Issue 13 | summer 2017
MEDICAL SCHEMES
MYTHS AND FACTS
FIRST AID Sun, Sea and an STD YOUR HEALTH
Banish Bad Breath
Dry January?
AFTER A HOLIDAY OF OVERINDULGENCE
How to beat LEISURE SICKNESS
NEED TO KNOW
Head and Neck Cancer DIABETES DURING
Pregnancy
Your baby's health
Brush up on visits to the dentist Every 6 months is best Book your next checkup at your nearest Intercare facility.
Go to www.intercare.co.za for more information Intercare Group
8
contents
Issue 13 | summer 2017
Be personal 2 32
10
14
3
INTERCARE News & events
4
SNIPPETS Latest health news
6
8
YOUR EXPERTS Your questions
Interact
31
From the experts
CEO MESSAGE
14
INFOGRAPHIC Banish Bad Breath
ALL ABOUT How to beat (at) leisure sickness HEALTH STRATEGY Dry January Anyone?
24
TRAVELGROUND Fairy Tale Forests
28
FIRST AID Sun, Sea and an STD
RECIPE No Bake Cheesecake in Mason Jars
Your body 16
follow on sociauls media!
Your health 10
KNOW IT ALL Medical Sheme Myths and Misconceptions
16
HEALTH ADVICE Gestational Diabetes
20
NEED TO KNOW Head and Neck Cancer
yo u. .. W e wa nt to hentsarandfrcusom to air their ers tom
20
31
ite all patie We would like to inv ing this magazine. us with input regard e vid views and pro will then be able remain relevant and In doing so, we can at healthcare gre a e eat “cr and to make a difference Please email us at er” on a daily basis. experience altogeth intercare.co.za ce@ en eri OR myexp info@intercare.co.za ideas and topics you with any suggestions, d about. rea would like to ORIAL ENQUIRIES ADVERTISING & EDIT ng: Health-B ytes Publishi health-b ytes.co.za 021 913 0504 | christa@ Grobler ista Chr or Publishing edit : Bernette Becker Design – Health-B ytes t | Printing BusinessPrin Proofing Albert Buhr
ADVERTISING: 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
professionals and team members’ best interests central to the process. During October 2017 Intercare was acknowledged as the runner-up in the Private Hospitals Industry category of the 2016/2017 Ask Afrika Orange Index®, the largest and most widely referenced service excellence benchmark in South Africa. Intercare competed against all acute care hospitals and Netcare was announced as the winner, Intercare in second place and Life Healthcare in third place. Being in the top three of this important national benchmark is a splendid affirmation that our efforts to always put our patients first and to create a great healthcare experience are worthwhile. Intercare has shown immense growth during this year and opened two new healthcare centres. The medical centre in Summerstrand, Port Elizabeth, opened its doors in September and the medical and dental centre at Mall@55 in Centurion was inaugurated in October.
Creating a home for over 1 000 healthcare professionals and other team members, as well as providing quality care to over one million patients every year, the Intercare Group’s unique and innovative model for the provision of a variety of healthcare services has seen the company’s network grow to 20 multi-disciplinary medical and dental centres, four day hospitals and three sub-acute and rehabilitation hospitals across the country, with more healthcare centres to follow suit. With our vision to create a great healthcare experience altogether and by providing consistent levels of service excellence to our patients, Intercare has attracted an investment from Mediclinic, a leading international healthcare player. The closer relationship with Mediclinic further enables Intercare to offer an innovative, end-to-end healthcare solution, with our patients, healthcare
It is with great expectations that we are looking forward to the opening of the stateof-the-art healthcare centre at 200 Rivonia Road, Morningside, in January 2018. The new facility includes the Intercare Medical and Dental Centre, Day Hospital and Sub-acute and Rehabilitation Hospital, as well as a large Dischem pharmacy, an Oncology Centre, the Bone and Breast Care Centre, as well as other care partners. Our success is built on the support of our patients, the foundation upon which Intercare operates, and we sincerely thank you for that. However, our achievements are only made possible by a comprehensive team effort and we would like to thank our healthcare professionals, team members and business associates for your particular contribution and dedication towards our accomplishments. May you and your loved ones experience a blessed festive season filled with peace, joy and precious family time. Warmest Regards, Dr Hendrik Hanekom Chief Executive – Intercare Group
CELEBRATES 15 YEARS OF EXCELLENCE Intercare recently celebrated 15 Years of Excellence. As part of the celebrations, team members shadowed a fellow team member to better understand the role that each one plays in serving our patients. It was followed by a celebratory lunch during which each member received a thank you gift.
page 03
snippets
tHhEAeLTlaHtNeEsWtS PREPARE FOR A
( p ollen)
BATTLE!
EXTREME DROUGHT IN WESTERN CAPE COULD WORSEN HAYFEVER SYMPTOMS The ongoing drought in the Western Cape could have dire implications for nasal allergy sufferers as we head into the sneezing and streaming season. When no or little rain falls, the exposure to significant pollen counts is sudden, which may exacerbate seasonal pollen symptoms. Pharma Dynamics – a leading provider of antihistamines – have partnered with UCT’s Allergy and Immunology Clinic to provide hayfever sufferers in the region with upto-date pollen counts. Access to pollen data can assist diagnosed patients to avoid outdoor activities when counts are high and can prompt them to increase their dose of preventative therapies, such as antihistamines following the advice from a doctor – especially during pollen peaks.
LOSING WEIGHT
– good for your brain too!
Losing weight can be an ongoing struggle for some people. While maintaining overall health means staying at the best weight possible, it's not easy. To lose weight, one should eat the right food and move more. By decreasing the number of kilojoules consumed and increasing the number of kilojoules burned seems essential enough, after about the first week of a ‘new’ diet the brain has figured out what's going on. In the body, fat cells release a hormone called leptin. This hormone is a signal to the brain that you are full and should stop eating.
“Pollen is a trigger for an estimated 30% of South Africans and can, in severe cases, trigger a fatal attack. Uncontrolled hayfever or allergic rhinitis will adversely affect asthma, making chest symptoms more difficult to control. Allergies don’t cut you any slack, so stick to your regimen till the worst of the season is over,” advises Pharma Dynamics’ spokesperson, Nicole Jennings.
When a person loses weight, there will be fewer fat cells, which means less of the hormone leptin. In brain scans of dieters who had lost 10% of their body weight, there was increased activity in the part of the brain that controls appetite. Lower levels of leptin mean feeling hungrier. The brain knows it needs that leptin and will signal a desire to go for high-fat foods like ice cream or pizza. Hanging in there, however, can be worth it not just for weight loss, but for brain wiring. In a study of patients who had lost weight and kept it off for almost a year, the activity in the reward region of the brain that processes cravings had gone down, and activity in the areas that rule impulse control had gone up. Stick with your “diet” and not only will your body look better, your brain will work more efficiently too.
Sources: www.allergyexpert.co.za | www.pharmadynamics.co.za.
Source: Labroots
Sports drinks anyone?
Like sports drinks when you exercise? In most cases, they‘re not needed and could be simply giving you extra kilojoules your body doesn‘t need. Stick to water.
