TECHNOLOGIST? To commemorate World Kidney Month in March, Life Healthcare magazine spoke to renal clinical technologist Reena Moodley at Life Fourways Hospital in Johannesburg. By Erin Coe What does your average day involve?
My day is split up into two parts as I am a renal clinical technologist as well as the manager of the renal dialysis unit at Life Fourways Hospital. This means that my time is divided into both admin and clinical tasks. These include managing billing, budgets and staff, interacting with patients and overseeing patients to ensure they receive adequate dialysis treatments.
What character traits should a renal clinical technologist have?
What does a renal clinical technologist do?
Renal clinical technologists treat patients who have concerns with their kidneys. Because kidneys are responsible for filtering waste products from the blood, it’s important they work correctly. If they lose function, waste can build up in the patient’s blood making them very sick. If this happens, patients may need to undergo dialysis. Dialysis is a treatment where the patient’s blood gets filtered through an artificial kidney and returned to their body. The main function of a renal clinical technologist is to operate the dialysis machine and ensure patients are clinically stable.
What did you study?
In 1997 I started my National Diploma in Clinical Technology – Nephrology at Durban University of Technology. Once I’d completed that I spent two more years at the university to get my BTech in Clinical Technology – Nephrology.
They need to be punctual, tolerant, supportive, dedicated and responsible. They also need to be good communicators because they have to liaise with specialists, patients and family.
What is the most challenging part of your job?
The lack of knowledge and understanding in many of our communities about kidney disease is the most challenging part of the work we do. We interact with people from different backgrounds and they often don’t understand the importance of regular check-ups.
What is the most rewarding part of your job?
The reward is to see a patient after a transplant – full of happiness and smiles, no longer dependent on a machine. Also, to see critically ill patients go home and have a second chance.
What other specialists do you work with and how do you work together?
I work with a nephrologist and a vascular surgeon. A nephrologist is a kidney
specialist who provides clinical consultation to all patients suffering from kidney disease. Once diagnosed, the nephrologist decides if the patient needs dialysis. When the patient does require dialysis they are referred to the vascular surgeon. The vascular surgeon then inserts the catheter necessary to enable the dialysis procedure. After that the patient is sent to the renal dialysis unit and that’s where the renal clinical technologist comes in.
Is there any specific patient you will always remember?
An elderly gentleman came in for dialysis. He had been diagnosed with cancer six years earlier, but he was still so positive and resilient and he fought until the end. He didn’t let his illness stop him from travelling and having fun with his grandchildren. Even when his medical aid wouldn’t pay for certain things he never gave up. He taught me that no matter what life throws at you, you must get up and fight.
What is your motto at the office?
When I started at Life Healthcare in 2009 my motto was ‘Always treat a patient as if it were you receiving dialysis’. This is a reminder to treat everyone with kindness and empathy.
How important is organ donation?
So important! There are so many patients in need of a kidney transplant and the waiting list is long – often up to eight years, depending on the blood group of the patient. We really need communities to understand that organ donation is a gift of life.
HYPERTENSION THE SILENT KILLER? High blood pressure is a common condition in South Africa and is a major risk factor for heart attacks, stroke, kidney disease and congestive heart failure. It is commonly underdiagnosed and inadequately treated.1 More often than not, there are NO symptoms. Hypertension is the silent killer! Symptoms can range from headaches, a "fuzzy" feeling or nausea to absolutely no symptoms at all. If there is one test you should be doing often, it`s a blood pressure reading.1
Research shows that any person that uses some form of blood pressure medication will live longer.2 We, at Sun Pharma, are proud to be a partner in ensuring that patients who are hypertensive have access to high quality medicines in South Africa and around the world. Sun Pharma has an array of anti-hypertensive medicines at affordable prices that are obtainable at your local pharmacy. Sun Pharma is the 4th largest generics company globally with medicines sold in 150 countries.
