Priority One Issue 2 | 2017

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PRI Make it yours

RITY NE

QUARTERLY MAGAZINE

ISSUE 1 - JULY 2017 WWW.ER24.CO.ZA

ER24 Global Assist

How an 11-year-old stole ER24’s heart

Depression - The silent killer

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PRI Make it yours

IN THIS ISSUE

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Page

Front page stories

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Who is ER24 Global Assist?

9 Schoolgirl steals ER24’s heart 17 Depression - The silent killer

Company interest 3

Emergency care research unit launches at ER24

Clinical 7 8

Page

Walking with cancer Testicular cancer: what you need to know

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Healthy living 4 Brain food for kids 15 Easy ways to boost your immunity 24 Back to work during cancer treatments

CONTACT:

Email: communications@er24.co.za Tel: 0861084124 Web: https://er24.co.za Emergencies: 084 124

DESIGN AND LAYOUT:

Ineke van Huyssteen

COPY COMPILED BY: Caryn Ross Mediclinic Infohub Ineke van Huyssteen

NEXT EDITION:

The next edition of Priority One will be published at the end of the third quarter of 2017.

STOCK IMAGES:

iStock (Getty Images) TriggerFinger Photography

NEXT CONTENT DEADLINE: Content for consideration may be sent to the ER24 Communications Department by any staff member or client. Send content to communications@er24.co.za

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ER24 staff

5 Eye-opening experience for Coenrad 12 Putting (shaved) heads together 25 Welcome to our family

Awareness

23 A crash course in cycling accidents

ER24 events 19 ER24 out and about at Middelburg Airshow

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Cover Story

Who is

ER24 Global Assist?

AEROMEDICAL

SITE BASED (SBMS)

CONCIERGE / ASSISTANCE

BUSINESS DEVELOPMENT

Our Aircraft • Dassault Falcon 50EX jet • Dassault Falcon 20 Jet • Cessna Citation V jet • British Aerospace Hawker 700 jet

Provision of Emergency Medical Services and integrated healthcare support to a variety of clients in high risk or risk- remote locations in South Africa and internationally.

Our Medical Concierge Services provide for daily patient management, including arrangement of appointments with identified healthcare providers, arrangement of hospital admissions, as well as transportation and accommodation for the patient and/or accompanying family members.

Our Global Concierge/ Assistance network extends to an expansive network of emergency service bodies.

This allows us to draw on a variety of related services when emergencies arise.

Services include: • Access to our Mediclinic Hospital Group including in-patient hospital referrals • Medical Case Management • Cost containment • International patient management • Repatriation of mortal remains

Key focus on developing and maintaining ER24 Global Assist customer relationships, ensuring delivery of world class services to our local and international clients.

Our aircraft are fully configured with world class critical care equipment and use state of the art technology.

Aircraft operate in vast parts of Africa and neighbouring islands.

Our extensive African network includes 3 000 service providers who facilitate transfers to Europe, the Middle East, Far East and America.

Ideally positioned to provide on-site clinics, Emergency Medical Services, medical staffing, medical procurement, emergency medical training, medical risk assessments and emergency response plans.

These services typically cover clients in the following sectors: Mining, Oil, Energy, Infrastructure and Utilities, Tourism, Hospitality and Leisure, Marine, Aviation, Healthcare, Government, Parastatals and NGOs.

Tracey Rouessart General Manager: Global Assist

Top (left to right) Alastair Lithgow, Illze Milbert Bottom: Odette Grobler

Priority One | Issue 2, July 2017

Top (left to right) Walter Egger, Tsholofelo Molautsi, Michelle Saayman Bottom: Peter van der Merwe, Dr Vernon Wessels, Reyno Dempers

Top (left to right) Cindy Kleinhans, Kabir Maharajh

Our Target Markets include: • Travel Insurance Providers • Medical Assistance Provider companies • Third Party Aeromedical service providers • Funders The team also ensures that service level agreements with clients are in place and adhered to, whilst delivering local and international marketing and communications campaigns.

Top (left to right) Raksha Dookhi, Andrew Lee

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Company interest

Emergency care

research unit launches at ER24

Prehospital emergency care systems are incredibly expensive to establish, maintain, and develop.

However, it has been suggested that developing and establishing these systems within low- and middleincome country settings may contribute to preventing 45% of deaths and improving morbidity by 35%.

Unfortunately, there is very little data and evidence to support the development of these systems with the South African context as most (however scant) research generated originates from developed healthcare systems in higher-income nations.

In order to invest into the research of these systems, in April 2017, ER24 established

a dedicated Emergency Care Research Unit (ECRU).

As the first of its kind in Africa, ER24 have invested in providing specific on-duty protected time to four young paramedic researchers to develop solutions to the most pressing matters in South African prehospital emergency care.

At the helm of ECRU is Mr Willem Stassen, who is currently completing his PhD in South African emergency care systems at Karolinska Institute in Sweden and Stellenbosch University.

ER24 is no stranger to conducting high quality research, having successfully

published one research article and was the single greatest contributing Emergency Medical Service at the 2016 International Conference on Emergency Medicine (9 presentations in total) as well as the Emergency Care Conference of South Africa.