YOUR HOLIDAY STARTS NOW
BY THE TIME A GIRL IS 17… she’s seen approximately 250 000 media messages telling her what she’s supposed to look like. Negative body image can lead to depression, social anxiety and eating disorders.
on your own doorstep!
Staying at home for the holidays might just be what the doctor ordered. You don’t need to travel far to relax, so go out and play a tourist in your own hometown! • • • • • •
Book a weekend at a spa or nature resort. Discover nature outside of your own neighbourhood. Take in some live theatre or music performances. See a show at the local dance or community centre. Explore local museums or art galleries. Source: www.alive.com Hike some new trails.
Rooibos Tea
relieves respiratory conditions, but also reduces high blood pressure. It works in similar fashion to ACE inhibitors and helps blood vessels to relax and widen, making it easier for blood to flow through.
– DRINKERS LESS LIKELY TO SUFFER FROM HEART DISEASE
Despite numerous advances in medical technology the prevalence of heart disease continues to escalate. In South Africa, it remains the number one killer after HIV/AIDS and deaths related to heart and blood vessel diseases are expected to increase by 41% in the next 13 years. According to Dr Dawie van Velden, “the biggest single risk factor by far is high blood pressure (hypertension), which is exacerbated by poor eating habits, obesity, lack of physical activity and excessive alcohol intake. “Across the world, we are seeing a huge move towards more natural methods including everything from diet, exercise, smoking cessation to destressing via music therapy, meditation, and even drinking home-brewed rooibos tea,” he remarks.
We know that a diet low in salt and sugar, and regular exercise can lower your risk of heart disease, but just how might rooibos tea help your heart and how strong is the evidence? A study conducted in Sweden found that 30 to 60 minutes after drinking 400ml of Rooibos, the activity of the angiotensin-converting enzyme (ACE) is significantly suppressed. This enzyme is believed to be involved in the development of heart disease and therefore ACE inhibitors are often prescribed to treat hypertension and heart disease. When blood vessels constrict, blood pressure increases, putting you at greater risk of heart attack or stroke. Rooibos tea is known as a bronchodilator, which not only
ANOTHER STUDY BY THE CAPE PENINSULA UNIVERSITY OF TECHNOLOGY (CPUT) SHOWED A POSITIVE EFFECT IN ADULTS AT RISK OF HEART DISEASE, WHO DRANK SIX CUPS OF ROOIBOS EVERY DAY FOR SIX WEEKS. The study found that rooibos not only protected against oxidative lipid damage, but also favourably improved the lipid profile of the participants by reducing total blood cholesterol levels by 10%, with a significant reduction in “bad” LDL cholesterol levels, as well as a significant increase in the “good” HDL-cholesterol. There is a mounting body of scientific evidence which shows that rooibos tea is a potent antioxidant, has antiinflammatory, antihypertensive and cholesterol lowering properties. Source: www.sarooibos.co.za
page 05
Sources: www.remedyland.com | www.therabreath.com | Sane Dentist Blog | Images: www.freepik.com
all about
How to beaEt (AT) LEISUR sickness Leisure sickness, like paradise syndrome, chronic fatigue syndrome, seasonal affective disorder and sick building syndrome, is one of those modern conditions that sounds bogus, unless you happen to suffer from it, that is.
WHAT ARE THE SYMPTOMS OF LEISURE SICKNESS?
The condition of developing
than in women (2.7%). Most
symptoms of sickness during
subjects reported having had
weekends or holidays, more
the symptoms for more than
commonly known as leisure
10 years and that the onset
sickness, was first identified
of the first episode could be
by Dutch psychologists Ad
associated with a specific life
LEISURE SICKNESS IS
Vingerhoets and Maaike Van
event, such as a marriage, the
ACTUALLY A SYNDROME
Huijgevoort in 2001.
birth of a child or starting a
WHERE PEOPLE
new job.
DEVELOP SYMPTOMS,
Vingerhoets, who surveyed
SPECIFICALLY DURING
1 128 men and 765 women
Many of those affected shared
THEIR VACATIONS AND
across Holland between the
certain characteristics – a
ON WEEKENDS, SUCH AS:
ages of 16 and 87, estimates
high workload, perfectionism,
that around 3% of the
eagerness to achieve and
• headache,
population may suffer
an over-developed sense of
• acute fatigue,
from weekend or vacation
responsibility to their work,
• insomnia,
sickness. It is slightly more
making it difficult for them to
• nausea,
prevalent in men (3.6%)
switch off out of work.
• vomiting,
• cold or flu, • sore or aching muscles
• MEDITATE: Changing how
you travel. It might mean
you react to stress – doing
using an extra vacation day
things more consciously
or two, but this will help
• depression,
and mindfully, less
you wind down and wind
• irritability and anxiety,
reactively, more calmly
back up more gradually.
• feeling generally unwell.
and efficiently, and less
There are ways to avoid
judgmentally – can impact
the issue when taking a
The symptoms usually
health. Keep in mind that
break.
dissipate once the person
you can meditate anywhere
returns to work or gets
– even on a plane.
or joints,
back to their usual routine. This list of adverse events
• SLEEP IN: Booking a
HOW TO AVOID IT SO, WHAT DO YOU DO
can also describe a similar
sleep-friendly hotel is the
IF YOU WANT TO AVOID
condition affecting some
first step in fending off
LEISURE SICKNESS?
new retirees.
illness during a vacation. Lack of sleep is linked
Of the 20 people in the
with higher levels of
Dutch study who claimed
inflammation and lower
to have recovered from
levels of immune function.
the condition, 85% were
Without proper rest, the
able to identify a specific
In those who suffer from
ability of natural killer cells
life change or episode
it, leisure sickness can be a
to kill those infected by
they held responsible
signal that your travelling
a virus weakens, as does
for its disappearance –
and non-travelling days
our immune cells’ ability
either a change of job or
surrounding a trip are out of
to protect us from getting
a fundamental change in
balance. There is evidence
sick.
attitude towards work and
HOW TO PREVENT IT
that eating healthy before you go, catching up on sleep
life in general. • CELEBRATE IN
and taking certain vitamins
MODERATION: Getaways
But if you can't change
or probiotic supplements
should be fun, but excess
your job (or your attitude),
could benefit the immune
alcohol, caffeine, and an
Vingerhoets suggests
system.
unhealthy diet can hinder
exercise on a Friday evening,
immune health, making it
which can help with the
STRESS EXPERTS OFFER
more likely that you fall ill.
transition from work to
THE FOLLOWING REMEDIES
Consider being sensible
weekend leisure; or if you
FOR KEEPING YOUR DAYS
for the day and swapping
are a perfectionist who takes
MORE EVEN-KEELED:
poolside cocktails for a
work responsibilities too
trip to the juice bar.
seriously, see a psychologist
• EXERCISE: Work out after work or a stressful day
for some cognitive therapy. • BUILD IN BUFFER DAYS:
– it may facilitate the
If you’re able, ease into
Alternatively, stick to work
unwinding process. This
and out of vacation by
and forget the holidays. It's
is key in preparing your
tacking a day onto the
cheaper, and they only make
body for the much bigger
beginning and end of your
you sick.
unwind: your holiday.
trip before and after
page 09
know it all
Medical scheme
MYTHS AND MISCONCEPTIONS THE WORLD OF MEDICAL SCHEMES IS A COMPLICATED ONE, AND THERE ARE MANY MYTHS AND MISCONCEPTIONS DOING THE ROUNDS. THE MEDICAL SCHEMES ACT, 1998, REGULATES THE OPERATION OF MEDICAL SCHEMES IN SOUTH AFRICA AND THE COUNCIL FOR MEDICAL SCHEMES IS THE INDUSTRY’S REGULATORY BODY. SO TO EASE YOUR MIND, HERE IS THE TRUTH ABOUT SOME MYTHS AND MISCONCEPTIONS.
