LIFE HEALTHCARE MAGAZINE DECEMBER 2016

SUMMER 2016/17

FREE COPY

PUBLISHED IN THE INTEREST OF YOUR HEALTH BY

PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE

MAN’S BEST FRIEND IS A

HEALER

• SUMMER 2016/17

The restoring power of animal-assisted therapy

SUMMER HEALTH • Hydrate • Be sun safe • Pedal your way to fitness ALERT!

THE HIDDEN HEALTH HAZARDS OF YOUR BUSY LIFE

PLUS

HOW MUCH VITAMIN D DO YOU REALLY NEED? 00_LIFE_COVER_Dec16.indd 1

2016/11/17 11:14 AM

ED’S LETTER

Life is…

Happy holidays!

SAMANTHA PAGE EDITOR

THE SEPTEMBER 2016 ISSUE OF LIFE HEALTHCARE MAGAZINE IS AVAILABLE AT WWW.LIFEHEALTHCARE.CO.ZA ‘MAKING LIFE BETTER STARTS HERE’

LIFE PLUS

LOOK OUT FOR LIFE PLUS BOXES IN OUR MAGAZINE FOR EXTRA INFORMATION AND HEALTH TIPS

A PUBLICATION BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP

IMAGE ANGIE LAZARO

sweeter when travelled with a dog, a cat or a guinea pig. I have all three so I can vouch for the power of animals to heal, offer unconditional love and bring hope. But don’t just take my word for it. Read our article on page 32, which makes a compelling case for the merits of a goal-directed intervention or clinical treatment using an animal to improve a patient’s social, emotional or cognitive functioning. Life Healthcare’s very own therapy dogs are living proof that man’s best friend is an excellent healer too.

Rehabilitation takes different forms, and for many patients one of the most urgent needs is regaining the ability to drive after a debilitating injury or medical condition. Life Healthcare’s rehabilitation units and therapists play a vital role in readying patients for reintegration into their communities and, assisted by Rolling Rehab’s Caroline Rule, they give their patients not just healing but hope to be able to reclaim their independence on the road.

Read more about the remarkable work they do on page 12.

The long lazy days of summer are almost upon us, so it’s also time to pay close attention to staying adequately hydrated (page 20), taking good care of your skin (page 52) and making plans to add a little movement to your day by dusting off your bicycle (page 28). Down time is as important for your mind as your body – on page 22, Lisa Lazarus guides you through the symptoms of burnout and how to avoid a complete meltdown.

While the holidays can be overwhelming with multiple commitments and the inevitable busyness of the season, take time to reflect, relax, recharge and really connect with those who are most precious to you. Giving to others and yourself is good for your health.

EDITORIAL Editor Samantha Page lifehealthcaremag@johnbrownmedia.com Art Director Monique Mouissie Managing Editor Simone Isaacs Copy Editor Raadiyah Abrahams Managing Editor (Life Healthcare Group) Tanya Bennetts EDITORIAL COMMITTEE Yvonne Motsisi, Denis Scheublé, Dr Nilesh Patel, Lucy Balona (CANSA), Dr Steve Taylor, Janette Joubert, Dr Sharon Vasuthevan, Liesel van Oudenhove MANAGEMENT Managing Director Lani Carstens Business Development Director Rebecca Smeda Group Account Director Joanne Peltz Account Manager Delicia Krause Production Director Nina Hendricks Financial Director Megan Paulse Human Resources Director Aashiqa Petersen

ADVERTISING Advertising Sales Director (Johannesburg) Moyra Beeming moyra.beeming@johnbrownmedia.com 011 507 9123; 082 375 4446 Advertising Sales Manager (Cape Town) Estelle Dietrich estelle.dietrich@johnbrownmedia.com 021 486 7609; 073 224 4996 PRODUCTION Production Co-ordinator Tessa Smith Reproduction Resolution Colour Printing Paarl Media Cape Life Healthcare magazine, 2nd Floor, Block A, North Side, Black River Park, Fir Street, Observatory, 7925 / PostNet Suite #2, Private Bag X11, Mowbray, 7705 Email: lifehealthcaremag@johnbrownmedia.com Tel: 021 486 7600 Fax: 021 486 7614 www.johnbrownmedia.com For magazine-related queries, contact John Brown Media.

Tel: 021 486 7600 Fax: 021 486 7614. PostNet Suite #2, Private Bag X11, Mowbray 7705.

Life Healthcare magazine is published by The Life Healthcare Group to provide patients, their families and the public with the most readable, interesting and relevant health and wellbeing journal available.

Life Healthcare magazine is distributed quarterly to patients at all Life Healthcare hospitals and to privatesector doctors. It has a guaranteed print order of 90 000 per quarter, with an estimated readership of 240 000.

Life Healthcare magazine can now also be read online.

Visit www.lifehealthcare.co.za Disclaimer: the opinions expressed by the authors of the articles published in this magazine do not necessarily reflect the views of The Life Healthcare Group Ltd or John Brown Media. The Life Healthcare Group Ltd or John Brown Media do not accept any responsibility for information given in the articles featured in Life Healthcare magazine.

ENDORSED BY

Whilst The Life Healthcare Group Ltd has agreed to advertise products in this magazine, the Group makes no representations or warranties as to the efficacy or use of the products. The products are advertised on condition that readers will make their own determination, including seeking advice from their medical practitioner or healthcare professional as to the suitability of the product for the intended purpose, prior to use. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of use of the advertised products.

WWW.LIFEHEALTHCARE.CO.ZA

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Contents

This month’s focus… Get set for summer LIFE 01 Life is…

A note from the editor

04 Over to You

Letters from our readers

08 News

Medical innovations, what’s new at Life Healthcare and latest reads

12 Drive for Independence

An occupational therapist is helping to empower those with disabilities reclaim their lives by teaching them to drive

By Keri Harvey

16 ‘I was determined to work hard at reclaiming my life’ Melonie McKechnie recalls her stroke and how important rehabilitation was in her recovery As told to Lynne Gidish

18 Uterine Fibroid Embolisation brings hope How this minimally invasive procedure is changing outcomes for women with uterine fibroids

By Sam Brighton

20 Hydrate for healthy living

As the weather starts heating up, getting enough to drink is important.