Reaching People. Touching Lives. References; 1. South African Hypertension Society website; www. www.hypertension.org.za. 2. ACC/ AHA 2017 Hypertension Guidelines; www.acc.org/latest-in.../2017/.../2017-guideline-for-high-blood-pressure-in-adults
CARE WOMEN AND HYPERTENSION / VACCINATION BASICS / MEDITERRANEAN COOKING
‘CARING ABOUT OTHERS, RUNNING THE RISK OF FEELING, AND LEAVING AN IMPACT ON PEOPLE, BRINGS HAPPINESS.’ HAROLD KUSHNER
DON’T WAIT: VACCINATE! Life West Coast Private Hospital embraced National Pharmacy Month 2017’s theme of ‘Don’t wait – vaccinate’ with a unique initiative to spread the word in the community. By Lynne Gidish
accinations are receiving a lot of hype in the world today. With the internet at our fingertips, it’s easy to access all sorts of information, and whether or not to vaccinate has become a hot topic for discussion globally. However, as Life West Coast Private Hospital’s Pharmacy Manager Elnette
du Toit says, ‘The sources of online information are not always reliable and with people tending to trust social media more than medical science today, we’re finding vaccination percentages going down all over the world. As a result, we are unfortunately experiencing outbreaks of dangerous vaccinepreventable diseases such as measles,
which can have serious life-threatening consequences for children and adults.’ The World Health Organization (WHO) cites measles as one of the leading causes of death among young children. Although the vaccine resulted in an 84% drop in measles deaths between 2000 and 2016 globally, there are still outbreaks throughout the world due to parents choosing not to vaccinate, including right here in South Africa. According to News24.com, during the last big outbreak of measles from 2009 to 2011, there were 18 431 confirmed cases of the disease in our country, with 18 deaths among the 552 cases treated at Cape Town’s Red Cross War Memorial Children’s Hospital. Last year, the National Institute for Communicable Diseases (NICD) confirmed there were measles outbreaks in the Western Cape, Gauteng and KwaZulu-Natal, which resulted in the Department of Health ramping up its vaccination campaign. ‘The problem,’ says Elnette, ‘is that when you choose not to vaccinate, you don’t just put your own child at risk. You put all children at risk, especially babies, since the first measles vaccine is only given at six months. It’s true that there are some side effects of the vaccine, as with any other medication, but these need to be carefully weighed up against the benefits it offers. That’s why we decided to go all out to create awareness in the community, promoting the importance of vaccinations in safeguarding the health of the country. ‘Vaccines provide immunity from many infectious diseases,’ she continues, ‘and help to prevent the spread of the more serious ones such as measles, which can have fatal consequences. ‘Our awareness initiative focused on the benefits of vaccination, what vaccines protect against, where they are available and when they should be administered. Our aim was to educate people about protecting their families, so we went back to the beginning and started in the maternity ward.’
LIFE PLUS VACCINES: THE REAL TRUTH A now-retracted study published in a well-respected medical journal in the late 1990s caused panic among parents with its suggestion of a possible link between vaccines and autism. It was confirmed later that the author falsified the study’s results, and in 2004 most of the co-authors withdrew their names from the study after it was discovered that the author also had undisclosed conflicts of interest and received payment from a law firm intending to sue vaccine manufacturers. The study resulted in many parents not vaccinating their children against measles, which led to worldwide outbreaks. In 2010 the medical journal finally retracted the paper, calling it an ‘elaborate fraud that has done long-lasting damage to public health’, as reported by CNN.
BUT WHAT ABOUT PORK GELATIN?
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Parents with certain religious beliefs may be concerned about the fact that some vaccines are made using pork gelatin. Muslim parents should be aware that the Islamic Medical Association of South Africa (IMASA) released a statement, which can be viewed on the National Institute of Communicable Diseases (NICD) website, that confirms its endorsement of vaccination of Muslim children.
