creating a great healthcare experience altogether
Issue 10 | winter 2016
WHICH IS BETTER?
Running or walking?
Snoring...
OR SLEEP APNEA?
Grab & Go
BREAKFAST IDEAS
Blood pressure
NEED TO KNOW
HEALTH ADVICE
Ask our experts CARING FOR
Elderly Parents Intercare Salubrity
Tranquility
6
contents Issue 10 | winter 2016
Be personal 2 32
10
14
CEO Message your experts Your questions
Interact 3
Intercare News & Events
4
SNIPPETS Latest health news
30
Recipe Page Banana Flapjacks
Your body
20
follow on sociauls media!
18
all about Warts 'n' all
27
First Aid Concussions
From the experts 10
DIAGNOSIS Snoring & Sleep Apnea
16
Intercare Salubrity Tranquility
20
NEED TO KNOW Blood Pressure
24
How to Care for elderly parents
Your health 6
Health Strategy Running or walking?
14
health Treats Grab & Go Breakfasts
23
HEALTH FACTS Flu season
yo u. .. W e wa nt to he ar fr om
24
30
tomers to air their ite all patients and cus We would like to inv this magazine. ing ard with input reg views and provide us l then be able wil remain relevant and In doing so, we can healthcare at gre a e eat and “cr to make a difference email us at ase Ple er� on a daily basis. experience altogeth are.co.za erc int ce@ en OR myexperi info@intercare.co.za ideas and topics you with any suggestions, out. would like to read ab orial Enquiries Advertisi ng & Edit ng: Health-B ytes Publishi health-b ytes.co.za sta@ 021 913 0504 | chri Grobler ista Chr or Publishing edit : Bernette Becker Design - Health-B ytes t | Printing BusinessPrin Proofing Albert Buhr
Advertisi ng: Language FREE copies of Bod y rcare are distributed at Inte tres. Medical and Dental Cen act cont se To advertise, plea ent. our advertising departm
CEO message
CEO
message
highest levels of satisfaction. Such initiatives cannot be once-off endeavours and these processes will continue in an iterative fashion, with the Patient Experience iniative being entrenched in our culture. We invite you to continue sharing your experiences with us at myexperience@intercare.co.za. The Intercare Group has seen phenomenal growth over the last few years and will continue setting new standards through the ongoing introduction of innovative products and services. The Group currently has four Day Hospitals, four Sub-Acute and Rehabilitation Hospitals and now, with the opening of the Medical Centre in Panorama, Cape Town, on 8 June, a complement of seventeen Primary Care facilities. In addition, Intercare Salubrity, a health-risk management company, was launched earlier this year. Salubrity by definition means “conducive or favourable to health and well-being”. Intercare Salubrity makes great health possible by creating an environment conducive to preventative, holistic and coordinated care for individuals, irrespective of their age, gender or
Our patients’ satisfaction is our first priority, and it is important to understand their needs and expectations.
medical scheme status. With the introduction of two genetic screening products, Tranquility and Serenity (offered in collaboration with Genoma, a Swiss Biotechnology company), Intercare Salubrity shifts the focus from medicine for the average to medicine for the individual. This is yet another example of how Intercare is
Once we understand our patients’ world, it
playing a leading role in changing the healthcare
is imperative that we act on it and redesign
landscape in South Africa.
our services to give them the best possible care. It is on this basis that we launched
On the 27th of May, 14 years ago, the first patient
the Patient Experience initiative last year.
walked into Intercare Glenfair. Although we didn’t
It consists of 2 phases. First, carefully
know what the future would bring, as we look
designed surveys were conducted and data
back today, it's been a wonderful journey. We’ve
were collected to give us objective insight
worked very hard and were blessed in abundance.
into our patients’ needs. This was followed
We will continue to fulfil our vision of “Creating
by the development and implementation
a Great Healthcare Experience Altogether” and
of a unique programme aimed at ensuring
to care for people the Intercare way.
that our staff and processes leave patients with the best possible impression, and
Dr Hendrik Hanekom (Chief Executive)
news and events Left hand side, near to far: Dr Brent Carstens (GP), Theresa du Toit (Practice Manager), Amanda Hanekom (Intercare Corporate), Dr Anne-Mique Snyman (GP), Dr Aneke Vrolijk (GP), Dr Alet Theron (GP), Dr William Barnard (GP)
ed ic al Ce nt re Op en in g of Pa no ra m a M
Right hand side, near to far: Adelia Schultz (Operations Executive), Dr Jonelle Malherbe (GP), Dr Koos van der Merwe (GP), Dr Hendrik Hanekom (Group CEO).
Intercare Panorama Medical Centre opened its doors on 8 June 2016. It is Intercare’s 17th medical centre and is situated in the Panorama Healthcare Centre in the northern suburbs of Cape Town. The centre offers an array of healthcare services, including aviation medicals, chronic disease management, Vitality wellness screenings, executive medicals and minor surgical procedures.
From left to right: Dr George Veliotes (Chairman, Intercare Group), Mr Gregory Roumeliotis (Industry Advisor, Genoma), Dr Frédéric Amar (CEO, Genoma), Dr Hendrik Hanekom (CEO, Intercare Group), Dr Cameron Meyer (Head, Intercare Salubrity)
lu br it y L au nc h of I nt er ca re Sa Intercare’s Centre for Lifestyle Management has been expanded, reformed and reborn as Intercare Salubrity – a company specialising in preventative, holistic and coordinated care for individual patients, medical-scheme members and company executives and employees. “Salubrity” means conducive or favourable to health or well-being, and with that in mind, Intercare Salubrity introduced genetic screening services through an exclusive partnership with Genoma, a Swiss-based leader in clinical diagnostics. It was a privilege to have the CEO of Genoma, Dr Frédéric Amar, present at the launch function.
page 03
snippets
tHhEAeLTlaHtNeEsWtS Take a nap and
recharge!
These pointers will ensure that each time you take a quick snooze, you are left feeling refreshed and ready to take on the rest of your day. • A nap doesn’t have to be long to be effective. A 10-20 minute “power nap” can help boost alertness and energy. Napping for longer than 30 minutes can up your chances of falling into a deep sleep, leaving you feeling a bit groggy and even more tired. • The position you sleep in can also affect your rest quality. Research has shown that resting on our sides, rather than our back or our stomach, helps our brains to discard waste products.
• Napping is beneficial no matter when you do it, but research says midafternoon is not only the most natural time of day to nap, it also may come with some extra health benefits, like lower blood pressure. Some European cultures still take a “siesta” or a break from their hectic days and lay down for a snooze. Source: medicaldaily.com
Wakey, wakey! Are you a “snoozer”? “Snoozing” an alarm can waste an average of 85 hours a year or 173 days of your life.
Forgive and forget
– yourself and others!