“The importance of research cannot be over-stated,” said Stassen.

“Often, in practice when faced with a problem solutions are proposed before the problem is adequately defined and understood.

Research allows us to understand the problems that we face in the context of the systems in which they occur and explore and investigate

ER24 Team Finance – After completing a successful financial year end and audits

these problems in a controlled manner. The results of these systematic investigations can then be interpreted and change can be effected.

Further to this, the data and results can be published to the betterment of the profession and system as a whole. To this end, research builds knowledge, provides a means to understand various issues, prove or disprove theories, test the efficacy of various interventions or “fixes” and assists in the advancement of the care systems.”

By having a dedicated Research Unit, ER24 hopes to be at the forefront of developing systems of Emergency Care towards the betterment of patient care across the country and beyond our borders.

A message from Muhammed Cassim, Financial Manager of ER24: “I would like to thank the ER24 Finance Team for their hard work and team spirit in completing another gruelling financial year end, as well as internal and external audits.

We are proud that we, as a finance team, have produced work at the highest level once again and have received clear audits.

This would not have been possible without such a brilliant, hardworking team. Thank You!”

Front Row (Left To Right) Given Ndou, Sandile Sithole, Phillip Sedibane Middle Row (Left To Right) Muhammed Cassim, Elouise Panchal, Somaya Wania, Refiloe Dube, Beaula Poonin, Naadira Abdul Back Row (Left To Right) Lynsey Shivanand, Christina Telela, Riaan Visser, Nhlanhla Shabangu, Dakalo Nemukula, Yaseen Cajee, Kiran Govender, Gregory Dlodlo, Joubert van der Linde

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Priority One | Issue 2, July 2017

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Healthy Living

Brain food for kids Which foods and healthy habits are really the best for growing brain function and development? We speak to a GP specialising in family medicine to find out.

Optimal health and wellness is dependent largely on a balanced and nutritious diet.

We quite literally ‘are what we eat’, as what we ingest on a daily basis has a huge part to play in our longevity. But a less acknowledged benefit of healthy eating is our brain power. That’s right: a healthy body really does equate to a healthy mind, especially in growing children.

‘Good food choices are critical in the overall wellbeing of young children,’ says Dr Carike Camphor, a general practitioner specialising in family medicine at Mediclinic Nelspruit. ‘While a good Priority One | Issue 2, July 2017

diet translates to a strong immunity and assists the growth process, concentration and general mood are also positively affected. A balanced eating plan really does pay off in the long term.’

Daily life is getting busier and busier in the modern day, and this applies to children too. School, extra-murals and homework all add up, not to mention social engagements.

And it is this fast-paced lifestyle that often leads parents to consult their family doctor out of concern.

‘It is fairly commonplace for parents to be frustrated about their child’s mood swings or lack of concentration,’ says Dr Camphor. ‘Sometimes consultations are on the advice of a school teacher, other times due to noticeable erratic behaviour patterns at home. More often than

not, a slight adjustment in a child’s nutrition rectifies the problem.’

Sleep and brain food Sleep is a critical element in our ability to function, something which Dr Camphor says often requires extra attention in the case of growing children.

‘It is important to assess a child’s daily life before drawing any conclusions,’ she says. ‘Difficulty in getting to sleep plays a huge role in determining children’s well-being and happiness in general, so boosting their magnesium levels to aid sleep is a good idea. Keeping an eye on both omega-3 and iron levels is also highly recommended, as these have a direct effect on their social behaviour as well as their natural ability to focus.’

Keeping these factors in mind, Dr Camphor offers the following nutritional and ‘brain food’ suggestions: – Combine to absorb: ‘Include protein with carbohydrates to offset the release of sugar. Seeds or eggs are a great addition to a cereal or bread-based breakfast.’

–Vegetable foundation: ‘Make vegetables the basis of your child’s lunch. They’re a great natural source of energy.’

–Sugar sensible: ‘Maintaining a consistent blood sugar level is important, but limit refined sugars as much as possible, particularly at night. Too much sugar results in hyperactivity and restlessness; too little (from whole and raw sources) leads to tiredness and irritability.’ |4

Staff

Eye-opening experien Paramedics are used to being at the forefront of emergencies. When a call comes in you respond as fast as possible to ensure that the patient has a fighting chance to live.

But what if the paramedic becomes the patient?

Coenrad Bronkhorst (27) is a Basic Life Support (BLS) paramedic at the ER24 Vaal branch.

Most of his family are also involved in the medical industry. After completing school at Vaalpark High School he went to work at a power station in Ermelo but soon realised this is not for him. He followed in the footsteps of the rest of his family because it felt like the best thing to do.

“Every day is a new day with new experiences. You have to be prepared for the worst. If you want to cry, cry.

If you want to laugh, laugh.

To know every day that I’ve saved a life makes me feel proud of my work. There are people looking up to us that trust us to help them in need.

It really is rewarding,” said Bronkhorst.