A scheme can exclude me from treatment for a pre-existing condition forever MYTH 1:
A scheme can force me to use network hospitals MYTH 2:
The money in the savings account is yours MYTH 3:
FACT: No, it can’t. A scheme
FACT: It is yours in that it
can encourage you to do
can only be used by you
FACT: No, they can’t.
so by guaranteeing no
to pay for your medical
They can only impose a
co-payments from your
expenses. You cannot draw
12-month waiting period for
pocket if you stay within
the money out in cash, or
a pre-existing condition. If,
the network. If you choose
use it to settle the bill for
however, they find out that
to use out-of-network
co-payments. This money
you did not disclose a pre-
hospitals or doctors (except
is carried over from year to
existing condition, you can
in certain emergencies),
year if you don’t use the full
be found guilty of fraudulent
the scheme can make you
allocation. It will only be
behaviour, and there might
pay the difference, but they
paid out to you four months
be penalties imposed
can’t force you to use certain
after you have left the
because of that.
healthcare services.
scheme.
Medical insurance is the same as a medical scheme MYTH 4:
FACT: Medical insurance is
I cannot claim anything during the three-month waiting period MYTH 6:
not covered by the Medical
FACT: You couldn’t buy a new
Schemes Act and functions
pair of spectacles, but if
more like an income-
you're in an accident, you
replacement product than
could definitely get treatment
medical cover. A medical
at the nearest trauma unit.
insurance product pays you out for certain diagnoses, or a hospital stay – it does not pay your medical bills.
A hospital plan will only pay for in-hospital treatment MYTH 5:
Medical schemes make a profit MYTH 7:
FACT: Medical schemes, as
trustees, not shareholders. Only 8 of the 23 registered, open medical schemes in South Africa achieved an operating surplus in 2015.
I cannot put my parents on my medical scheme MYTH 8
FACT: If they are financially dependent on you, and you can prove it, they can join as adult dependants on your scheme.
such, are not profit-making organisations. They might be part of bigger insurance companies, which do make a
A medical scheme cannot terminate my membership MYTH 9:
FACT: Generally, yes, but
profit, but there are different
all hospital plans also have
laws governing insurance
to pay for the treatment of
products and medical
25 chronic conditions. You
schemes. If they register
FACT: They can, if you are
might also be entitled to
a profit, it goes into the
unable to pay the monthly
claim for six-monthly GP
reserves of the scheme, and
contributions, or if you are
visits to have your chronic
this belongs to the members.
found guilty of making
prescriptions renewed.
Medical schemes have
fraudulent claims.
Sources: The Council for Medical Schemes; Alexander Forbes Health www.health24.com
page 11
know it all A scheme can encourage you to use the medication on their medicines formulary. but they cannot force you to take a particular type of medication.
I can change options whenever it suits me MYTH 10:
FACT: You can usually only switch options once a year,
If my scheme gives 100% cover it means that I don’t have to pay in anything MYTH 12:
A scheme can tell me which medication to use MYTH 14:
FACT: They can encourage you to use the medication
in January, on most schemes.
FACT: Not true. Schemes
on their medicines formulary.
This is done to streamline
can cover you for 100% of
If you choose not to, you
administration of things such
the medical fund tariff, which
might have to pay the
as savings accounts, which
may be considerably lower
difference in cost, but
are allocated on an annual
than the cost of the private
they cannot force you to
basis. Nothing stops you
hospital or private doctor.
take a particular type of
from changing options every
You could, however, end up
medication.
year.
with a big co-payment.
A scheme can refuse my application MYTH 11:
FACT: No, it cannot. A
My employer has to subsidise my scheme contributions MYTH 13:
Once my benefits run out, that’s it for the year MYTH 15:
FACT: Even if your savings
scheme can require a
FACT: No, they don’t. The
account is depleted, you are
late-joiner penalty and
employer can, as part of
still covered for in-hospital
impose a general waiting
your employment contract,
treatment.
period of three months, or
require you to belong to a
a condition-specific waiting
certain scheme, but they
You can also apply to your
period of no more than 12
don’t have to subsidise your
scheme for further ex-gratia
months, on a new member.
contributions. If you work for
payments for day-to-
However, a scheme cannot
the state, you might be lucky
day treatment. These are
refuse your application if
in getting a third of your
evaluated on a case-by-case
you can pay the membership
contribution subsidised, but
basis, according to certain
contribution.
it is a privilege, not a right.
protocols.
health strategy
DRY JANUARY
anyone?
GIVING UP DRINKING IN JANUARY IS MORE POPULAR THAN EVER, BUT HOW MUCH DIFFERENCE DOES AN ALCOHOLFREE MONTH REALLY MAKE?
The festive season is a fun
That is why January is a great
Not drinking alcohol (and
and social occasion, but it
time to think about cutting
other sugar-loaded drinks)
is also a time of year that
a bit down or taking a break
during January can benefit
sees some of us eating and
from alcohol, fizzy sugar
you in a number of ways.
drinking much more than we
drinks and fruit juice for a
usually would or should.
whole month.
The pros for your health: The cons for your health:
1. BETTER SLEEP
This sense of achievement
We may associate a boozy
can increase your willpower
drink with quickly sending us
and your confidence to say
1. Overindulge in February
to sleep, but drinking alcohol
“no” to an alcoholic (and/or
Some people have a tendency
before bed actually damages
sugary) drink throughout the
to overindulge even more
the quality of your sleep.
rest of the year. It also boosts
than they normally would
By slipping straight into a
your finances by not spending
at the end of the month,
deep sleep, you miss out on
money on alcohol.
especially because their
the vital stages of dozing.
tolerance to alcohol is likely
This can result in lighter, less
4. LOSE WEIGHT
to have lowered. This can
restorative sleep later in the
Alcoholic drinks are famously
damage your liver and make
night. While you may not feel
high in (empty) kilojoules.
you feel even worse than
these benefits straight away,
The number of people losing
you did at the start of the
it’s likely that you’ll feel more
weight during dry January are
month. When dry January
awake and alert during the
high, with 49% of participants
comes to a close, try to limit
day.
reportedly slimming down by
yourself to one or two drinks
cutting out alcohol and other
occasionally, rather than a
sugary drinks for a month.
binge-drinking weekend.
energy, and without the
5. CHANGE IN ATTITUDE
2. Alcohol withdrawal
hangover-headache you’re
Arguably the most important
For moderate drinkers,
likely to feel much better.
health benefit is a general
stopping alcohol for a month
Lots of people find that with
change in attitude towards
can be a challenge, but it is
this new-found energy they
alcohol. We all need a break
achievable and healthy. The
get more done and even use
and your body is no different.
same might not be the case
the opportunity to take up
Simply not having it for a
for daily drinkers and those
exercise.
month can make people
dependent on alcohol. Total
reconsider their relationship
alcohol withdrawal can cause
3. AN “EARLY” SENSE OF ACHIEVEMENT
with alcohol. A study of
anxiety, shakiness and even
857 participants found that
more serious symptoms like
Simply achieving something
64% drank less alcohol (less
seizures, and can eventually
you found difficult can help
frequently as well as less per
lead to heavier drinking in the
boost your confidence and
drinking day) even six months
long run.
give you a feeling of success.
after dry January.