This is how you get waterwise

By Ruth Rehbock

22 Time for some down time?

Life has never been more stressful, which is why taking time out is vital for your health and survival

By Lisa Lazarus

26 D o you HAVE Imposter Syndrome?

Do you give yourself credit for your achievements or think of yourself as a fraud? Take the quiz and find out if you believe in your success

28 Let’s ride

Pump up your tyres, put on a helmet and pedal your way to good health

By Erin Coe

52 be sun savvy this season

2

Summer 2016/17

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56

FOOD FOR FRIENDS AND FAMILY

32

46

IT’S SUMMER … ATCHOO!

MAN’S BEST FRIEND IS A HEALER

HEALTH

CARE

32 ANIMAL-ASSISTED THERAPY TAKES THE BISCUIT

42 ARE WE THERE YET?

38 PRENATAL SURGERY: SAVING A BABY’S LIFE IN UTERO

45 EVERYBODY’S TALKING ABOUT… EPIPEN

40 EPILEPSY AND PREGNANCY: THE LOW-DOWN

46 ALLERGY ALERT

What’s the science behind animalassisted therapy? Introducing the Life Rehabilitation therapy dogs

By Glynis Horning

A miraculous operation gives hope

By Charlene Yared-West

Women with epilepsy may feel anxious about potential risks to their unborn baby but the condition can be managed

By Mandy Collins

Follow these helpful guidelines for a stress-free trip with your little ones and make beautiful holiday memories

By Jocelyn Warrington

What you need to know about this life-saving medication

By Pippa Naudé

Experts discuss five common allergies you may experience in summer

By Raadiyah Abrahams

50 YOU CAN SEE WE CARE

Life Healthcare shares patient feedback on their CARE programme implemented in October last year

By Melanie Farrell

52 WHAT YOU NEED TO KNOW ABOUT SKIN CARE THIS SUMMER This is how you can take care of your body’s biggest organ

By Meg de Jong

56 FOR FRIENDS & FAMILY

In this collection of recipes, author Nicky Stubbs gathers her favourite dishes in a celebration of food and cooking

61 LIFE HEALTHCARE HERO

Clinical pharmacist Sharifa Essack at Life Brenthurst Clinic

62 MIND GAMES

Take a break with our puzzles and crossword

64 HERE’S TO YOU, 2017!

42

Do as the swallows do and fly confidently into 2017, says Samantha Page

TIPS FOR TRAVEL WITH LITTLE ONES WWW.LIFEHEALTHCARE.CO.ZA

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LETTERS

OVER TO YOU We’d love to hear from you

CARE IN ACTION I was admitted to Life Westville Hospital on 19 September 2016 for knee surgery and anterior talofibular ligament (ATFL) reconstruction. My day started badly as I woke up with a severe migraine caused by my unnecessary concerns regarding my hospital stay.

From admission, the staff in the theatre and the ward were exemplary, kind and attentive. The ward staff were very helpful when they saw the severity of my migraine and very supportive when they saw how distressed I was about my procedure. The day and night staff were very attentive and available to ensure my pain was under control.

The kitchen manager even came to check if I was happy with my food – wow, that’s what I call caring about your patients. Thanks to the kitchen for the delicious food.

One generally cannot say a hospital stay is great. However, mine honestly was. Thank you, Life Westville Hospital.

Sandra Wakeford

Wow, that’s what I call caring about your patients

WINNING LETTER

PEACE OF MIND

An example for our country I have just had my third visit to the Life Kingsbury Hospital in Claremont this year and want to tell you about this amazing place. In January, I was admitted with pulmonary emboli in both lungs. This came out of the blue and was a frightening experience. I was taken to ICU where the nursing staff understood my nervousness and went out of their way to reassure me. After two days, I was transferred to a ward where I stayed for five days while my medication was adjusted. Throughout my stay, the nursing staff were efficient, caring and friendly. What really impressed me was the interaction between them.

What an example to our country when people from different backgrounds can work as a team, appreciating each other’s contribution and friendship.

My two other visits were for the removal, under general anaesthetic, of a spider bite abscess and for a colonoscopy, which only involved day wards, but again I was treated with such warmth and understanding, from the gentleman on the admittance desk who jokingly suggested I should have a season ticket, to the anaesthetist who talked me through the process of conscious sedation.

Thank you to all the staff at Life Kingsbury Hospital; you do an outstanding job.

On 1 August 2016, my husband was admitted to Life Beacon Bay Hospital in East London for a same-day procedure.

From the time we were admitted in the early hours of the morning until the time we left the hospital to go home, we were treated with five-star service.

Each and every staff member we encountered was not only friendly, but also willing to help with any questions or concerns we had.

I would like to say a special thank you to Michelle, the sister who we met just prior to my husband’s op. She managed to turn my nervous tears into fits of laughter. It was an awesome feeling leaving him in pre-op with a smile on his face.

We are so grateful to all the staff at Life Beacon Bay in East London. You guys are doing a great job! Thank you for taking such good care of my husband.

Caroline Opperman

A GREAT READ Thank you for a very informative and interesting magazine! I make a point of going to my local hospital just to pick up a copy. I am pleased to see that the magazine is also available online. Many thanks for the wonderful articles, which are very inspiring.

Sally Zwiebler

Pauline Pearce

Win a Garmin vívomove watch valued at R2 899 The Garmin vívomove is a fashionable analog watch with activity tracking features and a one-year battery life. The vívomove combines classic design with function, adding activity tracking, sleep analysis and an alert (a move bar) to remind users when they’ve been inactive too long.