The night things changed On the night of the 17th of March Coenrad and his partner Crescendo Dillion Lee responded to a collision on the R553 close to the old Golden Highway in Vanderbijlpark.

‘I had a bad feeling that night that something was going to 5|

happen to me or one of my family members. I dropped my mother at my brother’s house just in case I didn’t make it back home and then I went to work,” said Bronkhorst.

“My partner and I still joked that this road is very dark and that we should be careful.

“When we arrived at the scene we saw one car lying on its side and another car in the bushes. A woman was screaming hysterically and crying. There were lots of people on the scene.

“First I started placing the road cones in the road. Then I got into the ambulance to assist my partner. While we were in the ambulance a bakkie drove into us from the back and the impact was so hard that I was thrown against a sharp edge inside the ambulance. As a result of this my kidney had burst,” said Bronkhorst.

At this point Lee made sure that the first patient was attended to and then he found Bronkhorst on the grass in pain. He put him on a drip and gave him some pain medication while waiting for back up.

Bronkhorst only woke up in ICU six days after the event. He had undergone two operations whereby his kidney, that was torn in two, was removed.

“When I woke up I was in shock and very emotional.

My family was very worried.

ER24 stood by me through all of this.

“My lifestyle has changed

Coenrad Bronkhorst with the photos of his ordeal.

“To know every day that I’ve saved a life makes me feel proud of my work. There are people looking up to us that trust us to help them in need. It really is rewarding.” since I lost the kidney. I love to braai and eat red meat but I have to cut this out of my diet to ensure that I stay healthy,” said Bronkhorst.

passionate about saving lives after seeing my partner in his position,” said Lee.

It isn’t only Bronkhorst whose life changed dramatically. His partner also learnt a lesson or two out of this experience.

“Even if you do everything according to the book.

Something can still go wrong.

“I prefer not to stay on a scene too long. I want to get moving as soon as possible.

My approach to a scene, such as where I parked with the ambulance, has changed. I am a lot more safety conscious now. I am even more

Although Bronkhorst went through quite an ordeal this hasn’t deterred him from still saving lives.

He dreams of becoming a pilot.

“It is one of my biggest dreams. I want to fly a helicopter for emergency services,” said Bronkhorst.

Bronkhorst even received his torn paramedic uniform, framed as a gift, from his branch and colleagues.

“We appreciate all that he has done. We will continue

His dreams at ER24

Priority One | Issue 2, July 2017

FOR nce COENRAD

Staff

to support him as a branch and as colleagues. He is just one of those people who you want to be around. He makes you look forward to your shifts at work and every call you go out on. The little gift is a reminder of what each and every medic faces when they turn up for work,” said John Ramcharan, ER24 Vaal branch manager.

Bronkhorst’s first day back on duty was on the 7th of June.

To watch ER24’s video on Coenrad, scan the QR code:

Coenrad’s partner, Crescendo Dillion Lee, getting a handshake from ER24’s Vaal branch manager, John Ramcharan.

Coenrad with his fiancé Robyn van Zyl.

Priority One | Issue 2, July 2017

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Clinical

Walking with cancer Submitted by: Red Ribbon Communications

An oncology social worker walks hand-in-hand with cancer patients, supporting them every step of the way.

Cancer – it affects every part of a person’s life. From the moment they receive their diagnosis, the journey is a complex and challenging one. It can cause immense distress as change permeates every part of life and patients are expected to learn how to juggle a whole new set of balls and face new and unexpected fears. It is into this confusing world that the oncology social worker steps, providing the support and guidance people need to make the right decisions and cope with the effects of cancer.

“I think the most important thing that any oncology social worker does is to determine the distress factors that patients and their families are experiencing, right from diagnosis to whichever stage of treatment they are at,” says Linda Greeff, Oncology Social Worker at Cancercare.

“Before treatment, during treatment, after treatment – we provide support services from diagnosis through the trajectory of care.”

An oncology social worker comes alongside a family, assesses their needs and determines precisely what strategies or interventions are needed to help them find their way along the cancer journey. And it is a journey.

Every aspect of a person’s life is impacted, emotions, 3 7| |

work, family relationships, spirituality, creating meaning in your life and more are turned on their heads. New plans are needed to deal with the uncertain futures that expect strength and resilience in the face of illness and upheaval. The oncology social worker helps people to manage this distress as effectively as possible.

“The level of stress a person feels is determined by their personality, the type of cancer they have, the stage of their illness and their levels of family support,” says Greeff.

“We provide a safe space for people to unpack their fear and anxiety. Helping them to understand what is going to happen next and to interpret the information provided by the doctor. We assist healing on a psychosocial level and also provide information about helpful resources.”

The oncology social worker not only supports patients, but works alongside medical practitioners to provide a multi-disciplinary approach to cancer care. Doctors are becoming more specialised and technical and often have less time to attend to the emotional needs of patients.

The oncology social worker provides a deft balance between their expertise and the patient’s mental wellbeing.