According the a new study in the Journal of Health Psychology, forgiving folk are able to handle stress better and protect themselves against the toll it takes on mental health. Researchers looked at the effects of lifetime stress on a person’s mental health, and how more forgiving people fared compared to people who weren’t so forgiving. People with greater exposure to stress over their lifetimes had worse mental and physical health. But the researchers also discovered that if people were highly forgiving of both themselves and others, that characteristic alone virtually eliminated the connection between stress and mental illness. How a forgiving personality protects a person from the ills of severe stress is hard to determine. The researchers speculate that people who are more forgiving may adopt better coping skills to deal with stress, or their reaction to ma jor stressors may be dulled. The sample of people in the study is small (148), and more research is needed to fully understand the benefits of being more forgiving. But study author Loren Toussaint says he believes “100%” that forgiveness can be learned. Many therapists work to cultivate forgiveness in sessions, he says, and his own prior research has shown that saying a short prayer or a brief meditation on forgiveness can help people take the edge off.
“Forgiveness takes that bad connection between stress and mental illness and makes it zero,” he says. “I think most people want to feel good and it offers you the opportunity to do that.” Source: www.time.com
HEALTHY KIDS...
all winter long
Aitishoo! Aitishoo!... We All Fall Down… Early to bed… Something as simple as a bedtime routine will help them stay on track with sleep throughout the week. Keeping those germs away this winter season can be tough with children playing and staying indoors most of the time. Check out a few of our favourite ways to keep your kids healthy throughout these tough winter months.
Play to stay healthy… Challenge your kids to an energising fun activity like a jump rope or hula-hoop contest. Catch a cough or sneeze… Teach your kids to cough or sneeze into the
Source: Inspire Magazine
crook of their elbow if they can’t get a tissue in time. Five a day keeps the doctor away… Help your family keep their immune systems up by eating five servings of fruits and veggies every day. Keep those germs away!… Pack tissues and a small bottle of hand sanitiser in your child’s backpack and teach them how to use it.
Sugar has never been so controversial. Here are five Very simple ways to cut down on the sweet stuff:
Are you ready for sugar tax?
1. Get cooking
3. Know your labels
5. Train your taste buds
The best way to ensure your food contains no hidden nasties is to make it yourself. The current focus on reducing sugar and showcasing fresh ingredients means the bookstores are full of inspiring recipe books.
Pasta and stir-fry sauces, cereals and even bread all contain “hidden” sugars. Check the nutritional content when buying processed food. The WHO currently recommends adults stick to 6–7 tsp of sugar a day (30g maximum; 1 tsp of sugar = 4.25g of sugar).
People who give up sugar for a period of time are amazed by how sweet things taste once they return to their normal foods. Adjust your palate by gradually making healthier switches to reduce your sugar intake. Mix your normal muesli with plain oats and nuts, go for chocolate with a higher cocoa content, try adding fresh fruit to natural yoghurt instead of buying high-sugar flavoured yoghurts, and switch to sugarfree nut butters. If you’re used to having something sweet after meals then try a chunk of cheese instead, some herbal tea (peppermint and liquorice has a lovely natural sweetness), or warm milk flavoured with cinnamon and nutmeg.
2. No sugary drinks
Fizzy drinks are real sugar bombs and, whilst fresh fruit juices contain vitamins and fibre, many commercial brands are laden with sugar. Stick to fresh juices with a high veggie content, and flavour water naturally with citrus wedges and fresh mint. Beware also of flavoured coffees and hot drinks with added syrups.
4. Keep the kitchen “junk food free”
Keep your kitchen stocked with delicious, healthy treats rather than sugary snacks. Munch on fresh veggie sticks with humus or guacamole as well as fresh fruit, and nuts. A bit of dark chocolate always goes down well (at least 85% cocoa).
Source: healthy-magazine.co.uk
page 05
health strategy
WHICH IS BETTER?
? g n i lk a w r o g n i n Run If you currently class yourself as a runner or a walker, you’re likely to be pretty happy in your camp. But if you’re thinking about picking up the pace or even slowing it down or you’re new to the habitual exercise scene, read on to discover the good, the bad and the downright ugly.
Walking If your goal is exercising for overall health and to improve your longevity, then walking is ideal.
medical literature, a change
function to run well. It puts
in diet, not exercise, is the big
more pressure and stress on
driver of shedding the kilos.
the body and increases the risk
The ugly
for injuries like runner‘s knee, hamstring strains, and shin
Each year, thousands of regular
splints (which plague even the
walkers are hobbled due to a
most consistent runners).
walking-induced pain or an old
To avoid the consequences
As a lower-impact form of
exercise injury that has been
of the repetitive impact,
exercise, most people are
aggravated by walking.
regular runners need to
The good
capable of walking. Plus, a
develop management
daily walk delivers many
techniques like stretching,
cardiovascular health benefits. A recent study published in the Journal of the American College of Cardiology
Running
The good
massage, functional strength exercises and other crosstraining activities.
As a higher-intensity form of
suggests that moving at a
exercise, running has been
Intense training over the
gentler pace – a brisk walk or a
proven to offer greater
course of many years can
slow jog for 1 to 2,5 hours per
fitness, weight loss and
also lead to permanent
week – lowers your risk of
overall health benefits. This,
changes in your heart that
death by 25%.
of course, also means you don’t
can set the stage for serious
need to exercise for as long to
cardiovascular problems.
In a new study published in
stay fit. Running may regulate
Arteriosclerosis, Thrombosis,
appetite hormones better
and Vascular Biology, regular
than walking.
walkers turned out to be
The ugly
Apart from the chafing (need we say more?), excessive
healthier than their running
In another (small) study,
endurance training may also
counterparts. Risk for
after running or walking,
dampen your immune system
hypertension, high cholesterol,
female participants were
and increase your risk for
diabetes, and heart disease
invited to a buffet, where
illness.
all dropped more significantly
walkers consumed about 200
among walkers (more than
kilojoules more than they had
Researchers at the University
9%), compared with runners
burned and runners ate almost
of Illinois, Urbana-Champaign
(about 4,5%).
850 kilojoules fewer than
found that prolonged intense
they‘d burned. Researchers
activity increases levels of
think this may have to do with
certain inflammatory proteins
If your exercise goal is weight
runners‘ increased levels of the
that can allow viruses – such
loss, you’ll need to do a lot
hormone peptide YY, which
as the common cold – to
of walking. Walking is a
may suppress appetite.
thrive. That means you might
The bad
slow way to burn kilojoules and won’t challenge your
The bad
get sick more frequently, and feel worse during bouts
Running is hard on your
of illness, if you‘re taxing your
as much as running will.
body and you’ll need to have
body with vigorous exercise
But, as has been proven in the
a certain level of strength and
on a regular basis.
cardiovascular fitness levels
page 07
MELOMAG | 13 |
health strategy
Which one will JUST STARTING suit me? OUT?
unusual pain or discomfort. However, it is important to
As important as exercise is,
If you’re new to the world of
challenge yourself to the point
it‘s important to get the right
regular exercise, walking is
where you feel some level of
dose. More isn‘t necessarily
definitely the best way to start.
breathlessness or muscular
better. Most of us are guilty of
Most people don’t realise they
fatigue – without this, your
gravitating towards activities
need to get their body fit to
body can’t grow fitter and
we do well and avoiding those
run – not the other way around.
stronger.
