BodyLanguage Issue 13 Summer 2017

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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So will we.

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Get tested.

Go to www.intercare.co.za for more information Intercare Group