“Previously it was hard for doctors to accept our role as they are used to being primary caregivers, but now they are more aware of the value we provide and the support we

Linda Greeff

give both them and their patients,” adds Greeff. “We open the door to patient conversations about cancer and assist them to develop their own personal action plan to address the emotional challenges they face while learning to navigate the cancer journey. We introduce them to supportive resources and empower them to become part of their own healing program.”

It is a challenging career, but an immensely rewarding one.

For Greeff, she gets enormous satisfaction in helping people to get to a safer place – they arrive upset, but they leave feeling a bit more relaxed and empowered.

“People living with cancer are grateful to receive tangible support in areas of need and welcome the opportunity to explore different options and issues that need to be problem solved as part of this journey,” she adds. “We help them to see that it is okay to express your emotions, to be authentic and to share experiences

with the people they love.

This feedback sustains us as professionals.”

Oncology social workers build relationships with people over many years and loss is part of the journey of all team members that work in oncology. This is why we need to be aware of our own vulnerability and ensure that we build our resilience to keep on being caring and available to our patients and staff.

“I think that many people still have a negative view of a social worker as someone who removes children or hands out food parcels, but the role has evolved past that significantly,” concludes Greeff. “Social workers in oncology are trained to work therapeutically and many have Masters degrees in either medical or clinical social work. We follow a patientcentered care model and our goal is to make the cancer journey as comfortable and empowered as possible.”

Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Clinical

Testicular cancer:

what you

need to know

David Scott taking part in the Discovery World Triathlon Cape Town last year. Photo: Chris Hitchcock

Touch your testicles every day. It could save your life.

According to the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program, almost half of the cases of testicular cancer cases are found in men aged 20-34. And almost 80% of cases occur before the age of 45 - this isn’t a form of cancer allocated to old age so the time to start getting to know your testicles is now.

While testicular cancer isn’t yet classified as a common form of cancer, it can affect you at any time of your life so it is best to be aware and be prepared. There are two types of testicular cancer.

The most common is germ Priority One | Issue 2, July 2017

cell testicular cancer which is diagnosed in around 95% of all cases and which is broken down into seminomas and non-seminomas. Both these types of cancer respond well to chemotherapy and have an excellent survival rate.

The less common types of testicular cancer are Leydig cell tumours, Sertoli cell tumours and lymphoma.

The good news about germ cell testicular cancer is that it has a 95.4% survival rate over five years if found early. The key word here is ‘early’. If you know the signs and what to look for, your prognosis is excellent.

Your first, best step towards staying safe is to check your testicles on a regular basis.

Get to know them now, while

they are healthy, so you can immediately identify any strange or unexpected lumps or changes in size or shape.

“It was just after my 30th birthday when I noticed a swelling in my testicle and, after watching and waiting for a few weeks, I realised was growing rapidly, so I went to see a urologist,” says David Scott (39), testicular cancer survivor.

One of the most common symptoms is the arrival of a painless lump, but sometimes the testicle can become swollen or grow bigger without any evidence of a lump. Pay attention to the size and shape of your testicles and to any other strange sensations you may feel in the area.

According to Cancer.org, some people get a heavy aching feeling around their scrotum area or lower belly.

Another sign, although a rare one, is for a man’s breasts to grow and become increasingly sensitive thanks to a shift in hormone production. This is commonly found with the rarer forms of testicular cancer and should also warrant a visit to a doctor.

Of course, many of the symptoms of testicular cancer are the same as the symptoms of a testicle injury. If they

have been hit, or have an inflammation or even if they have an infection, then they will likely cause you to feel the same levels of discomfort.

However, it is always best to be safe rather than sorry.

Especially with testicular cancer as the survival rate is so good if it is caught and treated promptly.

For David Scott, testicular cancer led him along a lifechanging road, a journey into the world of cancer and out the other side. He refused to see it as a death sentence and instead used it as an opportunity to change the way he approached his life and his diet.

“Going through the journey itself, I would say I was very fortunate as I am young and healthy. I did have some bad habits – the typical South African ones of binge drinking and occasional smoking – but those are now gone. Now I’ve become an athlete and pay a lot of attention to my health,” he concludes. “Focus on your diet and be as healthy as possible, and get over the experience emotionally. Stay away from negative people and harmful substances and bring it all down into bitesized chunks you can manage.

It is a mountain that can be climbed, and learned from.” |8

Community

Schoolgirl

steals ER24’s heart Recently ER24 responded to a call where a 11-year-old schoolgirl was knocked down by a car while on her way to school. Her leg was broken and paramedics had to cut through her school uniform.

This action was necessary to fully assess her injuries.

Although the little girl’s mom was devastated seeing her daughter injured, she was also very upset that the girl’s school shirt was cut open as they have no money and that was the only uniform she had.

Tannith Mottershaw, an Advanced Life Support (ALS) medic from the ER24 Johannesburg North branch, along with her partner Lliam Richmond, were the two paramedics on scene.

After they took the girl to the hospital, Tannith approached the mom and apologised

for cutting her daughter’s uniform.

“The mother broke down and said that she cannot afford a new school uniform. I told her that we will sort out the uniform and all the rest,” said Tannith.

That is exactly what she did.