Elnette and her team created unique fridge magnets featuring the South African vaccination schedule, to help new parents remember when their child’s vaccinations are due. These were distributed in Life West Coast Private Hospital’s own maternity ward, as well as at the local provincial hospital, while the hospital’s paediatricians and gynaecologists were also involved in distributing the magnets in their practices.
MEET OUR EXPERT
‘We’re still handing out magnets to new families in our maternity ward, and we’ve received positive feedback from parents, as they often forget when their baby’s next vaccination is due,’ says Elnette. ‘No one can force you to vaccinate, but please consider it. If you are concerned about side effects, don’t try to research them alone. Rather chat to your doctor or pharmacist, who will help you make an informed, scientifically based decision.’
Elnette du Toit is Pharmacy Manager at Life West Coast Private Hospital, and in this position she strives to make relevant information accessible to as many people as possible. Elnette believes Pharmacy Week is one way to do that.
In its statement, the association said the following: ‘IMASA is well aware that the Glorious Qur’an forbids Muslims from consuming pork (Al-An` m, 6:145) and in view of this particular ayah, Muslims in general are uncomfortable when they come to learn that porcine elements are used in the manufacturing process of certain vaccines.’ It noted that in 1995, more than 100 Muslim legal scholars participated in a seminar convened by the Islamic Organization for Medical Sciences on this topic. The consensus was that ‘transformation of pork products into gelatin alters them sufficiently to make it permissible for observant Muslims to receive vaccines containing pork gelatin’. Jewish parents should note that the Kashrut Department of the Johannesburg Beth Din confirmed on behalf of the Jewish community that it has been deemed permissible for children to be vaccinated against measles. The official letter of approval is published on the NICD’s website. WWW.LIFEHEALTHCARE.CO.ZA
TAKE THE PRESSURE OFF ‘I
Hypertension, or high blood pressure (HBP), is one of the leading causes of heart disease globally – and women are more at risk than many realise. Tracy Melass looks at the highs and lows of this condition
’ll admit I was a bit shocked at my diagnosis. Although I’m not the healthiest person I know, I take pretty good care of myself, and I’m young. But I’ve come to terms with it.’ Maria, a Cape Town mother of two, learnt she suffered from hypertension during a routine check-up after the birth of her second child, 12 years ago. Maria has been taking medication ever since and her condition is now just a part of her everyday life. ‘I take it as chronic medication and it’s covered by my medical aid, so I don’t really think about it.’ She
tries to keep healthy by doing weekly exercise classes (water aerobics and yoga), riding horses and participating in the occasional Park Run. ‘My high blood pressure is not a problem in my daily life at all,’ says Maria, ‘and if anything, it keeps me focused on my health.’ Maria’s journey is a lot more prevalent than one would imagine.
THE GENDER FACTOR
HBP is the most common condition attended to in primary healthcare facilities
But why is hypertension such a feared condition? According to HSFSA, around 40% of heart attacks, one in every two strokes and most cases of heart failure can be directly attributed to HBP. Around 65% of cases of kidney failure in South Africa are attributed to uncontrolled HBP. Hypertension is an important risk factor for heart disease in women. Dr Nischal Gathiram, who’s based at Life Westville Hospital, underscores the severity of the problem. ‘Cardiovascular disease (CVD) is a leading cause of mortality in females in every major developed country, and most emerging ones,’ he says, ‘and hypertension is the most common modifiable risk factor for CVD.’
ARE YOU AT RISK?
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in South Africa. ‘If you combine this with the fact that only half of women are aware of their hypertension, you can see the scope of the problem,’ says Gabriel Eksteen, a registered dietitian and exercise physiologist at the Heart and Stroke Foundation South Africa (HSFSA). The South African Demographic and Health Survey reports that 46% of adult women over 15 are hypertensive. Likelihood increases drastically with age, but it shows little preference for where you live, your education or wealth, or your ethnicity, says Gabriel. The worldwide prevalence of hypertension is expected to increase by 13% in females between 2000 and 2025.