Begin by determining the
we could improve upon. If you struggle to find
level of exercise you can
BEFORE YOU start...
motivation to run, and you‘ve
comfortably do – even if this is
If you have specific issues
always assumed walking isn‘t
just a 20-minute walk around
with any part of your body,
hardcore enough to improve
the shops. Then gradually
obtaining expert advice
your health, set those fears
build up to your workout goal
is important: a suitably
aside; walking appears to
by walking at least 5% further
qualified professional like
bestow all the same health
or faster each week.
a biokineticist can help to
benefits as running – without
identify your body’s weak
that either walking or running
want to pick up the pace?
is healthier than not doing
Listen to your body. Quite
capabilities. And a decent pair
either, whatever your health
often less is more, so don’t
of walking or running shoes is
goals.
push yourself through
a must.
the risks. It bears repeating
areas and recommend the best form of exercise to suit your
If you struggle to find motivation to run, and you’ve always assumed walking isn‘t hardcore enough to improve your health, set those fears aside; walking appears to bestow all the same health benefits as running – without the risks.
Cushioning Runners need more:
Runners who strike with their heel or midfoot should look for
What walkers should look for: Fitness walking shoes
Runners impact the ground
less built-up heels, while those
should not have a flared heel.
with three times their body
who land on the ball of their
Walkers strike the ground
weight with each step, while
foot need a more built-up heel.
with their heel, and a flared
walkers impact with only
heel impedes rolling forward
1.5 times their body weight.
Walkers will be striking with
through the step. A true fitness
Runners need more cushioning
their heel and rolling through
walking shoe would have an
in the heel and forefoot than
the step. They have no need
undercut heel rather than a
walkers, which is why you
for a higher heel.
flared heel or built-up heel.
see all of the hype about aircushioning systems.
What walkers should Flexibility look for: Walkers should look Both running shoes and walking
Walkers need less:
for running shoes with the least
shoes need to be flexible. Press
Walkers don't need extra
difference in height from the
down with the toe of the shoe
forefoot cushioning and
heel through the toe. This is
and see where the shoe bends.
most can do with less heel
called heel drop and often you
Many running shoe designs flex
cushioning. Extra cushioning
can find it listed in millimetres
most at the arch or midfoot.
adds extra weight, so it is a
(mm). Look for shoes with a
trade-off between a heavier
heel drop of less than 8mm,
But some designs flex most
shoe that lessens the trauma to
with 4mm or less being
at the forefoot. These suit the
your feet and legs, and a lighter
preferred. The shoe's outer sole
differing needs of runners who
shoe in which you may be able
can be deceptive: some may
strike at midfoot or with the ball
to run or walk faster.
appear to have higher heels,
of their foot. A shoe that bends
but the heel actually sits lower
at the arch does not provide
inside the shoe.
the platform they need.
Heel Height Runners strike the ground
A shoe that doesn’t bend at all
anywhere from the forward
Heel Flare
part of their heel through the
Running shoes may have a
many shoes marketed as
midfoot to the ball of the foot,
flared heel to provide extra
walking shoes do not flex at all.
depending on the individual.
stability for runners who strike
They are unsuited for fitness
Walkers should strike with
the ground at their midfoot or
walking. Fitness walking shoes
their heel. Running shoes are
forefoot. A flared heel is also
should flex at the forefoot, as
designed to provide stability
often seen on trail-running
walkers should push off with
for runners with a built-up heel.
shoes.
their toes.
is unacceptable. Unfortunately,
Sources: well.blogs.nytimes.com | www.greatist.com | www.walking.about.com
page 09
diagnosis
EA
PN A P E E L S D N A G N I R SNO
? e c n e r e f if d e h t is t Wha The big question is — How tired are you during the day?
throat and nasal tissue or
Normal snoring doesn’t
of your tongue can also get in
sleep and that of your family
interfere with the quality of
the way of smooth breathing.
members and roommates.
your sleep as much as sleep
Snoring can lead to poor
apnea does, so you’re less
Anybody can snore, but it has
sleep and daytime fatigue,
likely to suffer from extreme
been studied that more than
irritability, and increased
fatigue and sleepiness during
50% more men snore than
health problems. If your
the day.
women do. Men naturally
Just about everyone snores
occasionally, but if it happens frequently it can affect the quantity and quality of your
snoring keeps your partner
“floppy” tissue that is more prone to vibrate. The position
have narrower air passages
What is snoring?
compared to women, and
Snoring happens when
this increases their likelihood
Luckily, not everyone who
you can't move air freely
to snore. Although it can be
snores has sleep apnea, and
through your nose and throat
annoying to your bedmate,
not everyone who has sleep
during sleep. This makes the
snoring is not necessarily a
apnea snores. So how do you
surrounding tissues vibrate,
serious issue. But, there is the
tell the difference between
which produces the familiar
possibility that it could be a
normal snoring and a more
snoring sound. People who
sign of a dangerous medical
serious case of sleep apnea?
snore often have too much
issue and should be analysed.
awake, it can also create ma jor relationship problems.
Common causes of snoring
+ Being overweight or
+ The way you’re built.
may be due to a deviated
Men have narrower air
nasal septum, soft or cleft
passages than women and
palate, and swollen tonsils.
out of shape.
are more likely to snore.
+ Alcohol, smoking,
Fatty tissue and poor
A narrow throat, a cleft
and medications.
muscle tone contribute
palate, enlarged adenoids,
Alcohol intake, smoking,
to snoring. Even if you’re
and other physical
and certain medications,
not overweight in general,
attributes that contribute to
such as tranquilisers, can
carrying excess weight just
snoring are often hereditary.
increase muscle relaxation
around your neck or throat can cause snoring.
+ Age.
+ Nasal and sinus problems.
leading to more snoring.
+ Sleeping position.
Blocked airways or a stuffy
Sleeping flat on your back
As you reach middle age
nose make inhalation
causes the flesh of your
and beyond, our throat
difficult and create a
throat to relax, and your
becomes narrower and the
vacuum in the throat,
tongue to fall back and
muscle tone in our throat
leading to snoring. Other
block the airway. Changing
decreases.
causes of airway blockage
your sleep position can help.
Symptoms of snoring
Once the cause is identified, some symptoms can include:
may cause airways to become restricted.
+ Keep nasal passages clear,
Difference between snoring and sleep apnea
Snoring can be a symptom
High blood pressure, gasping
as a stuffy nose makes
of sleep apnea (which can be
for breath upon waking or
breathing difficult and
a potentially life-threatening
while sleeping, experiencing
creates a vacuum in the
medical condition, if left
a restless sleep, sore throat,
throat. Nasal washes or
untreated). When a person
feeling excessively tired
strips help you breathe
has sleep apnea, his or her
during the day and finding it
easier while sleeping.
breathing is irregular during
difficult to concentrate during
+ Dry air causes irritation
the daytime hours.
How to stop snoring?