‘I immediately sent out a message to the rest of the crew and everyone started contributing. We managed to raise more than R2 000 for her. We bought her a new school uniform, stationery, toys and much more,” said Tannith.

On Monday Tannith, along with some of the crew members, took the donations to Deborah at her family home in the informal settlement of Kya Sands, Johannesburg.

“We all got goosebumps as

we gave her the goodies. The first thing she picked up was the new school shirt. She was so happy about it and immediately hugged it close to her body,” said Tannith.

But Tannith and the team decided to do even more for Deborah and her family.

“When we arrived there we realised the mother was taking care of eight children.

We decided that we will be buying the family groceries every month for the rest of the year,” said Tannith.

Dr Robyn Holgate, ER24’s Chief Medical Officer, has also kindly offered her services. She will be taking over all further assessments and checkups needed by Deborah relating to her injury.

“ER24, as a company, has always embraced clinical

care. We promote passion regardless of financial status.

As a team, we embrace her and her mother,” said Dr Robyn.

“We will also be sponsoring the little girl’s transportation to and from the hospital,” said Dewet Jooste, branch manager of ER24 Johannesburg North, who also joined on Monday.

Jooste couldn’t be prouder of his team.

“They all went out of their way to make it happen.

Tannith was the team leader and took everything upon herself, but it was a big team effort. Everyone was willing to help. I cannot ask for a more amazing team. In the end, it isn’t just about the salary; it is about caring for another person,” said Jooste.

“ER24, as a company, has always embraced clinical care. We promote passion regardless of financial status.”

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Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Community

Dewet Jooste, branch manager, Paul Khati, Bianca Jordaan and Tannith Mottershaw handing over all the goodies they’ve managed to gather to Deborah (11).

“The first thing she picked up was the new school shirt.

She was so happy about it and immediately hugged it close to her body.”

Clothing, stationery, toys and much more were donated to Deborah.

Priority One | Issue 2, July June 2017 2016

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YOUR LOCATION OR YOUR LIFE We understand it can be daunting to phone for assistance. But providing accurate information is often crucial in saving a life.

There have been quite a few instances where there is a delay in dispatching an ambulance as a result of incorrect or unclear scene location provided by the caller. Most of the time the information that the caller supplies is the first point where a life can be saved.

An ambulance cannot locate you in time if they do not know exactly where you are.

ER24 has a dedicated, 24/7/365 Emergency Contact Centre that enables you to request an emergency vehicle telephonically.

The following questions will be asked when placing an emergency call: • What is your name?

• What is your telephone number? Do you have an alternative contact number?

• What appears to be wrong with the patient?

• Questions will be asked to determine what type of vehicle and medical practitioner to dispatch • What is the incident address?

• Complex name/Office Park/Street address, Area, Town, Province When you phone for an ambulance, remember to: • Notify security when you are in a building with tight security.

• State the precise location if the building is very big.

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• • •

State which entrance is the closest or most accessible if there are many entrances to the building Make sure there is someone to meet the crew.

Include additional landmarks if the road names are not clear

The town and province is very important as there are duplicate suburbs in multiple provinces. For example, Rosebank can be in Johannesburg or in Cape Town.

Santi van Heerden, ER24 Contact Centre Coordinator, cannot overstress the importance of receiving the correct location information.

“It is vital that we receive the correct information. Our map system works on Google Maps. This means any location that shows on Google Maps will be found on our system. There could be times where the addresses can’t be located. In those instances, we facilitate a call between our ambulance personnel and people on the scene so that they can give further instructions on their location.”

She also adds that while phoning for an emergency, stay as calm as possible.

“In most cases when people phone us they will run through the most important information in the first 20 seconds of the call. When our agents start asking the questions people tend to get impatient and frustrated because they have to repeat the information. Just wait for our agents to ask you the questions so that the correct information can be recorded.”

Priority One | Issue 2, June 2016

Staff

Putting (shaved) heads together

When Lauren de Swardt attended to a little girl on scene, she didn’t know that she’d also end up in hospital later that night. But it was Lauren’s injury on duty that possibly helped to save her life.

“I was busy treating a little girl in the back of the ambulance when a vehicle drove into us. Afterwards, when I went to hospital, they realised that I had not only fractured a rib, but I also had lesions on my lungs,” said Lauren, an Intermediate Life Support (ILS) medic from the ER24 Witbank branch.

By the end of March this year Lauren was diagnosed with Pulmonary Langerhans Cell Histiocytosis.

“It is similar to lung cancer but very rare,” said Lauren.

In hindsight, Lauren said that she was experiencing some of the now known symptoms.

“My symptoms were very minimum but I had chest pain and difficulty breathing upon excursion,” explains Lauren.

Lauren started with chemotherapy earlier this month. Her hair had started to fall out after the very first session.

On Saturday the 17th of June, her family and crew members from the Witbank branch showed their support by shaving their hair off. Those Priority One | Issue 2, July June 2017 2016

who weren’t brave enough sprayed their hair in different colours.

Estie Biela, operational paramedic at the Witbank branch and Lauren’s best friend, opted with the former.