The bar on the left shows your progress towards your personalised daily step goal, and the vívomove also tracks how well users slept by monitoring movement and restlessness. You can make every moment count with a vívomove watch.

Email Life Healthcare magazine (lifehealthcaremag@johnbrownmedia.com) about how you experienced life, health and care at a Life Healthcare hospital or facility and you could win.

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TIME TO MOVE

SUMMER 2016/17

2016/11/17 11:21 AM

Walk without pain Don’t let joint pain rule your life

Visit our website for more information

www.walkwithoutpain.co.za

Touching the lives of every South African under the Sun.

Today, Sun Pharma truly is a global phenomenon, employing over 30 000 people representing more than 50 cultures in five different continents. As the largest pharmaceutical company in India and fifth largest in America, with 2000 of the world’s best scientists committed to developing complex products, we additionally fulfill our core mandate of offering affordable generic medicines to all. Sun Pharma also offer generic anti-retroviral (ARV) medicines to needy patients in Southern Africa, supporting national governments in their effort to control the AIDS epidemic.

Sun Pharma has a state-of-the-art production facility in Roodepoort that manufactures analgesics, ARV’s, cold, cough & flu preparations, anti-histamines, anti-hypertensives, CNS drugs, vitamins & minerals, and a comprehensive range of over-the-counter (OTC) products.

Reaching people, touching lives.

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LIFE THE HEALTH BENEFITS OF CYCLING / AVOID BURNOUT / IMPOSTER SYNDROME

‘Let us dance in the sun, wearing wild flowers in our hair…’

Susan Polis Schutz

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LIFE NEWS

Medical innovations and Life Healthcare news SPOTLIGHT ON

The sunshine vitamin

3

FAST FACTS

#1 Vitamin D helps fight disease According to findings published in Circulation in 2008, the vitamin could help to decrease your chance of developing heart disease. #2 Vitamin D helps to counter depression Research has shown that the vitamin may play an important role in regulating mood. #3 Vitamin D may boost weight loss A study in the American Journal of Clinical Nutrition concluded that while people involved in the trial did not experience significant weight loss, supplementation was able to improve their heart disease risk markers.

NUTRITION

How you cook may affect your diabetes risk Do you love fried, grilled or baked food? Researchers of a recent study suggest boiling, steaming and poaching are by far safer and better for your health.

According to the study’s lead authors, frying, grilling and baking – also referred to as dry-heat cooking – produce substances called advanced glycation end products (AGEs). High levels of AGEs have been linked to insulin resistance, stress on the body at a cellular level and inflammation, which presents a high diabetes risk. ‘When you look at people with chronic diseases like type 2 diabetes or dementia put on a high-AGE diet or a low one, those on the low-AGE diet show signs of decreasing inflammation,’ said the head of the study, Dr Jaime Uribarri, a professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.

Source: Techtimes.com

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C O M P I L E D B Y S A M A N T H A P A G E im a g e s g e tt y / ga l l o i m ag e s , i st o c k an d s u pp l i e d

Vitamin D is produced in your skin in response to sunlight, which is why it’s sometimes called the ‘sunshine vitamin’. Perhaps its most important function is regulating the absorption of calcium and phosphorous, and facilitating routine immune system function. The vitamin is vital for the normal growth and development of bones and teeth as well as improved resistance against certain diseases, but while your body produces it naturally when directly exposed to the sun, dermatologists are divided. Elizabeth L. Tanzi, MD, FAAD, from the Johns Hopkins Hospital, argues that the benefits of obtaining vitamin D through UV exposure cannot be separated from an increased risk of skin cancer, while others say all you need is 10 minutes a day of midday, pre-sunscreen sun, especially if you have fairer skin. The Cancer Association of South Africa recommends instead that an adequate amount should be obtained from a healthy diet that includes food naturally rich in vitamin D (dairy products and fish), food or beverages fortified with vitamin D (fortified milk and fortified cereals), and/or vitamin D supplements.

Summer 2016/17

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2016/11/17 11:27 AM

NEWS

2357

The approximate kilojoules burnt per hour climbing stairs

SA HEALTH

MIND THE CURVES

IN AN EMERGENCY

C O M P I L E D BY SAMANTHA PAG E I M A G E S G ET TY/GALLO I MAG ES, ISTOCK AN D SU PPLI E D

Help at hand

Life Bay View Private Hospital in Mossel Bay in the Western Cape is dedicated to delivering excellent healthcare to all its patients on a daily basis – especially in emergencies. After extensive renovations and upgrades, the hospital now boasts a new emergency unit with highly qualified staff.

The unit is situated at the rear of the hospital – clear signage ensures visibility and accessibility – and has a separate entrance and waiting room, which makes the admission process more efficient. Open 24 hours a day with a doctor on call 24/7, patients are assessed according to an international triage coding system to prioritise treatment. The triage coding works as follows: RED Very urgent – receives immediate attention ORANGE Urgent – receives attention within 10 minutes YELLOW Receives attention within one hour of arrival GREEN You may have to wait up to four hours if there are more serious patients (codes red and orange) to attend to.

Staff keep patients informed about the waiting period. If your condition deteriorates while waiting, you can update the triage nurse immediately.

EMERGENCY NUMBER: 044 691 3718

If obesity in SA school children continues to increase at the current rate, 3.91 million children will be overweight or obese by 2025. It’s a staggering statistic, but according to research released on 11 October, World Obesity Day, obesity has reached epidemic proportions, with our girls at the greatest risk. The most recent national survey shows14.2% of primary school children are already overweight. This prevalence is highest at 30% in girls living in urban areas.

Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa, implores caregivers: ‘Parents have the single biggest influence over their child’s risk of obesity. Mothers should aim for normal weight before pregnancy, appropriate weight gain during pregnancy and exclusive breastfeeding for the first six months. Parents should introduce healthy eating habits from six months onwards and lead by example to create an active lifestyle for the whole family.’