There are plenty of self-help ways to stop or reduce
sleep. Typically, someone
in the nose and throat
with sleep apnea will actually
membranes, so an effective
stop breathing for short
humidifier will keep air
amounts of time 30 to 300
moist while you sleep.
times a night. It can be a big
+ Raising your head
problem if the person doesn't
snoring, and they include
approximately four inches
(but are not limited to):
and sleeping on your side
+ Losing weight to reduce
may help stop annoying
If you are constantly tired
snoring noises.
during the day, then you
excess fatty tissue
+ Exercise and working with
+ Avoid soy-based products,
get enough oxygen.
should consider being tested
hand weights to tone your
dairy, caffeine and heavy
for sleep apnea. Normal
entire body (including
meals at least two hours
snoring usually doesn’t
throat muscles)
before heading to bed.
interfere with your quality
+ If you smoke, the chances
+ Singing has been known to
of sleep, and it should not
that you will snore are high,
help control throat muscles
cause you to wake up feeling
as smoking causes irritation
and reduce snoring due to
unrested.
in the throat and nose and
relaxed muscles.
page 11
diagnosis What is sleep apnea?
of apnea during sleep your
resumes with a gasp or a
Obstructive sleep apnea
brain will automatically wake
choking sound. If you have
(OSA) is defined as the
you up, usually with a very
obstructive sleep apnea
cessation of airflow during
loud snore or snort, in order
(OSA), you probably won’t
sleep, preventing air from
to breathe again. People with
remember these awakenings.
entering the lungs due to an
OSA will experience these
obstruction. These periods
wakening episodes many
Most of the time, you’ll stir
of 'stopping breathing' only
times during the night and
just enough to tighten your
become clinically significant
consequently feel very sleepy
throat muscles and open your
if the cessation lasts for more
during the day: they have an
windpipe. In central sleep
than 10 seconds each time
airway that is more likely to
apnea, you may be conscious
and occurs more than 10
collapse than normal.
of your awakenings.
Anatomy of a sleep apnea episode
How do I know I have sleep apnea?
airway to collapse. During
sleep apnea episode, the
complain of excessive
the day we have sufficient
oxygen level in your blood
daytime sleepiness, often with
muscle tone to keep the
drops. Your brain responds
irritability or restlessness. But
airway open, allowing for
by briefly disturbing your
it is normally the bed partner,
normal breathing. When
sleep enough to kick-start
family or friends who notice
you experience an episode
breathing – which often
the symptoms first.
Sufferers may experience
will necessarily have sleep
+ A thick neck (neck
some of the following:
apnea. We possibly all suffer
circumference greater than
from these symptoms from
40cm)
times every hour. OSA only happens during sleep, as it is a lack of muscle tone in your upper airway that causes the
+ Extremely loud, heavy
As airflow stops during a
People with sleep apnea may
time to time but people with
snoring, often interrupted
sleep apnea demonstrate
Other physical attributes that
by pauses and gasps
some or all of these
put you at risk for obstructive
symptoms all the time.
sleep apnea include a
+ Excessive daytime sleepiness, like falling asleep at work, whilst driving, during conversation or when watching TV
+ Irritability, short temper + Morning headaches + Forgetfulness + Changes in mood or behaviour
+ Anxiety or depression + Decreased interest in sex Remember, not everyone who has these symptoms
Sleep apnea causes and risk factors
deviated septum, receding chin, or enlarged tonsils or adenoids (the most common
Certain risk factors have
cause of sleep apnea in
been associated with sleep
children). Your airway may be
apnea. You have a higher risk
blocked or narrowed during
if you are (or have):
sleep simply because your
+ Overweight + Male + Related to someone who
throat muscles tend to relax
has sleep apnea
+ Over the age of 50 + A smoker + High blood pressure
more than normal. Allergies or other medical conditions that cause nasal congestion and blockage can also contribute to sleep apnea.
People with sleep apnea may complain of excessive daytime sleepiness, often with irritability or restlessness. But it is normally the bed partner, family or friends who notice the symptoms first.
Treating sleep apnea
prescribed. CPAP is the gold
every day, and can be done
There are several forms of
standard treatment for OSA.
while commuting, walking
treatment for sleep apnea.
When wearing a CPAP mask,
or showering. Examples of
In mild and moderate cases
the machine will blow air into
throat exercises include:
weight loss and the use of
your airways to keep them
+ With a closed mouth, purse
dental devices (fitted by a
open throughout the night.
professional dentist), which
your lips and hold for 30-second intervals.
+ Out loud, repeat the vowels
are similar to an athlete’s
Address possible
mouth guard, can be wholly
allergens in your bedroom
(a-e-i-o-u) several times
successful. Two common oral
that may interfere with
during the day for three to
devices are the mandibular
your breathing such as:
repositioning device and
removing pets and washing
the tongue retaining device.
the bedding regularly in hot
behind your top front teeth
These devices open your
water to remove any mold
and move back and forth for
airway by bringing your
spores and dust.
five minutes each time.
+ Put the tip of your tongue
several minutes each day.
+ With your mouth open,
lower jaw or your tongue forward during sleep. In
Throat strengthening
move your jaw to one side
moderate and severe cases
exercises may help to reduce
and hold for at least 30
a dental device or nasal
or completely cease snoring.
seconds and repeat on the
continuous positive airway
These types of exercises
other side.
pressure (CPAP) are normally
should be done 30 minutes Source: Harvard Health Publications, www.helpguide.org
page 13
health treats
GRAB-AND-GO
s a e d I t s a f k Brea Fruit and cheese
A balanced, easy-to-assemble makeahead morning meal: Grab an apple, wrap a few cubes of Cheddar in plastic, and toss Âź cup of fibre- and protein-rich nuts into a resealable plastic bag.
Peanut butter waffle Instead of dousing a waffle in syrup, cut the sugar and boost the protein and fibre by spreading it with peanut butter. You can also sprinkle on some raisins, sesame seeds, or extra peanuts for even more fibre, which helps deliver the meal's nutrients slowly and steadily.
Strawberry shake In a shaker, combine vanilla or strawberry instant-breakfast porridge (look for the no-sugar-added kind) and 1 cup of low-fat strawberry cow's milk or soy milk. (You can also mix this the night before.) If you have time, use a blender to add strawberries or a frozen banana.
Cereal "sundae" A bowl of fibre-rich bran flakes (about 1½ cups) with low-fat milk is nearly the perfect breakfast. Make it portable by replacing the milk with vanilla yogurt and mixing it in a to-go container. Increase the fibre and vitamins by adding nuts or fresh or dried fruit, such as chopped pecans or blueberries.
Egg tortilla One of the most “portable” proteins is a hard-boiled egg, but it has no fibre or carbohydrates. So slice it, then roll it in a wholewheat tortilla with a piece of macon or pastrami and, if you like, a slice of cheese. Add a tablespoon of salsa for a shot of flavour and a smidgen of vitamin C.
Breakfast muffin This sandwich packs protein from egg, calcium from cheese, and fibre and B vitamins from the wholegrain muffin. Halve the muffin, spread chutney over the bottom half; top with two pastrami slices, one fried egg, and cheese. Place top half of the muffin over the bottom.
Morning pizza slice You could have a slice of last night's pizza (preferable to filling up on sugar or skipping breakfast). Or try a more sophisticated spin: Take a slice of crusty bread, spread it with three tablespoons of ricotta, and add tomatoes. Finish with a drizzle of olive oil (about one teaspoon) and a little salt and pepper.
page 15
Intercare Salubrity
Tranquility For more information about this test or to access Genetic Counselling, please call 086 999 0669 or send an email to genetics@salubrity.co.za.