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There are several risk factors for hypertension, including family history, age, race and quality of lifestyle. And while high blood pressure isn’t directly related to gender, pregnancy, birth control and menopause can increase its risk. Birth control pills may increase blood pressure. It’s also more likely to occur if you’re overweight, have had HBP during a previous pregnancy, have a family history of the condition or mild kidney disease. The combination of birth control pills and smoking may be especially dangerous for some women, as may alcohol abuse. There are also a number of factors that can put you at an increased risk of hypertension during pregnancy. These include hypertension during a previous pregnancy, obesity, being younger than 20 and older than 40, having diabetes and other chronic illnesses, and being pregnant with more than one baby. Pre-eclampsia, which occurs when high blood pressure is accompanied by protein in the urine and swollen ankles, fingers and face, is particularly serious, and contributes to about 13% of all maternal deaths worldwide. It’s usually
Gabriel Eksteen is a registered dietitian and exercise physiologist. He leads the Nutrition Science Programme at the Heart and Stroke Foundation SA and is involved in research in the Division of Nutrition at the University of Cape Town. His focus is on how exercise and nutrition can prevent cardiovascular and other lifestyle diseases.
a manageable complication, however, and typically disappears within two months after the baby is born. ‘Hypertension in pregnancy is a major cause of maternal and foetal morbidity and mortality,’ says Dr Gathiram, so ensure you consult with your medical practitioner every step of the way.
THE LIFESTYLE ‘CURE’
Experts typically recommend you eat a healthy diet, exercise regularly, stop smoking and maintain a healthy weight. Dietary changes are extremely effective, and the effects are greater the higher the initial blood pressure, and the bigger the shifts in eating habits, says Gabriel. A diet that provides more potassium, magnesium, calcium and less salt (added and hidden) is just what the doctor ordered for hypertension. Dr Gathiram recommends the DASH (Dietary Approaches to Stop Hypertension) diet, which can reduce systolic blood pressure by as much as 20mmHg when combined with lowered salt intake, and starting with blood pressure above 150mmHg. Medication is prescribed in cases where lifestyle changes aren’t enough. In some cases where someone makes radical lifestyle improvements, blood pressure can return to normal without the need for medication. ‘Hypertension is treatable and most women have a good quality of life, although this is restricted to a small degree in some by the side effects of the medication,’ says Dr Gathiram. He also notes that side effects from medication are more common in females than in males. The good news is that hypertension can be diagnosed and managed. And as Maria says of her condition, ‘I have it under control and live a healthy and happy life; it’s here to stay so I think it’s more beneficial to see it in a positive light.’ Sage advice indeed.
Dr Nischal Gathiram is a physician at Life Westville Hospital with a keen interest in cardiometabolic diseases, stroke and diabetes, and he provides clinical services in cardiovascular fields.
Taste of the
All Sorts of Healthy Dishes: The Mediterranean Way is successful entrepreneur Chantal Lascaris’s follow-up to her first book, All Sorts of Salads. Chantal has always been intrigued by the longevity and general health of the communities in the Mediterranean so, naturally, her latest offering explores a nutritious lifestyle that she rediscovered through her family’s background and time spent with locals in various communities in France, Italy, Greece, Spain, Turkey and Morocco – all adapted to incorporate local produce
Spanish prawns What a tasty little snack this is! The smoked paprika is Spain at its best, with cumin and origanum the perfect partners. Marinating allows the meat to soak up all the flavours, yielding succulent and delicious prawns. Feel free to cook them on an open flame as this will add a touch of smokiness to the flavour.
• ½ tsp smoked paprika • 1 clove garlic, finely chopped • ½ tsp ground cumin • ½ tsp dried origanum • 1 Tbsp olive oil • 2 Tbsp lemon juice • 200g fresh prawns with tails, shelled and deveined • wooden skewers • ½ lemon for serving
1. In a bowl, mix together the paprika, garlic, cumin, origanum, olive oil and lemon juice. 2. Add the prawns, coat well with the mixture and refrigerate for about 1 hour. 3. Thread a few prawns onto each skewer. 4. Heat a griddle pan, add a touch of oil and fry the skewered prawns until cooked. 5. Squeeze the juice of the ½ lemon over the prawn skewers and serve.