2. MORE ENERGY With more sleep comes more
Sources: bmihealthcare.co.uk, www.alcoholconcern.org.uk
page 15
health advice
TES GESTATIONAL DIABE
? k is r t a h lt a e h 's y b a b r Is you Almost 9% of pregnant
your bloodstream. To ensure
During pregnancy, blood
women suffer from
that blood glucose levels
glucose levels tend to be
gestational diabetes in South
stay normal, your pancreas, a
higher due to hormonal
Africa, according to a study
gland behind your stomach,
changes in your body.
in the scientific journal PLOS
produces the hormone insulin
ONE. Gestational diabetes,
that helps to move glucose
The placenta, which connects
which only occurs during
from your blood stream into
your baby to your blood
pregnancy, is diagnosed
your cells, so that they can
supply, produces high
when blood glucose levels
use it for energy. If your body
levels of hormones that can
are above normal, but below
doesn’t produce sufficient
interfere with the function of
the levels at which type 2
insulin levels or if it can’t
insulin in your cells. As your
diabetes is diagnosed.
use insulin effectively, blood
baby grows, your placenta
glucose levels will rise, which
produces more of these
can have an immediate
hormones, which is why
effect on your health or, if it
gestational diabetes usually
persists, long-term effects,
develops in the later stages
When your body digests
including an increased risk of
of pregnancy – sometimes as
carbohydrates, it is broken
cardiovascular disease, heart
early as 20 weeks.
down into glucose that enters
attack, and stroke.
Causes of gestational diabetes
Most pregnant women will
sibling has type 2 diabetes,
prior to falling pregnant).
experience slightly higher
your risk for gestational
Your risk also increases
blood glucose levels during
diabetes increases.
when you put on a lot of
pregnancy, especially after
+ PERSONAL HISTORY:
meals. However, when your
You’re more likely to
body is not able to handle
develop gestational
likely to develop gestational
these changes, it may
diabetes if you had it during
diabetes compared to other
develop into gestational
a previous pregnancy, if
races.
diabetes.
you delivered a baby that
weight during pregnancy.
+ RACE: Caucasians are less
weighed more than 4.1 kg,
Many people believe that
if you had an unexplained
gestational diabetes is
stillbirth, or if you have
directly caused by eating
Any pregnant woman can
prediabetes (slightly high
too much sugar during
develop gestational diabetes,
blood glucose levels that
pregnancy. Although too
but these factors could
may be a precursor to type
much sugar and unhealthy
increase your risk:
2 diabetes), according to
carbohydrates can contribute
the Mayo Clinic.
to risk factors like weight
+ EXCESS WEIGHT:
gain and obesity, it's not
Risk factors
+ YOUR AGE: The older you are when pregnant, the
People who are overweight
directly linked to gestational
greater your risk.
or obese have an increased
diabetes, according to
+ FAMILY HISTORY: If a family
risk of gestational diabetes
Durban-based registered
member like a parent or a
(particularly central obesity
dietitian Kerry Hillermann.
Symptoms
Organisation’s Global Report
Another risk factor of
on Diabetes, it can greatly
gestational diabetes is that
Gestational diabetes often has
increase the risk of foetal loss,
it increases your risk for type
no symptoms or may be mild
congenital malformations
2 diabetes later in life.
or similar to other symptoms
(e.g. heart defects, cleft lip
that are common during
and palate, Spina bifida,
pregnancy, like frequent
and limb defects), stillbirth,
urination, excessive thirst,
obstetric complications (e.g.
excessive hunger, and fatigue.
infections and syndromes),
“If you have been diagnosed
Usually, your obstetrician will
and maternal mortality (when
with gestational diabetes, it i
check your glucose levels
mother dies from pregnancy
possible to control it through a
during your routine prenatal
or childbirth-related
healthy diet and exercise while
visits to ensure your health.
complications).
monitoring your blood sugar
Health risks of gestational diabetes
It can also raise your risk
they are staying in a normal
of high blood pressure and
range,” says Johannesburg-
preeclampsia, which is a
based registered dietitian
If left undiagnosed and
serious condition that causes
Toni Brien. “If diet and
untreated, gestational
high blood pressure, and may
exercise are not sufficient,
diabetes can pose serious risk
cause kidney damage and
insulin injections may be
for both mom and baby, and
other problems.
prescribed by your doctor.”
The importance of a healthy lifestyle
levels regularly to make sure
according to the World Health
page 17
health advice Healthy eating habits during pregnancy
very quickly, which is not
2. SATURATED FATS:
ideal in pregnancy. Too
Although fat does not
much of these foods may
spike your blood glucose
It is very important to eat
also increase the weight
levels, it increases your
healthily during pregnancy
of your baby, as glucose
risk for cardiovascular
to ensure that your blood
is readily absorbed from
disease. As diabetes also
glucose levels stay at a
the blood by the placenta,
increases your risk for
healthy level. According
which may increase your
cardiovascular disease, you
toHillermann, a healthy diet
baby’s birth weight, and
may want to limit saturated
will help to prevent weight
may also increase their risk
fat to decrease your risk.
gain, hunger pangs, and will
for diabetes and obesity
Saturated fat is the fat
help keep blood glucose
later in life.
found in products produced
levels stable.
Foods to avoid
by animals. EXAMPLES of high-GI foods include butternut, potatoes,
FOR EXAMPLE butter or
processed grains (white
ghee, chicken skin, white
breads or rolls, white
fat on meat, white fat in
FOODS:
crackers, cakes, muffins, and
sausages, streaky bacon,
These foods will cause
biscuits), sugar, honey, and
and cream or full-fat dairy.
blood sugar levels to rise
sweet carbonated drinks.
1. HIGH GLYCAEMIC INDEX (GI)
ALTHOUGH GESTATIONAL DIABETES OFTEN GOES AWAY AFTER PREGNANCY, IT MAY POSE SEVERAL HEALTH RISKS TO YOU AND YOUR BABY DURING PREGNANCY, AND IT MAY ALSO INCREASE YOUR RISK FOR TYPE 2 DIABETES LATER IN LIFE.
Foods that you should eat more of
matchbox volume).
1. HEALTHY PROTEINS
whole egg.