Non-Invasive Prenatal Testing
An individual’s genetic material is divided into packages called chromosomes, which are stored in the nucleus of a cell. Humans have 46 of these chromosomes, consisting of 23 pairs with one chromosome of each pair inherited from each parent. Chromosomes can be abnormal in terms of their number or structure, which can result in a vast array of possible conditions in a child. Down Syndrome, caused by an additional copy of chromosome number 21, is the most well known of these. There is an increased risk of chromosomal abnormalities in the following situations, and women may want to consult a Genetic Counsellor if any are present in their family:
Luckily for expectant parents, there has been exciting new progress in the field of genetic screening in the unborn baby, with the advent of Non-Invasive Prenatal Testing (NIPT). Research has revealed that a foetus’s DNA enters the mother’s bloodstream from the fifth week of pregnancy. This DNA can be obtained by simply drawing blood from the mother, as would normally be done for any other test (such as a glucose test). Non-Invasive Prenatal Testing (NIPT) is the method of collecting this blood, isolating the foetus’s DNA and then testing it for abnormalities. NIPT is considered a great step forward in the field of foetal screening for a number of reasons:
+ A history of a chromosomal
condition in the family + A woman who has had a
previous pregnancy or child with chromosomal abnormality + Other tests have demonstrated possible abnormal findings, such as blood tests and ultrasound + Women who are older than 35 years
+ It assesses the foetal DNA
rather than indirect markers considered proxies for chromosomal abnormalities. It is thus much more accurate and reliable than the standard methods of screening, with correct results in 99.9% of tests + It can be done as early as the 10th week of pregnancy.
This allows the parents the maximum amount of time to consider options should the result be positive. + It can detect the following conditions, which represent a significant proportion of chromosomal abnormalities, in addition to confirming the baby’s gender: Trisomy 21 (Down syndrome) Trisomy 18 (Edwards Syndrome) Trisomy 13 (Patau Syndrome) Monosomy X (Turner Syndrome) Triple X Klinefelter Syndrome Jacobs Syndrome Microdeletion disorders including Prader-Willi, DiGeorge, Cri-du-chat syndromes Intercare Salubrity is excited to now offer this testing through its exclusive partnership with Genoma, a Swiss-based biotechnology company with the largest genetic clinical diagnostics platform in Europe and who specialises in genetic testing. Genetic counselling can also be arranged to help assess your risk and determine the need for testing.
page 17
all about
W’aArLtsL
’N
Many of us have had a wart somewhere on our bodies at some time. Other than being a nuisance, most warts are harmless and go away on their own.
Are Warts Contagious?
THINK PREVENTION
caused by viruses of the
Warts can be seen as
Although there’s no way to
human papillomavirus
contagious, but the risk of
prevent warts, it’s always
(HPV) family.
passing them on to other
a good idea to encourage
people is quite low as close
kids to wash their hands
skin-to-skin contact is needed.
and skin regularly and well.
area of the body, but tend to
The infection can however
If your child has a cut or
invade warm, moist places,
be transmitted indirectly
scratch, use soap and water
like small cuts or scratches
from contaminated objects
to clean the area because
on fingers, hands, elbows
or surfaces, such as a towel
open wounds are more
and bottoms of feet.
or the area surrounding a
susceptible to warts and
swimming pool. After being in
other infections. It’s also
Warts are usually painless
contact with the virus, it can
wise to have kids wear
unless they’re on the soles
take weeks or even months
waterproof sandals or flip-
of the feet or another part of
for a wart to appear. A tiny
flops in public showers,
the body that gets bumped
cut or scratch can make any
locker rooms, and around
or touched all the time. There
area of skin more vulnerable
public pools (this can help
are several types of warts,
to warts. Also, picking at a
protect against plantar
including common warts,
wart can spread warts to
warts and other infections,
flat warts and plantar warts.
other parts of the body.
like athlete’s foot).
More common in kids and teenagers than in adults, warts are skin infections
They can affect any
TREATING WARTS Warts don’t generally cause any problems, so it’s not always necessary to have
Wart
+ freezing the wart with liquid nitrogen (called cryosurgery) + using laser treatment (with recalcitrant warts)
them removed. Without treatment, it can take anywhere from six months
Within a few days after
to two years for a wart to
the doctor’s treatment, the
go away. A doctor might
wart may fall off, but some
decide to remove a wart if
stubborn warts may require
it’s painful or interferes with
additional treatments.
Signs and Symptoms OF:
Also make sure that your child:
common warts: • located on back of hands, around nails, and in the mouth, or at the site of cuts and scratches • small flesh-coloured bump • rough surface that looks like cauliflower • pink or white soft bumps in the mouth • tiny black dots inside the wart
activities because of the discomfort.
+ keeps the area of the wart covered while the medicine works + knows not to rub, scratch, or pick at it, to avoid spreading the virus to another part of the body or causing the wart to become infected
WHEN TO VISIT YOUR DOCTOR Talk with your doctor before LASER TREATMENT
Doctors have different ways of removing warts, including: + using over-the-counter or
using any over-the-counter wart medicine on the face, genitals or rectum. If you are diabetic please consult your doctor before using any treatments.
topical applications
Also call the doctor if a wart or surrounding skin is:
containing salicylic acid is
+ painful, red or swollen
effective in getting rid of
+ bleeding
warts.
+ changing in appearance
prescription medications to put on the wart – these
+ burning the wart off using a light electrical current
+ oozing pus
HPVinfected cells
Blood vessels
Flat warts: • located on the face, neck, arms, or legs • size of a pinhead • small smooth bumps with a flat top • flesh-coloured or pink to light brown • may occur in groups of 20 to 100 plantar warts: • located on the sole of the foot • pressed into the skin • tiny black dots inside • may be painful and uncomfortable – like walking on a small stone
+ spreads Source: kidshealth.org
page 19
need to know
10 things that can raise your
blood pressure
Around one in four South Africans has high blood pressure (although only half of them know it) – a major risk factor for heart attacks and strokes. Do you know the key causes?
There's no way of telling
To imagine the strain this puts
are more vulnerable. Smoking
from the outside if you have
on your heart, think of the
markedly increases the risk
high blood pressure. You can
pressure you need to blow
of heart disease or stroke for
feel perfectly well and yet
up a round balloon compared
a given level of high blood
the force of blood pressing
to how much you need to
pressure compared to a non-
against the walls of your
blow up one of those long
smoker.
arteries can be high enough
skinny balloons used to make
to be slowly causing damage
balloon animals.
that increases your risk of heart disease, strokes and
2. Family history
4. Excess alcohol
Regular alcohol intake is clearly associated with high
Have one or both of your
blood pressure. It seems to
parents had high blood
have an especially marked
pressure? Family history
effect on the blood pressure
contributes anywhere
of older women who smoke.
between 2% and 10% of your
For them, two standard
risk of developing high blood
drinks can elevate blood
pressure, depending on your
pressure. Regular heavy or
Sixty per cent of people aged
age and whether one or both
binge drinking, however, can
60 or more have high blood
parents had a blood pressure-
cause substantial rises in
pressure. Our arteries stiffen
problem.
blood pressure, sometimes
kidney failure.
But there are some known key factors that increase your risk:
1. Age
with age. This means the same volume of blood is forced into a smaller area and your blood
3. Smoking
extreme enough to lead to a stroke. Alcohol can also
This adds to the risk of
impact on the effectiveness
pressure may rise, sometimes
developing high blood
of blood-pressure-lowering
dramatically.
pressure and older people
medication.