“Before she was diagnosed she went to hospital for all the different tests. She told me that she was scared of having cancer as her mother died from it. I told her that if she has cancer I would also shave my hair off,” said Estie.

“The support I received has been amazing. Not only from ER24 but from all my colleagues. It was quite an emotional day but it was clear that I was not going through this alone,” said Lauren.

Lauren has been booked off from work for the next six months as her immune system is quite vulnerable. Staying at home, she says, is very hard to get used to.

“I try to keep a positive mindset. If something affects you, you go down with it. I am trying to stay positive. I always think that the little girl who I helped actually helped to save me,” said Lauren.

“This progressed from a year of clear lungs, because I had scans, to what it is now.

That being said, there is a very good indication that if something is wrong go get it checked and don’t just assume,” said Lauren.

Lauren de Swardt getting her hair shaved off

“It was quite an emotional day but it was clear that I was not going through this alone.” | 12 4

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Healthy living

Easy ways to boost your immunity

From immune-boosting foods to preventative medicine and exercise, we speak to a GP specialising in family health and look at four easy ways to keep bugs at bay this winter.

With winter on its way, cases of colds and flu are on the up. And while a drop in temperature can often go hand in hand with decreased immunity, it doesn’t have to be that way, says Dr Carike Camphor, a general practitioner specialising in family medicine in Nelspruit.

‘It’s that time of the year when people start suffering from minor illnesses owing to the elements,’ says Dr Camphor. ‘Patients book appointments for what they think might be symptoms of more serious illness, but are in fact common colds.

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But this sort of ailment can be remedied – and even prevented – at home. A small amount of self-maintenance and care can go a long way in preventing the dreaded winter ills.’

A common cold usually starts a few days before any distinct symptoms are experienced.

Slight fatigue gives way to a runny nose and/or a sore throat, and this feeling of stuffiness can eventually lead to a bad cough lasting anywhere up to a week or more. While these symptoms are fairly obvious, various preventative measures are often neglected in our fastpaced daily lives.

Prevention is better than cure ‘It pays dividends to plan ahead,’ says Dr Camphor.

‘With our winter season generally starting in June, I

recommend putting immune boosting measures in place ahead of time. Our vital energy starts getting depleted towards the end of summer, so thinking ahead and boosting the immune system sooner can make winter a healthier and more enjoyable time.’

Dr Camphor recommends the following preventative maintenance for a largely sickness-free winter: Supplementation: ‘Increased vitamin C intake is advisable. Although I recommend obtaining optimal vitamin and mineral levels through a healthy and balanced diet, supplementing with antioxidants like vitamin C is a good idea leading into winter. A daily dosage of 1000mg is more than enough

to boost immunity and maintain health.’

Hydrate: ‘Keep an eye on dehydration.

We tend to favour warm drinks like tea or coffee in winter and often neglect our water intake, which is critical for immune health.’

Influenza shot: ‘I recommend going for a flu vaccination before the onset of winter.’

Keep moving: ‘Staying active through winter is also important.

Don’t let shorter days lead to hibernation. Continued movement maintains fitness, which in turn enhances general health.’

Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Clinical

Depression -

The silent Killer Written by: Marvin Mukwevho Edited by: Dr Robyn Holgate

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Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Clinic Depression takes its victim silently, leaving loved ones saying, “We don’t know what went wrong. This person was fine. Just a bit sad but they were fine.” Let’s talk about it.

What is depression?

Depression is a real illness that affects the brain. It is a persistent feeling of sadness or loss of interest that characterises depression.

Anyone suffering from depression will share with you that it is not “just in the head”, it is not “imaginary” and it is way more than, “I’m just feeling down. I will be alright in a moment”.

Depression is a serious illness which is caused by a number of psychological, social and biological factors example an alteration in brain chemistry.

Factors which may lead to depression include excessive stress, grief, genetics, changes in physiological hormonal levels, diagnosis of certain medical conditions and difficult life circumstances.

This persistent feeling of sadness may lead to a range of presentations such as changes in sleep, appetite, energy levels, behaviour, or even concentration.

According to the World Health Organization, depression is one of the world’s most disabling disorders. Statistics reveal that 21% of women and 12% of men globally, will, at one point in their lives, experience a depressive episode.

Depression knows no discrimination. It has no preference. Men and women of every age, educational level, and social and economic background suffer from depression.

This illness infiltrates into even the fine details of its victim’s life. When one suffers from depression, their marriage, finances, health, Priority One | Issue 2, July 2017

family, career, friendships and literally every aspect of their life will be affected.

The effects of depression are even more detrimental when the victim thereof, suffers from another illness such as diabetes, heart problems, stroke, cancer or any other chronic illness. The biggest challenge with managing this disorder is that most people who suffer from the illness seldom seek assistance and therefore remain undiagnosed and untreated. Early diagnosis and treatment of depression is best as it can produce a better outcome.

What are the symptoms of depression?

Victims of depression often say that they are just feeling “down”. But when one looks closer, there is a change in everything that they do. Their entire life pattern changes.

Depression affects thoughts, emotions, behaviour and overall physical health.