Moreish Moroccan chicken salad Morocco is famous for its rich spices and flavourful food, and this dish is a mixture of these taste sensations. The cardamom provides the aroma, the turmeric the colour and the pistachios the crunch. The chicken’s flavour balances perfectly with the sweet, chewy dates and tart apples, while the pomegranate provides the finishing touch.
• olive oil for frying • 1½ onion, chopped • ½ tsp crushed garlic • 20 pistachio nuts, shelled and roughly chopped • 2 Tbsp roughly chopped pine nuts • 1 cup cooked brown rice • seeds of 2 cardamom pods • ½ tsp turmeric • salt and pepper to taste • 4–6 chicken breast fillets • ¼ cup white wine vinegar • 1 unpeeled red apple, chopped • 3 stalks celery, chopped
• 2 pitted dates, chopped • 2 cups baby spinach leaves • 2 Tbsp pomegranate arils SAUCE • 1 tsp sumac powder • 100ml chicken stock • juice of ½ lemon • ½ cup plain yoghurt • ½ tsp grated nutmeg • salt and pepper to taste 1. Preheat the oven to 180°C. 2. In a pan, heat a little olive oil and sauté the onion and garlic until the onion is translucent. 3. Add all the nuts and rice to the onion and garlic mixture and sauté for another minute or so. 4. Stir in the cardamom seeds, turmeric, salt and pepper, then sauté for about 3 minutes. Remove from the heat. 5. Cut pockets lengthways into the chicken breasts and stuff with the rice mixture. 6. Place the chicken breasts in an ovenproof dish, drizzle generously with olive oil and pour 1 tablespoon of the vinegar over each chicken breast. Season generously with salt and pepper. 7. Cover with a lid or aluminium foil and bake for approximately 20 minutes. 8. Remove the lid or foil and grill for another 5 minutes to brown the tops of the breasts. 9. For the sauce, add the sumac, chicken stock and lemon juice to a pan and simmer until reduced by a third. Add the yoghurt and nutmeg. Season with salt and pepper and stir occasionally, until the sauce begins to thicken. 10. Combine the apple, celery and dates. 11. Arrange the spinach leaves on a platter and place the apple and celery mixture over the leaves. Season with salt and pepper. Scatter over any leftover rice mixture. 12. Place the chicken breasts on top of the salad ingredients and pour over the sauce. 13. Sprinkle the pomegranate arils over all.
Brinjal with feta & pomegranates We often associate grilled cheese with added calories, but feta keeps the calorie intake low and people who are lactose intolerant can still enjoy the creaminess of this dish if they use feta made from goat’s or sheep’s milk. And not only is the brinjal tasty, but it also provides health benefits such as being
rich in bioflavonoids – important for a healthy heart. • 2 large brinjals • 4 Tbsp olive oil • 2 cups crumbled feta • 4–6 Tbsp pomegranate arils • chopped fresh parsley for garnishing 1. Preheat the oven to 180°C. 2. Cut the brinjals in half lengthways and score the flesh.
3. Brush the olive oil over the scored flesh, then bake the brinjals in the oven for approximately 20 minutes. 4. Sprinkle the feta on top of each brinjal half. 5. Grill the brinjal halves in the oven until the feta starts to melt. 6. Remove, sprinkle the pomegranate arils over the top, along with a sprinkling of parsley. 7. Serve immediately.
Giveaway! Life Healthcare magazine is giving away two copies of All Sorts of Healthy Dishes. Email firstname.lastname@example.org with ‘All Sorts of Healthy Dishes’ in the subject line by 31 April 2018 and stand a chance to win.