5. Being overweight or obese
stages of high blood pressure
6 grams a day, but most of
is likely to develop kidney
us eat more than this. Some
Obesity increases the risk
disease in the next six years
take-away pizzas contain
of developing high blood
if they don't receive blood-
13 grams per single pizza!
pressure in the next four years
pressure treatment.
Bread alone contributes 20
by 6%. Extra body fat around your middle carries the greatest risk.
6. Kidney disease
7. Excess salt in the diet
per cent of dietary salt intake and processed meats 15 per
Sodium chloride (salt) is
cent. Condiments, sauces and
the main source of sodium
marinades we add to food are
in most foods. As sodium
often very high in salt.
Inflammation and infection
in our blood increases, the
(among other things) can
blood vessels retain water
cause kidney disease, which
to try to balance the sodium
is a major cause of high blood
concentration. This extra
more common in people with
pressure. And once you have
water increases the volume
diabetes (60% of people with
high blood pressure, it can
of blood in vessels, causing
type 2 diabetes and 40% of
make kidney disease worse.
high blood pressure. The
people with type 1 have high
Someone with normal kidney
recommended maximum
blood pressure.
function who is in the early
salt intake is less than
8. Diabetes
High blood pressure is much
Source: WebMD
page 21
need to know 9. Low physical activity People who spend a lot of
time watching TV and little
What do blood pressure numbers mean?
A normal systolic blood pressure is below 120. A systolic blood pressure
time on physical activity have been shown to have
Knowing both your systolic
of 120 to 139 means you
higher blood pressure than
(top number) and diastolic
have prehypertension,
more active people.
(bottom number) blood
or borderline high blood
pressure numbers is
pressure. Even people with
important and could save
prehypertension are at a
your life.
higher risk of developing
10. Rare causes
About 5 per cent of people
heart disease. A systolic
with high blood pressure have a specific underlying
Blood pressure is measured
blood pressure number of
cause, generally related to
in millimetres of mercury,
140 or higher is considered
their kidneys, their aorta (the
as two figures, for example
to be hypertension, or high
major artery which takes
124/80 mmHg.
blood pressure.
+ The first number (124 in
A normal diastolic blood
blood away from the heart) or hormonal conditions. Unlike the most common forms of
this case) is known
pressure number is less
high blood pressure, which
as systolic pressure –
than 80.
generally require lifelong
pressure in the arteries
treatment, many of these
when the heart contracts.
pressure are curable.
A diastolic blood pressure between 80 and 89 indicates
rare causes of high blood
+ The second number (80
prehypertension. A diastolic
here) is diastolic pressure
blood pressure number of
– the pressure in the
90 or higher is considered
arteries when the heart
to be hypertension or high
rests between beats.
blood pressure.
Where does your blood pressure measure up?
HEALTH FACTS
Flu Season llion ult in between 3 and 5 mi Annual flu epidemics res 00 0,0 50 d between 250,000 and cases of severe illness an the world. deaths every year around
year! suffer from flu every le op pe VE FI F O UT ONE O
161km/h
The single best way
48 hours
ect Adults may be able to inf re others 1 day befo to symptoms develop and up
to prevent the flu is to get a flu vaccine every season.
is the speed the flu virus can travel through the air.
The length of time the flu virus can survive on surfaces.
k.
ng sic 5-7 days after becomi
What is the best treatment for flu?
inly Flu viruses spread ma made by droplets flu the th wi le when peop k. tal or cough, sneeze
Rest, liquids and antiviral medication.
tween May and August! be e ar els lev u fl ak pe e th Watch out,
More than 200
viruses can trigger a runny nose, sore throat, sneezing or coughing.
32.8° C
The temperature inside the human nose and the appropriate temperature at which rhinoviruses (flu germs) grow best.
A sneeze can spray
3000 infectious
droplets into the air.
page 23
how to
Care for your
elderly parents Is dad forgetting routine activities? Is mom having trouble managing the budget? Have you noticed that your parents’ driving skills have become dangerous to themselves and others? These are common signs that your loved ones may be having cognitive changes and potential memory loss. Now is the best time to talk with them about their health and well-being. Although these are hard conversations to have, start by bringing up your concerns with your loved one.
Concerned about your ageing parents’ health? Use this guide to gauge how your ELDERLY parents are keeping up – and what to do if they need help.
become angry when you bring
and resources to help them be
up your concerns, or that they
the best they can be. If you’re
ignore the concern by laughing
thinking about transitioning to
it off, you can call their doctor
a retirement village or nursing
to express your concerns in
home, plan ahead and get on
private.
a waiting list.
Typically, a doctor will refer
Even if your loved one isn’t
patients to occupational
ready to transition, in most
Suggest scheduling a doctor’s
therapy to either test cognitive
cases, you can stay on the
appointment where the three
performance or screen them to
waiting list until a spot opens.
of you can talk through your
see if they should still be driving
cares and concerns, while
and are able to perform routine
creating a long-term care
tasks at home. Once the test
plan.
results come back, together with the doctor, you and your
If you find that your parents
loved one can look at next steps
As your parents get older, how can you be sure they’re taking care of themselves and staying healthy?
When you are visiting your parents, consider the following questions: Mood and Brain Health
+ Does your loved one have
Memory and Thinking
+ Have there been problems
sudden or frequent
with wandering or getting
sadness?
lost?
+ Is there a loss of interest
forgetting about the stove
enjoy?
or other appliances or home
personality change? + Is your loved one experiencing excessive or unusual worrying? + Is organisation a problem? + Have you noticed difficulty in their learning new things? + Are there new difficulties with mental tasks? + Is there a lack of social or purposeful activities? + Does your loved one
+ Are there problems paying bills on time?
+ Have there been issues
in activities they used to + Has there been a
Trouble managing finances
equipment? + Is there concern about poor safety awareness or poor
+ Are you concerned about scams?
Health
+ Has your loved one had any falls? + Have there been
judgment? + Do they fail to take medication on time? + Are there spoiled foods in the fridge? + Is there a noticeable change
repeated trips to the emergency room (ER) or hospital?
Driving
+ Do passengers feel
in hygiene? + Have there been troubles with problem-solving? + Have they been calling more
suddenly seem or feel
frequently with an increase in
lonely?
concerns and questions?
worried? + Have there been any accidents or close calls?
Source: www.mayoclinic.com | www.healthpartnerslocalcare.org
page 25
how to
Taking action
depressed mood, memory
someone to clean the house
loss or other signs and
and run errands. A home
There are many steps you can
symptoms, encourage your
healthcare aide could help
take to ensure your parents’
parent to schedule a doctor‘s
your parents with daily
health and well-being, even if
visit.
activities, such as bathing.
you don't live nearby. For example:
+ Share your concerns with your parents:
+ Address safety issues:
Point out any potential safety issues to your parents – then
+ Contact the doctor for guidance: If your parents dismiss
make a plan to address the
your concerns, consider
problems. If your parents are
contacting the doctor
Talk to your parents. Your
no longer able to drive safely,
directly. Your insights can
concern might motivate
suggest other transportation
help the doctor understand
your parents to see a doctor
options.
what to look for during
or make other changes.