Your heart and lungs will love a swimming workout.

For improved fitness, try lane swimming, which gives you a greater return on your exercise investment.

TRY IT OR

SKIP IT?

Do sunscreens for animals help lower your pet’s risk of skin cancer?

The expert says: It’s true that dogs and cats, especially with light-coloured or sparse fur, can suffer from sun damage. Trouble often happens on the ears, which are vulnerable to the type of skin cancer called squamous cell carcinoma. But research has yet to show that any kind of sunblock is effective for animals. And accidentally using a dog’s formula on a cat can be dangerous – an ingredient in some dog products can be deadly to felines (plus, it’s hard to imagine your cat sitting quietly while you sunscreen her!).

Don’t spend a lot of money on something that’s not proven. Ultimately, experts say, the simplest way to protect furry ones is one of the same ways you keep yourself sun safe: whenever you can, choose the shade. Adapted from Dr. Oz The Good Life, September 2015 WWW.LIFEHEALTHCARE.CO.ZA

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BITS & BY TES

85% Can Twitter predict the next epidemic?

Scientists and researchers believe social media platforms like Twitter can ‘identify disease outbreaks and also predict the timing and location of new outbreaks.’ There’s a lot of noise in cyberspace but when filtered correctly, the stream can offer value in tracking diseases because tweets allow some description and context for time and location.

Dr Mark Dredze, assistant research professor of computer science at Johns Hopkins University in Baltimore, has developed an algorithm that automatically filters tweets to identify people with flu and separate those from tweets that include the word ‘flu’ but aren’t related to actual cases. He applied this algorithm to the epidemic of January 2013 and was able to match the CDC’s estimates of actual flu rates.

In future, researchers will continue to use this real-time surveillance since the information they receive with regards to location, gender and age is timelier and as accurate as what’s collected by organisations like the CDC or WHO. THE FUTURE OF HEALTH

healthcare trends to look out for

#1 Ambient wellness

This is when health-boosting features are embedded in your environment. Think daylight lamps to boost your mood, meditation pods in your workplace or special air-filtering on planes to reduce jet lag.

#2 Calibrated health

Customisation is a global trend and now this could apply to your health too. Think tailor-made care that presents an individualised approach to your diet, fitness regimen and even your treatment.

#3 Virtual reality

VR has been steadily gaining momentum in gaming but health practitioners believe this tech can be harnessed for healing. It’s already been used to help patients overcome phobias and now there are games that improve cognitive ability and physical fitness.

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KIDS’ SAFETY

Track your tot Wearable technology has evolved so much that you can learn more about you and your health in real-time. Devices and apps can help you track your heart rate, daily steps, food consumption, your mood, and now you can monitor and keep your kid safe too with a super-intelligent mini GPS tracking watch. The GPS Kid Tracker Smart Wristwatch allows you to issue commands into the mobile terminal and listen to peripheral sound in your child’s environment, as well as have an emergency two-way conversation. In an emergency, your child can activate the one-button SOS, which will call a number you have pre-entered, and if the watch is forcibly removed, parents will receive a phone alarm. An added feature is a ‘geofence’ which is also programmed into the device so that if your child moves out of a certain zone, you’ll receive an instant notification. An added health benefit is a pedometer that calculates your child’s walking distance. The watch retails at around R700 (www.loot.co.za) in South Africa. kidssmartgpswatch.com

TECHNOLOGY

A SITE TO SEE The Skin Cancer Foundation is the only international organisation devoted solely to education, prevention, early detection and prompt treatment of the world’s most common cancer. Visit www.skincancerfoundation.org for information, news and inspiration.

I MAG ES GETTY/GALLO IMAGES AND SUPPLIED

SOCIAL MEDIA

The percentage of doctors enthusiastic about new digital health technology, according to a recent survey by the American Medical Association (AMA). The report further revealed that the doctors surveyed believe that digital health solutions ‘are advantageous to patient care’.

SUMMER 2016/17

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i mag es gETTy/gaLLO ImagES aND SuPPLIED

books

Fix-4-Nails

®

IMPORTANT

SHELF HELP

Fungus or no fungus, loose and/or damaged nails need Fix-4-Nails to recover www.loosenails.co.za info@fix-4-nails.co.za Tel: 0861 999 907

The latest reads to nurture your mind, body and soul

Quiet Power

By Susan Cain (Penguin)

EDITOR’S CHOICE

what do Bill Gates, JK rowling, rosa Parks and Meryl Streep have in common? while you may be tempted to say that they are famous, you probably wouldn’t guess that they all rated themselves as introverts when they were growing up. in Susan cain’s Quiet Power, she examines searching for your place in the world (through childhood, adolescence and your early twenties) and how we’re sometimes plagued with insecurity and self-doubt, which could manifest as being shy, quiet and sometimes even aloof. focusing on the strengths and challenges of being introverted, Quiet Power presents examples from school, family life and friendship, applying the breakthrough discoveries of Quiet, cain’s first book on the subject, to readers who so badly need them. cain’s book is not just insightful; it’s also empowering and gives the reader the tools to unlock their power in their own quiet way.

Your PregnancY nutrition guide

By Henrietta Norton (Penguin) Nutritionist and writer henrietta Norton draws on her vast experience with mothers-to-be to provide a clear, practical guide to eating during preconception, pregnancy and the early stages of motherhood. Some common questions are answered for expectant moms, such as which supplements to take, how to maintain good health during pregnancy if you’re vegan, which nutrients are important during each trimester and how to deal with morning sickness and fatigue. in addition, there are handy meal plans for every trimester, a list of foods to access on your smartphone and chapters on breastfeeding and labour nutrition. Your Pregnancy Nutrition Guide will be an invaluable companion on this memorable journey and beyond.