This is an extract from All Sorts of Healthy Dishes: The Mediterranean Way by Chantal Lascaris, published by Struik Lifestyle. RRP R230
Kleftiko This is Greek cuisine at its best. Who can resist the aromas and flavours of roasted lamb? Kleftiko literally means ‘stolen lamb’. The name originated during the 19th century when ‘commoners’ were banned from owning their own animals, so people used to steal a lamb and cook it in a home-made oven; really just a hole in the ground, covered with a rock. No smells or smoke could escape to betray the thief and the lamb could be safely left to cook slowly for several hours. • 1.5kg leg of lamb (bone in) • slivers of garlic • 8 Tbsp olive oil • cake flour for dusting • salt and pepper to taste • 3–4 stalks celery, roughly chopped • 3–4 small carrots, roughly chopped • 1 onion, roughly chopped • 3–4 sprigs of fresh rosemary • ½ lemon, cut into wedges • 4 Tbsp balsamic vinegar • 2–3 cups red wine
I M A G E S H E N K H A T T I N G H © P E N G U I N R A N D O M H O U S E S O U T H A F R I C A ( P T Y ) L T D 2 0 17
Apple slices This dish is the perfect ending to a relaxed dinner: special yet stressfree because it’s so easy to make. Serve it with sugar-free sorbet and it’s sure to be a winner. • 2–3 Granny Smith apples • cake flour for rolling • 1 x 200g roll readymade puff pastry • 2 Tbsp fig jam • 50g Emmenthaler, thinly sliced • 1 egg, lightly beaten • sugar-free sorbet for serving • fresh figs for garnishing • sprigs of fresh thyme for garnishing 1. Preheat the oven to 160°C. Grease a baking tray. 2. Slice the apples about 5mm thick and place in a pot of boiling water.
3. Cook for about 3 minutes, until softened. Remove and drain on absorbent kitchen paper. 4. On a floured surface, roll out the puff pastry and cut into long strips about 5cm wide. Cut them into 10cm lengths. 5. Spoon some apple slices onto half of the strips of pastry. 6. Onto each, spread a small amount of fig jam over the apples. 7. Place a slice of cheese on top, followed by another strip of pastry. 8. Brush the top pastry layer of each stack with the egg and arrange them on the prepared baking tray. 9. Bake for about 25 minutes or until the pastry is golden and cheese has melted. 10. Cut off any bits of cheese that might have escaped from the sides. 11. Serve about 2 slices per person with a spoonful of sorbet. Garnish with figs and thyme.
1. Preheat the oven to 170°C. 2. Cut 6–7 small incisions in the lamb in various places and push the garlic into them. 3. Rub the olive oil over the surface of the lamb. 4. Dust the entire surface of the lamb with the flour and season with salt and pepper. 5. Place in a roasting pan and scatter the vegetables, rosemary and the lemon wedges around the pan. 6. Pour the balsamic vinegar over the lamb and then add about 2 cups of the red wine. 7. Cover and roast for about 2 hours, then turn the lamb and return to the oven for another 2 hours. Check once or twice to ensure that the meat isn’t dry. If necessary, add the remaining wine. 8. Once cooked, remove and shred the meat. Liberally coat the shredded lamb with the cooking juices and serve. 9. Best served with Greek-style lemon potatoes and briam.