+ Encourage regular medical checkups:
+ Consider home care services:
If your parents are having
If you’re worried about
trouble taking care of
a parent’s weight loss,
themselves, you could hire
upcoming visits.
Sometimes parents won’t admit they need help, and others don’t realise they need help...
That’s where you come in.
Being human and understanding
If you and your siblings or
Make sure your parents
will take you a long way.
family members are all on
understand the problem
Sometimes cognitive
the same page, this is a
and your proposed solution.
impairments are to blame
huge help. Always think of
Remind your parents that you
or stubborn family members
the serenity prayer when
care about them and that you
are the culprit. Whatever the
it comes to helping ageing
want to help promote their
problem, it will most likely be a
people: “Please grant me the
health and well-being, both
challenge; but it’s important to
serenity to accept the things
today and in the years to
separate what you need from
I cannot change, the courage
come.
what your parent needs.
to change the things I can, and the wisdom to know the difference.” Unfortunately, that last part is often hard to sort out when it comes to seniors, but getting help from people with geriatrics training can help. And family members are key to helping their loved ones through the challenges of ageing.
E D I U G D I A T S R FI us
Concussions are serio
Athletes take on
to serious injuries. Doctors
cause the brain to bounce
numerous risks each
may describe concussions
around or twist in the skull,
time they step on the
as “mild” because they are
stretching and damaging
field, hop in the pool,
usuall y not life-threatening,
the brain cells and creating
or climb on a bike.
but the effects can be
chemical changes in the
serious and you should seek
brain.
One of those risks is head
medical attention.
injuries. Regardless of whether or not an athlete participates in contact
WHAT IS A Concussion?
sports, a sport-related
Signs and Symptoms Athletes who show or report one or more of the
concussion could happen to
A concussion is a type of
signs and symptoms listed
almost any athlete, at any
traumatic brain injury (TBI)
below, or simply say they
time.
caused by a bump, blow,
just “don‘t feel right” after
or jolt to the head or by a
a bump, blow, or jolt to the
P articip ating in sports is
hit to the body that causes
head or body, may have a
thrilling and fun for all ages,
the head and brain to move
concussion or more serious
but high-imp act contact and
rapidly back and forth.
brain injury.
slippery surfaces can lead
This sudden movement can
page 27
first aid
Concussion Symptoms Reported
Concussion Signs Observed
Signs and symptoms
+ Headache or “pressure”
+ Can’t recall events prior to
not know how serious the
+ Nausea or vomiting. + Balance problems or
+ Appears dazed or stunned. + Forgets an instruction, is
in the head.
dizziness, or double or blurry vision.
+ Bothered by light or noise. + Feeling sluggish, hazy, foggy, or groggy.
+ Confusion, or
concentration or memory problems.
+ Just not “feeling right”, or “feeling down”.
Action plan:
or after a hit or fall.
generall y show up soon after the injury. However, you may injury is at first and some symptoms may not show up for hours or days.
confused about an
You should continue to check
assignment or position,
for signs of concussion right
or is unsure of the game,
after the injury and a few
score, or opponent.
days after the injury.
(even briefly).
If the concussion signs or symptoms get worse, you should take him or her to the emergency department right away.
+ Moves clumsily. + Answers questions slowly. + Loses consciousness + Shows mood, behaviour, or personality changes.
Anybody with a possible concussion needs to be seen by a doctor.
1. Remove From Play If the concussion happens while playing sports, you should also: 1. Remove the athlete from
affecting your child for a lifetime.
2. Seek Medical Care Most athletes are treated in
play. When in doubt, sit
the emergency department
them out!
or in a doctor’s office after
2. Keep the athlete out of
a concussion and get to go
• Any memory loss right after the injury • Any seizures right after the injury • Number of previous concussions (if any)
3. Tests for Concussion and Brain Injury
play the day of the
home. However, when the
injury and until a doctor,
injury is more serious, they
The doctor may do a CT scan
experienced in evaluating
may need to stay in the
of his or her brain to look for
for concussion, says he or
hospital overnight.
signs of a more serious brain
she is symptom-free and
injury. Other tests such as What to Tell the doctor
“neuropsychological” or
Tell the doctor if the athlete
“neurocognitive” tests may
Children or teens who return
is taking any medications.
also be performed. These
to play too soon – while the
Share the following:
tests help assess the athlete’s
brain is still healing – risk a
• Cause of the injury and
learning and memory skills,
it’s OK to return to play.
greater chance of having a
force of the hit or blow to
the ability to pay attention
repeat concussion. Repeat
the head or body
or concentrate, and how
or later concussions can be
• Any loss of consciousness
very serious. They can cause
(passed out/knocked out)
permanent brain damage,
and if so, for how long
quickly he or she can think and solve problems.
4. Get Concussion Care Instructions
5. Recovery From Concussion
After a concussion, physical
Ask for instructions from
Rest is very important after
and learning – should be
the athlete’s doctor on
a concussion because it
carefully watched by a
return to play. These
helps the brain heal. The
medical provider. As the
instructions should include
injured athlete may need
days go by, the patient can
information about when
to limit activities while he
expect to slowly feel better.
they can return to play and
or she is recovering from a
what steps you should take
concussion.
Keys to Recovery
to play. Before returning to
Any physical activities or
• Rest.
play an athlete should:
activities that involve a
• Take it slow.
• Be back to doing their
lot of concentration, such
• Talk to your healthcare
and cognitive activities – such as concentration
to help them safely return
regular school activities. • Not have any symptoms
as studying, working on
provider.
the computer, or playing
from the injury when
video games or solving any
doing normal activities.
kind of puzzles may cause
• Have the green light from
concussion symptoms
their healthcare provider
(such as headache or
to begin the return-to-
tiredness) to come back
play process.
or get worse.
A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.
Sources: www.cdc.gov; HEADS UP resource centre, www.brainline.org
page 29
recipe
BANANA
Flapjacks
OPTION ONE
py on the outside, and Fluffy on the inside, cris bananas and vanilla – h wit delicately flavoured top them with sliced or drizzle them with honey ting of icing sugar. dus a and ries ber or s banana Prep time: 10 minutes tes Cook time: 20 minu tes Total time: 30 minu cks
Makes 12 “big” flapja
Ingredients For Flapjacks
Instructions 1. In a medium bowl, whisk
griddle, and swirl it around.
6. Drop the batter by ¼-
cupfuls onto the griddle,
• 375ml flour
together the flour, sugar,
spacing the flapjacks. Cook
• 30ml sugar
baking powder and salt.
until a few holes form on
• 12,5ml baking powder
2. In a small bowl, mash
• 2,5ml salt
the banana with a fork until
• 1 small, over-ripe banana,
almost smooth.
peeled (the browner, the better) • 280ml milk • 2 large eggs
3. Whisk in the eggs, then
top of each flapjack and the underside is golden brown, about 2 minutes.
7. Flip the flapjacks and cook
add the milk and vanilla and
until the bottom is golden
whisk until well blended.
brown and the top is
4. Pour the banana mixture
puffed, 1 to 2 minutes
• 2,5ml vanilla extract
and the melted butter into
more. Using the spatula,
• 45ml unsalted butter, melted
the flour mixture. Fold the
transfer the flapjacks to a
For Cooking
batter gently with a rubber spatula until just blended;
serving plate.