• Egg (poached or boiled). One serving is one large
According to Hillermann,
• ½ cup of any cooked
it’s a good idea to include
legumes (lentils, chickpeas,
protein with every meal to
butter beans, kidney beans,
help manage blood sugar
cannellini beans, or borlotti
levels. A typical portion
beans).
size should be around 3
• 240 ml of low-fat
servings of protein at lunch
unsweetened milk or 175 ml
and at dinner and about
of low-fat unsweetened plain
1–2 servings of protein at
yoghurt.
breakfast. 2. CARBOHYDRATES EXAMPLES:
The average daily energy
• White fish, salmon,
requirements during
mackerel or tuna (not
pregnancy is about 4–5
crumbed or battered). One
starchy vegetables and grains
serving is about 30g of
and about 1-2 low-GI fruit,
cooked fish (about a standard
says Hillermann.
When you eat is important “Eating regularly is important to keep blood sugar levels stable,” says Brien. You should be eating every 3–4 hours, but this can differ from woman to woman depending on your blood glucose control. Seeing a registered dietitian may help you to develop a healthy eating plan that will suit you and support you through your pregnancy.
An example of a healthy meal plan during pregnancy
LUNCH:
fibre, low-GI grain (any).
Johannesburg-based
MID-AFTERNOON SNACK:
• Half a cup of cooked oats.
registered dietitian Lila
1 slice of low-GI bread with
Bruk gives the following
peanut butter and a small tub
example of a healthy diet to
of yoghurt.
EXAMPLES: • One slice of low-GI seeded bread. • Half a cup of cooked high-
3. HEALTHY FATS
Chicken salad with 3 wholewheat crackers.
Eat about four servings
follow during pregnancy to
of healthy fats that are
decrease your chances of
DINNER:
goodfor your heart, like
gestational diabetes.
1 sweet potato, grilled hake,
monounsaturated fats, omega 3, and omega 6s. EXAMPLES:
and steamed vegetables. BREAKFAST: ½ cup bran cereal with
EVENING SNACK:
fat-free milk and a fruit.
3 whole-wheat crackers with
• Avocado
fat-free cottage cheese.
• Nuts
MID-MORNING SNACK:
• Olive oil
1 fruit and small tub yoghurt.
• Tuna
SPEAK TO YOUR DOCTOR OR DIETITIAN FOR FURTHER
• Salmon References on request.
ADVICE.
Written by: Liezl Russell, Freelance Journalist
page 19
need to know
HEAD AND NECK CANCER Is it a death sentence?
HEAD AND NECK CANCERS FORM THE FIFTH MOST COMMON CANCER TYPE AND CAUSE FOR CANCER-RELATED DEATHS WORLDWIDE. SIGNIFICANT GEOGRAPHIC VARIATION EXISTS IN THE INCIDENCE OF SQUAMOUS CELL CARCINOMAS OF THE HEAD AND NECK.
Squamous cell carcinoma (the most common type encountered in the head and neck region, accounting for more than 90% of cases) are malignant (cancerous) growths that begin in the flat squamous cells that form the epithelium (inner lining) in many parts of the head and neck. A tumour limited to this layer of cells is usually called carcinoma in situ. A tumour that grows beyond the squamous cells and moves into deeper tissues is called invasive squamous cell carcinoma. Adenocarcinomas arise in glandular cells, such as those found in the salivary glands.
HEAD AND NECK CANCER CAN DEVELOP IN SEVERAL DIFFERENT PARTS OF THE HEAD AND NECK REGION. SOME OF THE MOST COMMON INCLUDE THE FOLLOWING: • Oral (mouth) cancer • Laryngeal (voicebox) cancer • Pharyngeal (throat) cancer • Thyroid cancer • Nasal cavity and sinuses • Nasopharyngeal (the region behind the nose) • Parathyroid (glandular structures just behind the thyroid, playing an important role in the maintenance of calcium levels) cancer • Skin cancer
HOW DO HEAD AND NECK CANCERS PRESENT?
progressive blocked nose, or recurrent sinus infections that do not respond to
Each type of head and neck
conventional treatment
cancer (according to the
• chronic sore throat
region) may be associated
• chronic or progressive
WHAT ARE RISK FACTORS FOR DEVELOPING A CANCER IN THE HEAD AND NECK REGION? Many head and neck cancers
with a specific group of
hoarseness/change in voice
arise after prolonged
symptoms.
quality
exposure to known risk
• constant ear ache (with
Symptoms for further investigation include the following: • a lump or swelling in the
neck being present longer than two weeks • a sore (painful or painless) in the mouth that won’t heal (the most common symptom) or that bleeds easily • a red or white patch in the mouth that doesn’t go away • frequent nosebleeds,
a normal ear examination) • difficulty chewing,
factors such as tobacco, alcohol, and cancer-causing agents in the workplace.
swallowing, or moving the jaws or tongue • pins and needles of the
These cancers are generally considered preventable.
tongue • loosening of teeth
Others, such as parathyroid
• false dentures that no longer
cancer, are not associated
fit • discolouration in a mole;
with any preventable risk factor. Some people who
a skin sore that is crusting
develop head and neck
or ulcerated, or that fails to
cancers have no known risk
heal (these are also signs of
factors.
possible skin cancer)
page 21
need to know The following factors have been shown to increase your risk of developing a cancer of the head or neck:
TOBACCO AND
WHAT CAN I DO TO PREVENT A CANCEROUS LESION DEVELOPING IN THE HEAD AND NECK REGION?
ALCOHOL USAGE
survival for people with head and neck cancers. That being said, the current advice is that all individuals visit their primary care physician for a yearly
Tobacco is the single largest risk
Making certain lifestyle
physical examination of
factor for head and neck cancer.
changes can significantly
the head and neck and
lower a person’s risk of
oropharynx (the middle
PROLONGED SUN
developing head and
section of the throat that
EXPOSURE
neck cancer. Quitting
includes the soft palate,
smoking can substantially
the base of the tongue,and
reduce the risk, even for
the tonsils). Any suspicious
those who smoked for
lesion or concern raisedby
many years. People who
the general practitioner,
already have a head and
needs to be evaluated by
neck cancer and quit
a head and neck cancer
EPSTEIN-BARR VIRUS
using tobacco, can reduce
surgeon. This will include
(EBV)
the risk of developing a
an endoscopy (investigation
Exposure to EBV, which is more
second tumour by as much
with a fibre-optic camera)
commonly known as the virus
as 60%. People who are
and further tests, if
that causes glandular fever, plays
exposed to toxic fumes
indicated.
a role in the development of
and dust in the work place
nasopharyngeal cancer. It’s got
or in other environments
a higher incidence in Eskimos,
can reduce the risk of
Asians and the black population.
head and neck cancer by
HUMAN PAPILLOMAVIRUS (HPV) HPV infection is one of the most commonly diagnosed sexually transmitted diseases, after HIV.
wearing protective face POOR ORAL AND
masks. Companies can also
DENTAL HYGIENE
install air-filtering systems
HOW IS CANCER IN THE HEAD AND NECK REGION TREATED AND WHAT IS THE SUCCESS RATE?
to minimise employees’ ENVIRONMENTAL OR
exposure to harmful fumes
Many cancers of the head
OCCUPATIONAL
and dust.
and neck can be cured,
INHALANTS
especially if they are found early. The different
Inhaling wood dust, asbestos, paint fumes, and certain chemicals may increase the risk of head and neck cancer. MARIJUANA USE
ARE THERE ANY SCREENING TESTS TO BE DONE TO PICK UP THE PRESENCE OF AN EARLY HEAD AND NECK CANCER?