Available at and participating pharmacies and salons The ideal conditions created by Fix-4-Nails® under the nail is the secret of its success in ‘restoring by regrowth’ of loose and fungal damaged nails www.lifehealthcare.co.za

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Caroline’s goal (here with Thandeka Mona) is to get disabled people living as independently as possible, and with Rolling Rehab she can help them to drive again

DRIVE FOR INDEPENDENCE Occupational Therapist Caroline Rule founded Rolling Rehab to empower disabled people by assisting them to drive. In July this year, she was honoured with the Albie Sachs Occupational Therapy Association of South Africa (OTASA) Award, sponsored by Life Healthcare. Caroline speaks to Keri Harvey

‘H

elping people with disabilities and improving their lives is what makes me tick,’ says Joburg Occupational Therapist Caroline Rule.

‘It’s just in me, and it excites me.’

Caroline has been an occupational therapist for 25 years and has worked abroad in spinal rehabilitation and with children. ‘Spinal injury is my passion and where I believe I can make the biggest difference,’ she says.

Occupational therapists work across the population, from babies to the elderly, with a variety of people who have a cognitive or physical dysfunction to help them integrate 12

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Nina Strydom (right), Clinical Support Specialist at Life Healthcare, awarding Caroline Rule (left) the Albie Sachs Occupational Therapy Association of South Africa Award, which is sponsored by Life Healthcare, in July this year

into society. ‘My expertise,’ explains Caroline, ‘is working with people who have had spinal cord injuries; both paraplegics and quadriplegics. When I worked in rehabilitation, our goal was to get people living as independently as possible, whether it was teaching them to brush their teeth or to function in the work environment. Now, through Rolling Rehab and Driving Ambitions, I help them learn to drive again.’

‘Clients who suffer major medical and functional problems as a result of an acute disabling condition require specialised medical care and intensive multidisciplinary therapeutic interventions to help them address a multitude of problems and regain

SUMMER 2016/17

2016/11/17 11:30 AM

FIT FOR LIFE

as much functionality as possible,’ says Christi-Mari Botes, an occupational therapist at Life Rehabilitation at Life Eugene Marais Hospital. ‘At our rehabilitation unit, we often refer our patients to Caroline Rule and we are proud and excited by their success stories when they regain their independence in driving.

‘Many occupational therapists working with clients who have had a physical injury or disability that left them unable to drive are asked whether they will be able to drive again. It’s not an easy question to answer because each case is different based on vehicle adaptations available, the legal framework and the specific disability or injury. This is when I would enlist Caroline’s help,’ explains Christi-Mari. ‘We refer clients to Caroline when we need specific input about their driving ability and require an assessment. If a client is not yet

When you put somebody who has a severe disability in a car and they discover they can drive, it changes their life ready to drive, Caroline will make recommendations about aspects therapists need to focus on. A follow up assessment will gauge whether there has been an improvement.’ Christi-Mari adds that they always look forward to Caroline’s talks, such as the one she presented at their rehabilitation unit on 3 November as part of stroke awareness.

Assessment of clients by Rolling Rehab includes a full medical and driving history, perceptual and cognitive tests and reaction speed tests, as well as physical assessments, visual screening tests and an on-road driving test. ‘We need to understand any functional difficulties the client has in order to understand how to work with them and get them back on the road safely. ‘Paraplegics seldom need

Restoring quality of life

Douglas Riches had a stroke in July 2014. It affected his muscle coordination and speech and left him with a strong tremor in his left arm and difficulty coordinating his left leg. Today, he is smiling and back on the road again, driving independently.

Sibusiso Mogale, born with short arms and no hands, was ready to give up on getting his driver’s licence. He contacted Caroline, who mentored and guided him through his driving test with a steering spinner (a modified steering device, as seen in the photo above).

Joubert du Plessis broke his neck and back at the T6 vertebrae in a road accident in December 2012.

Despite the rehabilitation he received in the Eastern Cape and at Life Eugene Marais Hospital in Gauteng (which he says was ‘awesome’ and enabled him to ‘achieve a lot of progress’) he is a wheelchair-bound paraplegic.

But this has not stopped Joubert from driving his adapted vehicle, which allows him to control the brake and accelerator pedals in his car with a rod that is connected to his steering wheel.

WWW.LIFEHEALTHCARE.CO.ZA

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FIT FOR LIFE

an assessment as they have strength in their upper limbs.’

Caroline explains that as long as a client – paraplegic or quadriplegic – can transfer him- or herself into and out of a car, they have the strength to drive. She clarifies that quadriplegics have impaired leg and arm function, but are not necessarily completely paralysed. However, a high-tech vehicle for use by quadriplegics with minimal strength has recently been donated to the Driving Ambitions driver training project. It allows a driver to drive the vehicle from their wheelchair.

Any driver who has a physical disability and needs an adaptation to the vehicle has to hand in his or her driver’s licence and be retested for a new restricted licence. This is essential for insurance.

Since starting Rolling Rehab, Caroline has trained driving instructors who work with clients using adapted hand-control vehicles at centres in Johannesburg, Pretoria, Pietermaritzburg and Durban.

‘When you put somebody who has a severe disability in a car and they discover they can drive, it changes their life,’ smiles Caroline. ‘The vehicle just has to be correctly adapted for them and they are independent again.

Nothing gives me more joy than being able to give clients this independence.’

‘Everyone involved in rehabilitation at our units – doctors, therapists, nurses and other support staff – believes that our primary aim is to help our client and their family cope with their disability by achieving maximum independence and minimum reliance on on-going professional support, so that they can contribute to society and return to their communities. When this happens, it’s a triumph for all of us,’ says Christi-Mari.

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Rehabilitation

THE RIGHT CHOICE FOR ACUTE REHABILITATION Life Rehabilitation is the leading provider of acute rehabilitation services in the country, operating almost two thirds of all private acute rehabilitation beds in South Africa. We offer acute outcomes-driven physical and cognitive rehabilitation for patients disabled by stroke, brain or spinal trauma and other disabling injuries or conditions.