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Divan received a Jakes Gerwel Service Hero Award at the recent Life Achiever Awards
id you know that spina bifida is the second-most common birth defect in South Africa?’ asks our hero Divan Schutte, a stock controller at Life Rosepark Hospital in Bloemfontein, who was born with the condition. ‘Sitting at number one is congenital heart disease.’ Spina bifida is a congenital defect where some of the bones that make up the unborn baby’s spinal column don’t join together properly, leaving an opening in the spine, usually in the lower part of the back.* Disability varies from child to child but the damage typically affects mobility. ‘I had many operations as a child,’ recalls Divan, 28, who has worked at Life Rosepark Hospital for six years. ‘My parents had to do a lot of research on their own to understand spina bifida and the treatment options that were available. ‘Nowadays this knowledge is readily available and there have been some astounding advances in medical technology since I was born.’ Divan’s personal experience motivated him to launch an awareness campaign in the hospital to tell staff about spina bifida. ‘I contacted Hannika Struwig, our marketing manager, and pitched my idea to raise awareness in the hospital with a small campaign. Hannika put together an awareness package including leaflets and yellow ribbons, and we launched it on 25 October, Spina Bifida Day. ‘The campaign ran for a month and it was a great success,’ says Divan. ‘I felt as if I was talking about spina bifida for a month, non-stop!’
Determined Divan Schutte refused to allow spina bifida to hold him back, and dedicates his free time to raising awareness about the condition. By Melanie Farrell As a result of Divan’s awareness campaign, the paediatric unit manager, Nurse Bets Steyl, now refers parents to a support group, the Association for Spina Bifida and Hydrocephalus (see below), when a baby is born with spina bifida. Divan is open about living with spina bifida and although he faces daily difficulties, he recalls a ‘pep talk’ a friend gave him in early 2017. ‘He basically said I had to get out of my comfort zone and I realised that he was right,’ explains Divan.
The main goal is independence ‘I also wanted to honour my parents for everything they have done for me through the years. They had to make many difficult decisions on my behalf when I was a child and I decided that the best way to show my gratitude would be through the way I live my life. ‘Someone with a severe form of spina bifida can actually live a life that’s close to normal, with a substantial amount of independence. ‘The main goal when dealing with any sort of disability is independence. Having some independence makes a big difference to the quality of your life,’ says Divan. Actively involved in a Johannesburg support group for those living with spina
bifida, Divan is keen to share what he knows in order to help others in a similar position. His dedication to going above and beyond what his job calls for earned him the Jakes Gerwel Service Hero Award for Personal Care at Life Healthcare’s recent awards and recognition event, the Life Achiever Awards. ‘I am living proof of how surgical intervention can improve a person’s quality of life. We can really, literally, change the world,’ says Divan. *Source: Association for Spina Bifida and Hydrocephalus (ASBAH)
LIFE PLUS Spina bifida support
The Association for Spina Bifida and Hydrocephalus (ASBAH) provides support for those affected by spina bifida. It has offices in Cape Town and Johannesburg, and you can also find the group online. www.asbah-sa.org Find ASBAH on Facebook. www.facebook.com/AsbahSa-419078231622855 WWW.LIFEHEALTHCARE.CO.ZA
PUZZLE THIS... Test your mental agility with our brain-teasers
1 CROSSWORD PUZZLE 2 SUDOKU
Difficulty level *** ACROSS
1 Brahmanist 6 Upper limit 9 Mailing abbr. 12 Had a home-cooked meal 13 Barn bird 14 Seine matter 15 Acted grandmotherly 16 Rifle attachment 18 Short and thick 20 Fork option 21 Flightless bird 23 Wet wiggler 24 Liberace’s prop 62
25 Croupier’s tool 27 Crystallined rock 29 To-do list 31 Film festival city 35 “Sinker” 37 Shipbuilding wood 38 Loosen 41 Ultra-modernist 43 Take a whack at 44 Lunch hour 45 Removed with the teeth 47 Jack Webb series 49 Grinder 52 Type squares 53 Inseparable
54 Cost 55 Snitch 56 Join together 57 Under a spell DOWN
1 Possessed 2 “Am — blame?” 3 Obi ornament 4 Losing plan 5 Ill-deserved 6 Repair, as shoes 7 Vacationing 8 Thickness 9 Columbus’ home
10 Song of joy 11 Top 17 East 19 Started 21 Mound stat 22 Periodical, for short 24 Black Berry, e.g. 26 Conclusion 28 Square dance group 30 Buck’s mate 32 “House of Cards” provider 33 Listener 34 Firmament 36 All together