POOR NUTRITION
treatment modalities include the following:
Surgery Surgery is the primary (first) treatment for most
A diet low in vitamins A and B
No screening method has
cancers of the head and
can increase your risk.
been proven to improve
neck.
Improvements in surgical
create a new jaw using part
radiation therapy) is used
techniques allow surgeons
of a bone in the patient’s
to treat head and neck
to remove many more
own leg (called the fibula).
cancers that are difficult
tumours while sparing vital structures involved. Some patients may require
to reach surgically or that
Radiation Therapy
cannot be cured by surgery alone. This approach is also
surgical examination of the
Radiation therapy alone
used to treat patients for
lymph nodes in the neck
or in combination with
whom surgery would cause
(called neck dissection)
chemotherapy is standard
significant functional or
to determine if any cancer
curative treatment for
cosmetic disability, such
cells have spread beyond
many patients with head
as loss of the larynx (voice
their original site. New
and neck cancers. Which
box), with its associated
techniques allow surgeons
approach is used depends
loss of natural voice and
to remove these lymph
on the extent of the tumuor
the need for a permanent
nodes while sparing nerves
as well as the specific
stoma (hole) in the front of
that are important for
region of origin. Radiation
the neck. Chemotherapy
shoulder function.
and chemotherapy can be
has been shown to enhance
used in combination when
the effectiveness of
Reconstruction of bones
treating more advanced
radiation therapy, improving
and other structures is
disease.
cure rates compared to
often possible immediately following surgery.
radiation therapy alone for
Chemotherapy
advanced cancers such as those originating inthe
Where the jaw bone must be
Increasingly, chemotherapy
nasopharynx.
removed, the surgeon can
(in combination with
References on request.
Written by: Dr Johann D. Kluge | ENT Head and Neck Surgeon Head and Neck Consultant, Steve Biko Academic Hospital, University of Pretoria
page 23
TravelGround
STAY AT THESE
S T S E R O F E L A T Y IR A F
e lovely velGround had som t so very far away, Tra d a romantic weekend in no est for rk da , ep ha a de and the woodcutter Once upon a time in luxurious so Red Riding Hood delicious meal before retiring to her a tree-filled sta ys, and getaway. ved nd ser eke s we wa ir s ldilock ring the a granny cottage, Go had a blast with her seven friends du ite bed, and Snow Wh
GROOTVADERSBOSCH, SWELLENDAM, WESTERN CAPE: This indigenous forest, situated near Heidelberg and Swellendam, has only been a reserve since 1986, but has quickly grown in popularity. Featuring nearly all of the great indigenous afromontane forest trees, of which the giant redwoods are the most characteristic of the region, there is plenty of dappled shade to make your forest walk a comfortable one.
Augusta de Mist
Rates: From R1320 per night for 2 people Though some way away from the forest itself, the beautiful 2- to 3-sleeper units at this guesthouse in Swellendam will ensure that you sleep like Snow White to awaken feeling fresh and ready for a day amongst the trees.
Hermitage Huisies
Rates: From R750 per night for 2 people Some 50 km west of Grootvadersbosch you’ll find these adorable 2- to 5-sleeper cottages. If a day trip to the forest and dinner at one of Swellendam’s restaurants is on your itinerary, Hermitage is the perfect, tranquil accommodation to retire to after an eventful day. It is also right next to the berry farm!
Brackenhills Private Nature Reserve
Rates: From R1200 per night for 2 people If you’d like to be right on the forest’s doorstep, Brackenhills is the way to go. These 2-sleeper glamping tents and single caravan make use of a fully equipped communal kitchen, otherwise traditional African meals can be prepared for you.
HOGSBACK FOREST, EASTERN CAPE: With its breathtaking waterfalls, expansive green canopy and snow-covered forest floor during the winter, it isn’t all that hard to see why it is said that the forest at Hogsback inspired J.R.R. Tolkien to write The Lord of the Rings.
Granny Mouse House
Rates: From R650 per night for 2 people This charming owner-run guesthouse is nestled in a beautiful, flowery garden in the quieter part of town. Accommodation is offered in 2-sleeper guestrooms which are perfect for travellers and couples looking to find some peace and quiet amongst the trees.
Hogrock Falls
Rates: From R900 per night for 2 people The two log cottages offer excellent views of the forest. Equipped for self-catering, the units can be booked separately or together. The cottages offer a quaint, cosy option close to the waterfalls and are each suited to a family of 4 or a couple simply looking for romantic forest walks.
MAGOEBASKLOOF, LIMPOPO: Known as the “Land of the Silver Mist”, Magoebaskloof in Limpopo will take you back to the fairy tale forests of your youth. The nearby town of Haenertsburg offers plenty to do and to see, but if you’d like to be left in peace, there are countless hiding places here.
Pavetta Country House
Rate: R1400 per night for 8 people Nestled in a pine forest at the edge of the Haenertsburg Trout Association’s trophy dam, this self-catering house is a great pick and comfortably sleeps 8 adults and 2 children. It's the perfect, secluded getaway for friends or a family.
Magoebaskloof Birders' Cottage
Rates: From R700 per night for 2 people Birders and adventure bathers alike will be pretty pleased with what these secluded cottages have to offer. Each unit is equipped with an indoor fireplace, private outdoor baths offering views of the forest or the mountainside, and are off-the-grid with gas appliances and water heated by a donkey system.
The Stables and The Loft @ Glenogle Farm
Rates: From R1500 per night for 2 people Want to horse around between the trees? Then Glenogle Farm has 2 beautiful units for you to choose from!
Source: All images found on TravelGround.com
page 25
TravelGround TSITSIKAMMA FOREST, GARDEN ROUTE, WESTERN CAPE: The Tsitsikamma National Park, if properly explored, packs quite a punch for any nature lover. Boasting 116 giant tree species, one of which, the “Big Tree” yellowwood, is about 800 years old with a circumference of 9m, Tsitsikamma is worth a trip and, therefore, worth a stay as well.
Misty Mountain Reserve
Blue Horizon - Absolute Tsitsikamma
Pear Tree Cottages
Tsitsikamma Lodge
Rates: From R1800 per night for 4 people Flanked by the Indian Ocean on the one side and the Tsitsikamma Mountains and Forest on the other, this lodge offers breathtaking views and nature activities like fishing and cycling.
Rates: From R770 per night for 2 people Have an environmentally friendly forest-stay in one of these two quaint, secluded 3- to 4-sleeper cottages which are equipped with self-catering facilities. Set in tranquil surroundings near the Storms River Peak, the frogs and birds will sing you to sleep.
Rates: From R2000 per night for 2 people Situated on the breakers with the forest as its backyard, this 8-sleeper self-catering house offers breathtaking ocean views — maybe you’ll even spot some whales or dolphins!
Rates: From R1595 per night for 2 people Rustic log cabin meets grand lodge at this beautiful hotel set in the forest and surrounded by the mountains. Each of the 34 cabins have luxurious amenities like a private deck and a spa bath, and delicious meals are served in the restaurant on site.
PLATBOS FOREST, OVERBERG, WESTERN CAPE: Join owners Francois and Melissa Krige at the southernmost forest reserve in Africa, just off the R43 between Gansbaai and Hermanus.