Our reach by the numbers

5

PROVINCES

acute rehabilitation units

304 beds

400+

healthcare professionals

LIFE PLUS

For more information, visit www.rollingrehab.co.za; www.auto-mobility.co.za or call 083 560 6886, and for Life Rehabilitation information, visit www.rehab.co.za

I M A G E S SU PPLI E D, I C O N S FLATICON

International Day of Persons with Disabilities is on 3 December

SUMMER 2016/17

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Major illness? Stroke? Traumatic injury?

Your journey of recovery starts here

Let Life Healthcare’s Acute Rehabilitation Team of dedicated experts assist you to prioritise and develop your care journey to recovery Life Rehabilitation is a specialised healthcare service dedicated to providing rehabilitation care to patients recovering from:

■■Head injury ■■Spinal cord injury ■■Severe orthopaedic injury as a result of injury on duty or car accident ■■Stroke and nerve related injury or illness that has resulted in weakness or paralysis ■■Traumatic injury, amputation and/or joint replacement

We also support:

■■Elderly patients with weakness and inability to walk ■■Unsteadiness and weakness following a severe medical illness ■■Cancer recovery ■■Post-surgery for strengthening and stabilisation

Life Rehabilitation has extensive knowledge in managing the rehabilitation requirements of our patients. Each patient has unique needs and we develop care treatment plans tailored towards the individual in collaboration with families.

Our interdisciplinary team includes:

■■Rehabilitation doctors ■■Rehabilitation nurses ■■Physiotherapists ■■Occupational therapists

■■Neurocognitive psychologists ■■Speech and language therapists ■■Social workers ■■Dieticians

Will my medical aid pay for the treatment?

Most medical aids pay for acute rehabilitation to facilitate return to function and reduce complications. Life Rehabilitation offers you a global fee tariff which is inclusive of hospital, doctor and therapists costs. This ensures that patients are protected from medical savings being depleted.

What do I do next?

We can assist you in obtaining the referral to our facility to further facilitate recovery. Please contact us for further assistance.

For more information please contact us on Tel: 011 219 9626 or email: Rehab.Headoffice@lifehealthcare.co.za www.lifehealthcare.co.za

FIRST PERSON

‘I WAS DETERMINED TO WORK HARD AT RECLAIMING MY LIFE’ In October 2011, 47-year-old Melonie McKechnie tripped over a small stone during a run, resulting in minor abrasions and a bruised shoulder and eye. A week later she developed one of her infrequent migraines, with symptoms intensifying during a race the next weekend – so she took some medication. The following day, she tried to put on her running clothes. That’s when it all went black... wreck. I had no idea if or when I would recover and couldn’t imagine living like this for the rest of my life, but my Comrades training soon kicked in and helped me deal with the situation. I was determined to work hard at reclaiming my life and gave myself a year to get better and race.

I spent two months at Life Riverfield Lodge doing intensive rehab, which continued at Life Groenkloof Hospital rehab centre. It was an uphill battle but I put everything I had into it.

I hit rock bottom the next November when race day came and went. I’d fought hard to get back on the road but couldn’t even do so driving a car! I was devastated and so low that I even contemplated

IN HER DOCTOR’S WORDS

Melonie’s journey taught me a valuable lesson about the fragile nature of life very early in my career as a therapy unit manager. It saddened me that someone who was so fit and lived such a healthy life could undergo such a tragedy. We deal with a lot of patients who go through intensive rehabilitation but the way Melonie approached hers – with determination and tenacity – has always stayed with me. She worked extremely hard every single day, so much so that upon discharge she was able to walk independently with a walking aid and had greatly improved overall. She took the discharge recommendations to heart and continued her outpatient therapy with the same drive and motivation. I was reacquainted with Melonie when I invited her to speak at Life Riverfield Lodge’s Open Day on 22 September 2016, and am so proud of her and the progress she has made since her discharge. During her speech, she said that she’d made the decision not to allow her disability to define her, but for her to define her stroke. Melonie McKechnie will remain an amazing inspiration to all of us at Life Riverfield Lodge as well as fellow stroke survivors.

– Ida Geldenhuys, Therapy Unit Manager at Life Riverfield Lodge 16

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Melonie says she is still a work in progress, but she won’t let her stroke stop her from getting back on track suicide. But the love and support from family and friends, together with counselling, helped change my mindset and I realised that the only way forward – and to take back control – was to accept the new me. My husband and son were with me all the way and helped me develop a good sense of my weaknesses and strengths, to adapt my life accordingly.

It’s been a long, slow journey to get where I am today – about 80% back to where I used to be – and I’m still a work in progress. I’m totally independent, back at work full-time, and am happy to cycle instead of run. There’s no doubt my incredible team of doctors, therapists and nurses, and the excellent rehab I received at Life Healthcare hospitals played a huge role in my recovery.

They never stopped encouraging and supporting me even in my darkest moments and I’m so grateful to each and every one of them for their endless patience, kindness and help.

A S T O L D T O LY N N E G I D I S H

I

was absolutely terrified when I woke up in ICU surrounded by my family.

I had no idea what had happened and when I realised I couldn’t speak properly or move the right side of my body, I panicked. My husband Ian told me I’d had a stroke and should relax as we’d get through it together. I was stunned.

How was this possible? I was young, fit, healthy and had completed my sixth Comrades Marathon earlier that year.

And now I was in trouble.

I spent a week in ICU, followed by a week in the ward before transferring to Life Riverfield Lodge. I was wheelchairbound with a catheter, unable to do anything for myself and an emotional

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2016/11/17 11:31 AM

You

Tube

Uterine Fibroid Embolisation

brings hope ‘A

uterine fibroid is an overgrowth of the normal muscle and soft tissue cells of the uterus,’ says Dr Gary Sudwarts, an interventional radiologist at Life Fourways Hospital and Life Kingsbury Hospital. Twenty to 40% of women have

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fibroids in their uterus, however, not all fibroids need to be treated. ‘Only about 20% of those who have fibroids require treatment,’ he says.