38 Hypnotised 39 Bellini opera 40 Raise a glass to 42 Pizzazz 45 Part of N.B. 46 Links warning 48 Promptly 50 Blackjack component 51 Embarrassed
3 WORD SLEUTH
Find the hidden words in the diagram. They run in all directions
Jade Kelly Marigold Olive
Poppy Red Rose Ruby
Scarlet Sienna Violet
Cocoa Emerald Hazel Ivory
For each of the three words on the right, change one letter to an A and then rearrange the letters to spell a word that has three As. 3 4 BANANAGRAMS PARABOLA MARINARA FANTASIA
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
GIVING THE GIFT OF LIFE
In a new biography of Professor Christiaan Barnard, author James-Brent Styan examines the impact of the historic first heart transplant and one man’s indelible influence on humanity 1967, Christiaan Barnard and a team of South African medical specialists did what was considered to be impossible and performed the world’s first successful human to human heart transplant, following decades of hard work and intensive research. It catapulted South Africa to the forefront of medical progress. By 1973, organ transplant programmes were available only in a few public hospitals, including Johannesburg General and Groote Schuur in Cape Town. Today there are 18 transplant centres in South Africa, 8 government and 10 private facilities. A major constraint to organ transplantation today remains the availability of donor organs. The human tragedy of a patient awaiting an organ for transplantation is often traumatic for both patients and surgeons. In an old column in the Cape Times, Barnard recounted the experience of a patient who was dying and knew it. ‘He knew his only hope of survival was dependent on the death of someone else. It is one of the more macabre aspects of transplantation surgery, one that has a strong psychological effect on the people on the receiving end of it.’ Over the years following the first heart transplant, the levels of bureaucracy involved also made the process increasingly more complicated. By the end of the 1970s, bureaucracy had increased the red tape relating to organ donation and this led to huge delays – delays that often meant that by the time 64
all the boxes had been ticked, the organs were no longer feasible. ‘Legislation made the possibility of getting healthy donor hearts more a miracle than a possibility. While lots of other, valuable cardiac surgery was happening, especially on children, the era of South African heart transplantation was basically over,’ Barnard commented. Cardiac diseases are claiming more and more lives today. In South Africa, 210 people die every day of heart-related disease. No one is immune to heart-related diseases and some are more vulnerable than others, namely children and the poor who are particularly susceptible to contracting
rheumatic fever, which can destroy their hearts. The impact of rheumatic heart disease is set to increase rapidly and cause many more fatalities among poorer populations in developing countries into the future due to the upsurge in urbanisation. Lifestyle choices, including less exercise and poor dietary choices, as well as high blood pressure will have an increasing impact on people in developing countries like South Africa. Today there’s approximately 4 300 South Africans at any one time waiting for organ donations. In 2015, there were 548 organ and corneal transplants in South Africa. This included 27 adult hearts. In the future, there is no doubt that South African medical institutions will come under increased pressure due to the increasing number of people who will be contracting heart disease. Huge choices lie ahead for African governments. Barnard once compared the bitterness of losing these (transplant) patients to sucking on an old copper coin. ‘If you ever want to know what real loss or failure feels like, try spending a hard night at work trying to save a patient’s life and then go home the next morning as the sun is rising, knowing it was all for nothing.’
Author’s postscript note: Please consider registering as an organ or tissue donor. Visit www.odf.org.za to learn more. This is an excerpt from Heartbreaker by James-Brent Styan, published by Jonathan Ball. The book is available in Afrikaans (Hartbreker) and on e-book and is available at all good book stores.
ifty years ago on 3 December
In this issue of Life Healthcare magazine, the content focuses on the changes you need to make at the beginning of the year to ensure good h...
Published on Mar 6, 2018
In this issue of Life Healthcare magazine, the content focuses on the changes you need to make at the beginning of the year to ensure good h...