Platbos Forest
Rates: R850 per night for 2 people Platbos Forest offers a range of accommodation options under 1000-year-old milkwoods. Experience this off-the-beatentrack- forest in an off-the-grid -way when you find yourself in the Overberg region again.
ARE YOU AT RISK OF A HEART ATTACK OR STROKE?
Ask your Doctor, Nurse or Pharmacist to ASSESS YOUR RISK
Anti-platelet therapy is recommended if you are at HIGH RISK for a STROKE or HEART ATTACK1 IF YOU WEIGH 75 KG OR MORE 75 kg +
• Ensure you are getting enough anti-platelet therapy for your weight2
A HEART
• Ensure that your anti-platelet therapy is enteric-coated to help protect your stomach3
2 HEART MOMENT WITH BAYER
Adapted from: 1. Vandvik PO, Lincoff AM, Gore JM, et al, Primary and secondary prevention of cardiovascular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141; e637S-e668S. 2. Cox D, Maree AO, Dooley M, et al. Effect of enteric coating on antiplatelet activity of low-dose aspirin in healthy volunteers. Stroke 2006; 37: 2153-2158. 3. Dammann HG, Burkhardt F, Wolf N. Enteric coating of aspirin significantly decreases gastroduodenal mucosal lesions. Aliment Pharmacol Ther 1999; 13: 1109-1114. Bayer (Pty) Ltd, Reg. No.: 1968/011192/07, 27 Wrench Road, Isando, 1609. Tel: 011 921 5044 Fax: 011 921 5041 DATE: July 2016. L.ZA.MKT.GM.07.2016.1354
75 kg +
first aid
D T S n a d n a a e s , n u S NWELCOME HOLIDAY SOUVENIR
AN U
HOLIDAY SOUVENIRS SHOULD BE PHOTOS, KEEPSAKES, AND MAYBE SOME SEA SHELLS. A SEXUALLY TRANSMITTED DISEASE (STD) IS NOT SOMETHING YOU WANT TO BRING BACK FROM YOUR HOLIDAY.
in unprotected sex don’t
bumpy, or worse – silent
think they’ll get an STD.
but deadly – infections that
Based on their impression
can be spread by intimate
of their sexual partner,
contact. So, how can you tell
cursory risk assessment of
if someone has an STD?
the activity, and their level
The first rule is to never
STD before engaging in
Getting tested for STDs is the only way to know with 100% certainty whether someone has an STD.
have unprotected sex, not on
sexual activity. There is no
However, there are certain
holidays or any other time.
real consensus about what
signs and symptoms that
Secondly, look for signs to
signs would clue you in to
can be useful if you’re
tell if someone has an STD.
whether or not someone has
worried about how to tell
Most people who engage
one of the burning, drippy,
if someone has an STD.
of intoxication, most people assume they’d be able to tell if their partner had an
WE CANNOT STRESS ENOUGH THAT THE MOST COMMON SYMPTOM OF STDS ARE NO NOTICEABLE SIGNS OR SYMPTOMS AT ALL!
3. Does this person have a sore throat or throat infection?
5. Does this person have a rash?
A sore throat, difficulty
hands or soles of the feet
1. Does this person have bumps on their genitals or mouth?
swallowing, redness,
can be caused by:
sores in the mouth or on
syphilis: Red or brown,
Bumps, warts, pimples,
the throat, loss of voice,
non-itchy rash
blisters, or sores on or
and (in rare cases) throat
around the genitals can
fungus can be caused by:
QUESTIONS TO ASK YOURSELF ABOUT YOUR PARTNER TO HELP GAUGE IF THEY HAVE AN STD:
be caused by: • HSV-1, known as oral herpes, and HSV-2, known as genital herpes: Lesions • Molluscum contagiosum: Flesh-toned spots with a sunken, concave
pockets of pus, chancre
• Chlamydia • Gonorrhea: Swollen glands in the throat • Syphilis: Large, gray or white lesions • HIV: White or yellowish fungal infection • HPV
appearance
Scabs on or around the
6. Does this person have a high-risk job? Certain jobs carry a higher risk of contracting an STD, such as: • Doctors, nurses, ER staff, first responders, and • Aid workers/
4. Does this person have pink eye?
genitals are typically a
Conjunctivitis, known as
sign of bumps that have
pink eye, can be caused by:
oozed and started healing.
• Secondary stage
other hospital staff
• Human Papiloma Virus (HPV): Genital warts
Rash on the palms of the
• Gonorrhea
missionaries • Janitorial staff who work with bodily waste or contaminated water • Sex workers and adult entertainers
• Chlamydia • Herpes
2. Does this person have chronic flu-like symptoms? Fever, chills, fatigue, swollen joints, and nausea can all be signs of an STD, such as: • HIV • Chlamydia • Gonorrhea • Syphilis
page 29
first aid THERE ARE MANY OTHER
sexual, like a rash on your
POSSIBLE INDICATORS THAT
armpit or spotting between
• Risk of sexual assault
SOMEONE HAS AN STD, BUT
menstrual cycles, could be
• Dangers of “date rape”
WITHOUT AN STD TEST,
the first sign of an infection
THERE IS NO WAY TO BE
that could go unnoticed and
ABSOLUTELY SURE.
untreated, leading to very serious side effects.
What may look like a
distinguish between normal and abnormal vaginal discharge. Burning during urination could be due to
area could be a result of an
• Hepatitis B vaccination for sex tourists or those taking a prolonged holiday to high-risk areas – for example, gap year students
ADVICE TO TRAVELLERS AND HOLIDAY MAKERS
allergic reaction to a new
• Attendance at STD clinics if unprotected sexual intercourse occurs
laundry detergent.
• Prevalence of STDs/ HIV
Conversely, something that
• Safer sex including
in area to be visited seems completely non-
advice • Information on postfor HIV
The best way to avoid STDs if you are sexually active, is to practise safe sex and get tested regularly.
a urinary tract infection and itching in the genital
drug • Alcohol consumption
exposure prophylaxis
bump could be an ingrown hair. It can be difficult to
new partner
condom use with any
• Travel packs including condoms, drugs for HIV post-exposure prophylaxis
RECIPE
Ingredients • 1¼ cups Cookie Crumbs such as Tennis Biscuits • 3 tbs Butter (Melted)
MAKES GS 5 SERVIN (MASON JARS)
• 1/8 tsp Cinnamon • 2 tbs White Sugar • 226g Cream Cheese • ½ cup Condensed Milk • 1 tbs Lemon Juice • 1 tsp Vanilla Extract • 10 large Strawberries (Chopped) • ½ cup Chocolate Chips
Instructions for the crust:
NO BAKE
cheesecake S
IN MASON JAR
cheesecake – Easy, melt-in-your-mouth d always there an great for warm weather, son jars have Ma when you’re in a pinch. w, making meals no ile wh a for nd tre been a d fun. Try this and desert interesting an . ipe delicious rec
1. Pour crumbs into a medium bowl; stir sugar in.
2. Add melted butter, and stir until well combined. Set aside.
g: Instructions for the fillin 1. Using an electric mixer, set at medium-high speed, beat the cream cheese in a large bowl until smooth.