8. Wipe the griddle clean
• Vegetable oil
do not over-mix. The batter
with paper towels, add
• Unsalted butter
will be thick and lumpy.
more butter and oil, and
For Serving
5. Set a griddle or non-stick
repeat with the remaining
pan over medium heat
batter. Serve the flapjacks
• Honey
until hot. Put a pad of
while still hot with honey,
• Sliced bananas
butter and one tablespoon
sliced bananas and icing
• Icing sugar (optional)
vegetable oil onto the
sugar if desired.
Flourless
ck s BANANA Fly reaallypareja made with
– the Gluten-free and dairy-free up with seems like you’d just end It s. egg and s ana ban just resembles y trul t duc pro l fina but the scrambled banana-eggs, edges. py cris h wit , golden brown a flapjack. Piping hot and tes | Cook time: 15 minu Prep time: 10 minutes cks pja fla all sm tes | Makes 8 Total time: 25 minu
Ingredients For Flapjacks
eggs together until the yolks
OPTION TWO 7. Flip the flapjacks: It is best
and whites are completely
to do this very gently and
combined. Add the vanilla
fairly slowly — the opposite
extract. Pour the mix over
of regular pancakes.
the banana and stir until
Gently work a spatula
• 2 eggs
the eggs are completely
about halfway under the
• ¼ teaspoon vanilla extract
combined. The batter will
flapjack, then lift until the
• Extra toppings like chopped
be very loose and liquidy,
unsupported half is just
more like whisked eggs
barely lifted off the pan.
than regular flapjack batter.
Lay the flapjack back down
• 1½ large bananas, ripe to overripe
nuts
For Cooking • Unsalted butter
For Serving
• Honey, butter, or blueberries, to serve
Instructions
1. Mash the banana: Peel the bananas and break it up
3. Heat a non-stick frying pan
on its other side. Some
over medium heat: Melt a
of the loose batter will
little butter in the pan to
probably spill onto the pan
prevent sticking, if you like.
as you do this; just be sure
4. Drop roughly 2
tablespoons of batter onto the hot griddle. It should sizzle immediately — if not, turn up the heat slightly.
5. Cook the pancakes until
to lay the flapjack on top of the spill and nudge any excess back under it.
8. Cook the flapjacks for another minute or so, until the other side is also
into several big chunks
the bottoms look browned
golden-brown. You can flip
in a bowl. Use a fork to
and golden when you lift
the flapjacks a few times
thoroughly mash the
a corner — about 1 minute.
if you need to in order to
bananas. Continue mashing
The edges should also be
get them evenly browned.
until the banana has a
starting to look set, but the
(Flipping is much easier
pudding-like consistency
middle will still be loose
once the second side is set!)
and no large lumps remain;
like barely set jelly.
Keep the finished flapjacks
a few small lumps are ok.
6. Sprinkle any loose
You should have ⅓ to ½
toppings, like nuts over the
cup of mashed bananas.
top of the flapjacks as the
2. Stir in the eggs: Whisk the
warm in the oven if cooking more than a single batch.
9. Serve while still hot.
first side cooks.
page 31
your experts
YOUR s to Email your question .za experts@intercare.co
Stress or thyroid?
I am a 36 year old woman suffering from lack of energy, hair loss and constipation. Is it stress or can it be my thyroid? People get information from the internet and social media, and then try and treat their symptoms with overthe-counter products (like vitamin B compounds for lack of energy or iron supplements for hair loss). This may lead to a delayed diagnosis. Yes, stress can lead to hair loss and lack of energy, but so may hypothyroidism (underactive thyroid function), iron deficiency anaemia or even pregnancy (and a whole list of other conditions)! The best advice with any concerning or non-specific symptoms is to rather see your GP (and not try and diagnose yourself with Google)! A GP would be able to take a good, comprehensive history and then do a general examination. This may or may not be followed by selective blood tests to exclude or maybe diagnose an underactive thyroid. Dr Yolande Louw – GP Silver Lakes Intercare
Bed-wetting
My son is six years old and still wets his bed, although infrequently. At what point should I worry about my child’s bed-wetting? Enuresis (bed-wetting) is defined as the involuntary or voluntary repeated discharge of urine into clothes or beds at a stage when bladder control should have been established. Most children with a mental age of five have obtained bladder control during the day and night. The diagnosis of enuresis is made when urine is voided twice a week on at least three consecutive months. The incidence of enuresis at five years is 7% for males and 3% for females. At age 10 it is 3% for males and 2% for females. At age 18 it is 1% for males and extremely rare in females. There is a marked familial incidence. Dr Ernst Teichler – Paediatrician Silver Lakes Intercare
How serious was my fall?
I fell several days ago. The cut on my leg doesn’t seem to be getting better. Do I need to see a doctor? Yes, visit your doctor to evaluate the severity of the wound. The healing process can be influenced by several conditions – uncontrolled hypertension, high cholesterol levels and high blood glucose levels. The doctor needs to check for these conditions also. Dr Wilma Bergh – GP Silver Lakes Intercare
Contact our Intercare experts at INTERCARE SILVER LAKES Tel: 012 809 6000 | Fax: 012 809 6001 Email: silverlakes@intercare.co.za Hazeldean Square, Corner of Lynnwood and Silver Lakes Roads, Silver Lakes, Pretoria
TAKING RADIOLOGY INTO THE FUTURE
Morton and Partners is proud to have been able to provide radiology services to patients and doctors in Cape Town over many years. We have radiology departments in 9 hospitals and 6 X-ray centres extending from Tableview to Tokai. Why choose Morton and Partners? •
We offer a comprehensive radiological service.
•
Our radiology team is a mix of experienced general radiologists and internationally trained super-specialists.
•
We offer specialized radiology such as MRI of the female pelvis, MRI of the prostate and gastro-intestinal tract, digital mammography/tomosynthesis, interventional radiology, musculoskeletal ultrasound and image guided injections.
•
Our large geographic footprint ensures that your radiology studies performed at any Morton & Partners department will be made available to any doctor you consult in a hospital we serve.
•
Up-to-date equipment including 3T MRI, wide-bore MRI, digital mammography with tomosynthesis, cardiac CT scanners and high frequency musculoskeletal ultrasound probes.
•
Our picture archiving and communication system enables storage of images and reports. Your doctor can view your studies in the consulting room, at the bedside, at home or on a mobile tablet.
www.morton.co.za
Broad Road Medical Centre, Wynberg 021 797-4160
Life Vincent Pallotti Hospital, Pinelands 021 531-7635
Chris Barnard Memorial Hospital, Cape Town Cape Town 021 424-8090
Mediclinic Cape Town, Gardens 021 424-2332
Intercare Century City 021 834 9680
Mediclinic Milnerton 021 551-6330 Melomed Bellville Hospital 021 946-1020
Life Orthopaedic Hospital, Pinelands 021 531-7814
Melomed Gatesville Hospital 021 637-8121 Melomed Tokai Hospital 021 276 1789 Rondebosch Medical Centre 021 689-7717/8 Women’s Imaging Tokai 021 276 1790
Medicross Practices: Kenilworth: 021 670-7660 | Langeberg: 021-980 5117 | Parow: 021 936-7311 | Tableview: 021 521-1009 | Tokai: 021 701-9958