Treatment is considered when fibroids affect a person’s quality of life or, in some cases, are life-threatening due to prolonged, severe bleeding. Symptoms include

excessive bleeding, anaemia, pressure on the bowel and bladder, and infertility.

Mashadi Mathosa, 34, was diagnosed with fibroids when she was 25 years old.

She never thought her period pain was different to anyone else’s. One day, after a massage, she began to discharge alarming clots and realised this was

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2016/11/17 11:32 AM

i m a g e s g e t t y / g a l l o i m a g e s , ISTO C K

Uterine fibroids cause heavy bleeding, pain and infertility. In the past, a hysterectomy was the only option for women suffering from large fibroids, but a minimally invasive procedure known as uterine fibroid embolisation (UFE) now offers permanent relief without having to resort to a much more invasive hysterectomy. By Sam Brighton

GR OWING LIFE

more than just period pain. After being misdiagnosed with pregnancy twice, she was referred to a gynaecologist who diagnosed multiple, large (five to seven centimetres) fibroids. After undergoing an open surgery myomectomy (removal or excision of the fibroids) in 2009, she was pain-free for a few years before her heavy periods returned and made her ‘sick and tired of being sick and tired’.

A visit to her gynaecologist revealed

Treatment is considered when fibroids affect a person’s quality of life or in some cases are life-threatening due to prolonged, severe bleeding

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that the fibroids had regrown and a hysterectomy was recommended.

This seemed like a drastic option to Mashadi who had never had children.

After hearing Dr Sudwarts speaking about UFE on the radio, she got in touch with his office to thank them for raising awareness about fibroids. As a journalist, Mashadi had researched UFE but thought she didn’t meet the criteria due to the size of her fibroids. Dr Sudwarts’ office contacted Mashadi to see if she was in fact eligible.

In April this year she underwent UFE and the results have had a significant impact on her life. ‘My toiletry bill is less because I’m not changing pads every hour. Since the UFE I’ve lost six kilograms because

MEET OUR EXPERT

I can participate in my life now, and I just don’t feel so self-conscious any more,’ she says emphatically.

HOW DOES THE UFE PROCESS WORK?

UFE essentially clots the blood flow to the fibroids, which ‘starves’ them of their nutrient supply, causing them to shrink and die. The procedure is performed under deep sedation, meaning the patient simply goes to sleep and wakes up when the procedure is over, and will have no memory of it. Dr Sudwarts explains: ‘We inject a tiny amount of local anaesthetic in her groin just over the artery into her leg and then insert thin wires and catheters through a nick in the skin into the uterine artery. We embolise the left and the right uterine arteries through the one incision, and what I mean by “embolise” is we inject tiny little particles – you can see them, but they are very small – into the arteries that supply the fibroids. When the fibroids have their blood supply or uterine supply blocked, they die, and shrink as they die.’

UFE FAQ Does medical aid cover UFE? Almost all the major medical funders cover UFE in South Africa. Contact your provider for more information.

After UFE, can fibroids regrow?

The answer is yes, they can, although it is much less common than after a myomectomy.

Regrowth is more likely in younger women.

How long does the procedure take?

Around an hour, and the patient will spend a night in hospital.

HOW DO FIBROIDS AFFECT FERTILITY?

The short answer is we don’t know yet. ‘There are two main theories on how fibroids cause infertility. One is the fibroid is a big mass in the uterus and it would affect the embryo implanting. The second theory is that there’s a change in the blood flow within the uterus, so the fibroid will draw blood away from the developing embryo,’ says Dr Sudwarts.

HOW IS UFE DIFFERENT FROM A MYOMECTOMY OR HYSTERECTOMY?

Both a hysterectomy and a myomectomy physically remove the fibroids, however,

Dr Gary Sudwarts is a Cape Town-based radiologist with an interest in interventional radiology, who works closely with fertility specialists and gynaecologists. He has worked as a general radiologist and trained doctors in radiology, but now devotes his time to the micro-invasive treatment of uterine fibroids.

they are more complicated and higherrisk procedures compared to a UFE. A myomectomy surgically removes those fibroids that can be seen. Often, there are smaller fibroids that cannot be felt or seen that will continue to grow after the surgery. A hysterectomy will remove the uterus (where the fibroids are growing) entirely, making pregnancy in future impossible. A UFE, however, destroys the fibroids, leaving the uterus intact, allowing it to function as normal once the fibroids have shrunk and died.

‘They will die within the next few days (after surgery) but it will take a few months for them to shrink,’ says Dr Sudwarts. The recovery time (in hospital and off work) after UFE is much quicker than after myomectomy or hysterectomy.

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M

any people are surprised to learn that the body is made up of about 70% water. Our brain and heart each have a liquid content of around 70%, while our lungs are 80% fluids. Even our skin and bones contain water.

So we need to replenish the water content of our bodies regularly so that all organs can perform optimally: blood flows easily through veins and arteries, skin and mucous membranes are moist and, on a cellular level, the balance of salts, minerals and sugars (electrolytes) is kept stable. If this balance is disrupted,

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HYDRATE FOR HEALTHY LIVING the body cannot function properly and you feel ill. The only way to recover when this balance is upset is to drink a solution containing electrolytes: the ideal balance of salt, sugar and minerals (potassium and sodium) you find in sports drinks and rehydration solutions.

‘We lose water through sweating, which cools the body to its ideal temperature. In hot weather, we can lose around 500ml per hour, which is why we must drink regardless of whether we feel thirsty or not,’ says Johannesburg dietitian Amanda van Huyssteen, who has rooms

at Life Flora Clinic and Life Wilgeheuwel Hospital. However, it’s important to note that outside temperatures will affect how much water you need at any given time.