Some of the symptoms may include a feeling of sadness or hopelessness, possible guilt or moodiness and they may present angry outbursts. Socially a loss of interest in friends or family and favourite activities are common. Other possible signs are decreased concentration, sudden short-term memory loss, thoughts of self-harm or hallucinations.

In the work environment potential signs may be excessive absenteeism or withdrawal from the company. Family members may notice signs of substance abuse, tiredness or lack of energy, unexplained aches or pain, changes in appetite or sudden weight loss or gain. While some of these symptoms may not be indicative, specialised healthcare providers may identify clusters or on-going

events that allow them to diagnose and treat the depression. These aspects may have an important impact on daily life and need professional intervention.

There are several types of depression and it is important to speak to a Psychologist or a Psychiatrist as treatment often may involve therapy and medication. Treatment plans differ and are tailored to each patient’s symptoms. Taking somebody else’s medication may not work as the types of depression the two victims are suffering from may be different.

Recovering from depression Since depression changes a person’s entire life, our patient needs to pay attention to all aspects of life and make some major and forceful changes to overcome their feelings of helplessness.

Even though, as with most things in life, this will be much easier said than done, but to successfully defeat depression, here are some of the life changes one should make, in conjunction with following your prescribed treatment plan: •Get some exercise: Regular exercise can help you sleep better and improve your mood.

Sleep well: Anti-depressants have proven to have an effect on the patient’s sleeping pattern. Some patients sleep excessively while others have insufficient sleep. It is therefore, important to get into a good sleep routine. Get a regular bedtime schedule and wake up at the same time every day. Avoid midday naps. Before going to bed, read a book that you enjoy or relax to some music.

•Eat a Healthy Diet: Unfortunately, there is no food that can terminate the presence of depression,

however, a healthy diet can keep you feeling good about yourself and provide you with some critical nutrients.

Reduce your fat and sugar intake and eat lots of vegetables, whole grains and fruits. Caffeine has properties and effects that may cause anxiety and palpitations.

Therefore, it is advisable to cut down on coffee intake, chocolate, tea and fizzy drinks.

•Manage your weight: Excessive weight gain, during a time when one is battling with the disorder may have detrimental effects. Managing your weight is important as this will also have an impact of self-esteem.

•Avoid alcohol and drugs: The possibility of over indulging in alcohol, in an attempt to numb the effects of the depression is extremely high.

So rather avoid alcohol and drugs completely. Alcohol and drugs can interfere with the chemical properties of any prescription medication.

•Stay connected and get involved: People who suffer from depression tend to isolate themselves. Stay connected to people who care about you. Get involved by forcing yourself to do that which you used to do with those you did it with and enjoyed it. Resist the temptation of isolating yourself. Keeping positive company will help you to channel your thoughts and emotion in the right direction.

No matter who you are or what your disposition in life is, you can win the battle against depression. There are still people who love you and need you. Get help. Conquer.

ER24’s nurse and trauma counseling team are available 24/7 to our members. Call 084 124 to speak to a member of our counseling team today. | 18

Events

ER24 out and about ER24 provided medical services at the Middelburg Airshow on 24 June 2017.

Russel Meiring, ER24 communications officer, attended and took some photos of the event.

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Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Events

Priority One | Issue 2, July 2017

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Events

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Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Events

Priority One | Issue 2, July 2017

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Awareness

A crash course in cycling accidents

Cycling is an increasingly popular sport in South Africa.

Avid mountain biker Dr Mike Mulder, an orthopaedic surgeon at Mediclinic Constantiaberg, advises on what you need to know about accidents – both before and after a fall.

Common causes of accidents Dr Mulder lists three main culprits that may cause you and your bike to involuntarily part ways: hitting something, losing control, and speed.

‘Whereas mountain bikers have to deal with things like trees, rocks and the like, road cyclists have unpredictable traffic to contend with, which increases the potential for serious injury substantially,’ says Dr Mulder.

Bike control is also important for preventing falls, and Dr Mulder urges especially mountain bikers to be realistic about their skills. ‘Don’t be coaxed by your mates into tackling a trail that’s above your skill level,’ he advises.

On both road and trail, speed increases not only the risk of an accident, but also the severity of injuries.

Injuries: the infamous five Dr Mulder names these as the most common injuries sustained during cycling accidents: •Collarbone breaks and fractures •Acromioclavicular (AC) joint separation (shoulder) •Radial head fractures (elbow) •Wrist injuries 3 23 | |

•Rotator cuff injuries (the group of muscles and tendons keeping your shoulder together) After an accident They say in cycling that it’s not a matter of if you’ll fall, but when. Dr Mulder lists these basics you should know about treating someone straight after an accident: •Check for visible injuries.

•If the person can stand up and move by themself, get off the road/trail to a safe space.

•If not, or if there are signs of damage to their helmet, don’t move them.

•If someone is unconscious or severely injured, turn them on their side.

•Take off their shoes and socks to ease swelling of the ankle.

•Don’t throw water in their face.

•Immediately call an ambulance, or if you’re on a trail, go look for help.