2. Beat in the condensed milk a little at a time, scraping the sides of the bowl if necessary.
3. Mix in the lemon juice and vanilla. 4. Pour half of the crumb mixture into 5 x
1 cup mason jars. Put a few chocolate chips onto the crumbs.
5. Pour some of the cheesecake mixture on top, add strawberries. Sprinkle the rest of the crumb mixture, another layer of the cheesecake mixture and finish with strawberries.
6. Chill in the fridge for at least 2 hours. 7. When ready to serve, drizzle chocolate or maple syrup on top.
Note: You can substitute the strawberries with any other kind of fruit or nuts. Be creative and use what you have on hand. Source: thehomejournalist.com
page 31
your experts
YOUR s to Email your question .za experts@intercare.co
Prostate cancer treatment
Last year I was diagnosed with prostate cancer after a routine PSA test. It had not spread, and the doctor decided to adopt a six-monthly blood and prostate examination. Had I not had the PSA test I feel I would have soldiered on in blissful ignorance. But receiving no treatment sends my mind into overdrive. Are they not missing something? Your worry is understandable. Most people diagnosed with cancer are keen to have treatment as soon as possible to get rid of all signs of it. But with prostate cancer, all is not what it might seem. One of the most important things to point out is that this type varies greatly in how aggressive it is: prostate cancer is mostly something you die with, not of. Since the arrival of PSA testing – which measures a protein called prostate-specific antigen – there have been more prostate cancer “diagnoses”. But PSA levels can be raised for other reasons, too (such as an enlarged prostate or even recent sexual activity), and a biopsy is needed for confirmation. It is best to seek a consultation with a urologist for a clinical review and possible biopsy of the prostate.
These questions were answered by Dr Vinesh Reddy, a General Practitioner and Dr Nadine Williams, a dentist from Intercare Glen Marais Medical and Dental Centre.
Contact our Intercare experts at INTERCARE GLEN MARAIS Tel: 011 922 5000 | Fax: 011 922 5001 Email: glenmarais@intercare.co.za Address: Cavendish Glen Centre, 127 Monument Rd, Glen Marais, Kempton Park
Cholesterol levels increasing I’m 39, I eat healthily and I’m slim, but a routine blood test last year showed I had high cholesterol. A test last week showed my levels are getting higher. Do I need statins or should I rather change my diet?
It is not mentioned if your blood test also included the values for “bad” HDL (highdensity lipoprotein) and “good” LDL (lowdensity lipoprotein) cholesterol. I presume you mean your total cholesterol number was high and getting higher. Your total cholesterol number is not a good indicator of heart disease risk; there are several laboratory values that are better predictors of heart disease and overall health risk. It is suggested that you do a full lipogram to determine the individual makeup of your total cholesterol count (HDL and LDLcholesterol, triglyserides and lipoprotein, etc.). This can be performed at your GP. The full lipogram results would be a better indicator for further treatment options if needed.
Long-term use of sleeping pills I have insomnia and rarely sleep for more than three hours a night. But when I started taking sleeping tablets (Zolpidem), I slept for six or seven hours for the first time in my life. Are there any problems with using these pills long term?
Yes, long-term use is not recommended. The ease with which these sleeping pills are prescribed increases the likelihood of the major problem associated with all of them: dependence and withdrawal symptoms, which eventually can lead to psychosocial strain. Zolpidem has a licence for the short-term treatment of insomnia and, therefore, should only be taken for a maximum of four weeks in order to avoid these problems. It is recommended that you confirm your insomnia diagnosis first. Perhaps you have primary sleep disorder, rather than insomnia. The difference is that insomnia is sleep disruption often as a result of an event, such as a bereavement or stress. With primary sleep disorder, there does not appear to be a clear cause. The treatment options to explore also differ between these two diagnoses.
Matters of the heart
I'm only 29 but I keep feeling this pounding sensation in my chest, as if my heart is skipping six or seven beats every minute. I used to smoke ten cigarettes a day, but I quit last year. Also I've been preparing for exams so have been stressed and I drink two cups of coffee daily. I'm very concerned. Should I see a cardiologist? The symptoms you described should be investigated, as it could be attributable to numerous causes. But do not be alarmed as the cause is unlikely to be serious heart disease given your age. The sensation you describe is in fact due to extra beats occurring (known as ectopic beats, or extra systoles). It's the gap before the next heartbeat, a compensatory pause, that you're noticing. See your GP and – after explaining your medical history – you will undergo an electrocardiogram (ECG), to obtain an electrical recording of your heart's activity. This will help the doctor to identify the type of disturbance and whether you should be referred to a cardiologist.
Stubborn ingrown toenails My son is 19 and has had six or seven procedures to remove ingrown toenails on the big toe of his left foot. He's had infections in that toenail more times than we can remember and has been in constant pain for at least ten years. He's so fed up that he wants the whole nail removed. Is that the best option?
The experience your son has had is far from unusual. Ingrown toenails are most common in adolescents, though it's not known why. An ingrown toenail develops when the growing nail (usually on the big toe) digs into and pierces the skin and soft tissue surrounding it, often causing pain and infection as bacteria that otherwise live harmlessly on the skin get underneath. Removing the toenail – a procedure carried out under local anaesthetic – is a definite possibility, though the issue may still recur a year or so down the line when the new nail has fully formed. The actual outcome depends on the patient, underlying medical issues and level of activity. It is best to visit your GP to determine if this is the best alternative.
Teeth discolouration
I am a non-smoker, but I drink a lot of coffee and tea and therefore some of my teeth have discolouration. What is the best way of getting my teeth whiter? If you don't want to give up drinking coffee and tea, it is important to look after your teeth in order to keep staining to a minimum. Tannins from coffee and tea attach to plaque and discolour teeth. Keeping your teeth smooth and clean at all times is the best way of getting your teeth whiter. Drinking black tea can cause lasting discoluration (more than coffee), but it is possible to reduce staining by developing healthy oral care habits. At home, simple things such as brushing your teeth regularly can help. Brushing twice a day is good, but brushing immediately after you drink a cup of tea is even better. Drinking water after a cup of tea can help reduce the amount of tannin left in your mouth, too. Switching from black tea to herbal or green teas can also reduce staining, although it will not eliminate the problem altogether. If a scale and polish does not remove the existing stains, external bleaching is safe and reliable, and the best way of getting your teeth whiter than the natural shade.
Do I really need to floss?
I really struggle when flossing my teeth. Are there any alternative methods to clean in between my teeth and is flossing really that important? Flossing breaks up plaque (bacterial biofilm) on your teeth. Not flossing leaves you vulnerable to gum infection (gingivitis), which can lead to gum disease (periodontitis) and eventually cause tooth loss. In addition to a healthier mouth, there’s another benefit to flossing your teeth: fresher breath! • If you have tight spacing between teeth, use a dental floss which is made specifically for “tight teeth” (thin and flat instead of just a thread). • Plastic, Y-shaped disposable flossers and floss holders that allow for extra reach • Small, round interdental brushes and/or pointed rubber tips • Wooden or plastic pics (called interdental cleaners) It is important to choose one that works for you, so it can be done once daily.
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