•Even if you are able to walk away from a fall, have yourself checked out at the nearest hospital.

Preparing for the worst – on and off the bike While you never know when disaster might strike, Dr Mulder mentions a couple of precautions you can take to help reduce the risk of an accident: •Carry your phone with you.

•Get an SOS and tracking app.

•Ride with a buddy. If not, tell someone when and where you’re going to ride.

•Carry a basic first-aid kit.

•Get fit and stay alert.

Fatigue causes you to lose concentration, which may increase your risk of having an accident.

The fitter you are, the longer it takes for fatigue to kick in.

•Have fun and up skill.

Cycling is about having fun – you’ll not only get fitter, but your handling skills will also improve.

‘Don’t be coaxed by your mates into tackling a trail that’s above your skill level.’

Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

Health

Back to work during cancer treatments Starting work again during or after cancer treatment can be a difficult transition to make. While cancer treatment is different for everyone, a Mediclinic oncologist gives general advice on how to cope with work during cancer treatment.

‘Treatments can last a couple of months, so we try to disrupt normal activities as little as possible and encourage patients to continue working,’ says Dr Conrad Jacobs, an oncologist specialising in radiation and chemotherapy at Mediclinic Cape Gate and Mediclinic Durbanville hospitals.

‘However, the types of cancer treatments and treatment regimens differ widely depending on the patient’s type of cancer.

Some need to be hospitalised and others require a quick outpatient injection or even chemotherapy tablets they can take at home. Treatments all have different side effects, ranging from minimal discomfort to severe pain.

So each case will need to be managed independently, depending on the treatment regimen,’ Dr Jacobs adds.

He says a lot of research has gone into helping to minimise the side effects of chemotherapy, making everyday challenges easier for cancer patients to manage.

‘While the treatment hasn’t

Priority One | Issue 2, July 2017

changed all that much in terms of side effects over the past 10 years, there are a lot more medications available to manage those side effects more effectively,’ he explains.

If you are discharged from hospital after cancer treatment and are able to return to work, here are general tips to help you cope: 1.Be kind to yourself. Try to reduce your workload and discuss a strategy with your manager so you don’t feel overwhelmed.

2.Take control of your inbox.

Some people find it effective to set up an automatic reply that they will only check their emails twice a day. Stick to the rule.

3.Listen to calming music.

With high-speed internet available at most companies these days, you can choose your favourite tunes on YouTube, which will help you block out stressful and distracting noises and make your day more enjoyable.

4.Be honest. When you’re not feeling well and need to go home early, be honest with your colleagues and let them support you.

5.But don’t withdraw.

Chatting and laughing with colleagues may help to lift your mood and forget about your worries for a while.

6.Make time for healthy lunches and snacks. Eating regularly throughout the day

may help minimise symptoms such as nausea.

7.Make time for mild exercise. A walk in a nearby park at lunchtime could help you feel refreshed and boost your immune system – but stay away from crowded places that could have the opposite effect.

My colleague is going through chemo – how can I help?

1.Don’t ignore the situation, but take your cues from your colleague. Be genuine and heartfelt in your comments; ask them how they are doing and how you can help. Avoid well-meaning but potentially harmful comments such as ‘Just stay positive!’ – they could make your colleague feel as if their very real fears and concerns are not

legitimate.

2.Offer help in concrete ways, such as bringing your colleague a healthy lunch once a week or making time to stroll in the park together.

3.Remember, each cancer story is different and your cousin’s child’s best friend’s father’s cancer tale might not be helpful to your colleague.

Rather let them know you are available to talk or listen and let them take the conversation from there.

Above all, keep your relationship normal, show patience and compassion, and keep your colleague’s confidentiality – do not discuss their treatment or symptoms with anyone without their permission.

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ER24 staff

Welcome to

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Specialised Customer Service Agent

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We are glad to have you part of our family.

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Priority Priority One One || Issue Issue 2, 2, June July 2016 2017

accident ANGELS

JOIN TODAY FOR GUARANTEED PRIVATE MEDICAL CARE accidentANGELS™ guarantees treatment in a private medical facility for all members after a vehicle accident.

When medical aid members do not have enough money in their medical savings, accidentANGELS™ will take care of any shortfall.

Paramedics stabilises patients at accident scenes.

Members of accidentANGELS™ are identified by either an accidentANGELS™ MasterCard® or vehicle sticker or license disc. accidentANGELS™ members are also listed on the ER24 database.

For payment members use their accidentANGELS™ MasterCard®.

If a member requires further medical treatment for their injuries, R200 000 is set aside by accidentANGELS™ for the required treatment.

Our panel of in-house attorneys then process each RAF claim to ensure that the maximum amount recoverable from the RAF is refunded to the member at no additional cost. http://www.accidentangels.co.za/

ER24 is South Africa’s largest emergency medical response company. After identification of our members, transport to the nearest private medical facility is organised.

On notification of a vehicle accident, up to R10 000 is loaded onto the member’s accidentANGELS™ MasterCard®.

Patients are treated in the trauma/emergency centre of a private facility.

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