SIDE EFFECTS OF DEHYDRATION

If you exert yourself, or it’s very hot outside, and you haven’t taken in sufficient fluids, you might be on your way to experiencing some very unpleasant and potentially dangerous side effects. Minor ones include headaches, dizziness and an inability to concentrate, however, if you get

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2016/11/17 11:34 AM

I MAG ES GETTY/GALLO IMAGES

When the temperatures rise, consuming enough liquid is important whether you’re playing sports, travelling or simply sitting in the sun.

Ruth Rehbock gets waterwise

T H E WA Y W E E A T

heatstroke, you will most likely experience nausea and vomiting, which need to be treated immediately.

Most important, dehydration also affects the heart, making it work that much harder to pump blood around the body, sometimes leading to a rise in blood pressure.

‘If the volume of blood in the body decreases, your heart has to beat faster,’ says Amanda. ‘With too little fluid in the body, your blood becomes thicker and more concentrated and cannot flow easily. Blood pressure increases because the body squeezes the blood vessels to help circulate the blood.’

We ought to consume hydrating fluids regularly throughout the day, especially if you’re physically active or it’s hot outside, although the standard recommendation of eight glasses of water per day has come under scrutiny by some experts. Writers of the chapter on water in the Food-Based Dietary Guidelines for South Africa say we shouldn’t drink according to a fixed drinking regimen, but many health practitioners stick to the eight-glass recommendation. Eight glasses certainly isn’t harmful.

ENJOY YOUR FLUIDS

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Experts agree that water is the best choice, but it’s not everyone’s favourite.

Amanda advises people drink plain sparkling mineral water or soda water, fruit juice, and low-fat or fat-free milk, rather than drinks loaded with sugar.

Some scientists also believe that tea and coffee count as fluids, as long as your body is accustomed to them.

You can also make your own flavoured water. Amanda recommends adding sliced lemon, mint leaves or any fresh herbs, strawberries or cucumber slices. Keep in mind that we also get water from food.

The wonder of water Water is a natural appetite suppressant, which helps you maintain a healthy weight. Most people suffer from hunger on a regular basis, but this clue can actually be your body telling you it’s feeling dehydrated. Drinking enough water flushes out your system, reducing calcium in your urine and the risk of kidney stone formation, and helps to prevent urinary tract infections in both men and women. Water may also prove as a weapon against illness and viruses by flushing toxins and invading substances from the body. It could also assist in controlling allergies – when you’re dehydrated, thicker mucous and drainage may collect in your lungs and throat.

Food like yoghurt, apples, pears, oranges and vegetables like carrots and cooked broccoli are 80 to 89% water. Strawberries, sweet melon, watermelon, celery and lettuce contain 90 to 99% water. ‘If you eat a varied diet that includes plenty of fruit and vegetables, you naturally increase your intake of fluids.’

If you prefer hot-water drinks, there are plenty of options for you too. ‘Add fresh ginger and lemon slices to boiling hot water, let it steep for a while and drink. You can also use apple slices and cinnamon sticks in hot water and sweeten with a little honey to make them really tasty,’ she says.

Strawberries, sweet melon, watermelon, celery and lettuce contain 90 to 99% water ‘My advice for people who struggle to drink water is to always have water on hand,’ says Amanda. ‘Don’t rely on walking to the water cooler or tap to get a glass of water – keep a jug of water on your desk and a bottle of water (or flavoured water) in the car.’

The writers of Food-Based Dietary Guidelines for South Africa, however, want South Africans to be aware that drinking too much can cause problems.

The document states that we should drink according to our thirst, but if you’re someone who sweats a great deal doing sport or manual work, you ought to be aware of how much fluid you need to keep up your performance.

RESOURCES

LIFE PLUS

• ‘“Drink lots of clean, safe water”: A food-based dietary guideline for South Africa’; (Chapter 9, Food-Based Dietary Guidelines for South Africa) • The US Geological Survey’s Water Science School: ‘The Water in You’ water.usgs.gov/edu/propertyyou.html • ‘10 Ways to Stay Hydrated (That Aren’t Water)’ dailyburn.com/life/health/healthy-foods-stay-hydrated-without-water/

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TIME FOR SOME

DOWN TIME?

I MAG E GETTY/GALLO IMAGES, ISTOCK AND SUPPLIED

Life has never been more stressful and many professionals feel like they’re constantly on the verge of a mental meltdown. Lisa Lazarus explains why taking time out is vital for your health and survival

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MIND WISE

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uraya*, 44, is an academic at a university in the Western Cape. ‘I reached total burnout a couple of years ago, after chairing a difficult committee (of great ethical importance) in which I rubbed many people (including powerful professors) up the wrong way. This resulted in me waking up regularly at 2am feeling anxious. Eventually I got physically ill ... with shingles,’ she says.

Suraya is not alone. Many South Africans suffer from mental exhaustion to varying degrees. Globally, one out of four adults have high blood pressure, for many the cause being a stressful lifestyle.

These days, laptops are packed with the holiday luggage and smartphones keep us constantly updated with what’s happening at the office. No wonder so many professionals feel like they’re always on edge, both mentally and physically.

Burnout, explains Werner Teichert, clinical psychologist at Life Poortview, is a state of ‘emotional, mental and physical exhaustion caused by excessive and prolonged stress’. As the cycle of stress continues, the person begins to lose interest or motivation in daily activities that have a physical or psychological component.

Says Werner: ‘Eventually, one feels disengaged, infused with both a sense of relentless helplessness and a loss of control. Coupled with no hope of positive change, there is also a feeling of detachment and sadness, which is the result of excessive amounts of stress over a prolonged period of time’. Suraya describes this when

MEET OUR EXPERTS

she says: ‘Every fibre of my being was drained of energy; it was horrendous.’

This makes it easy to confuse depression with chronic exhaustion or burnout. ‘It’s difficult to distinguish the two conditions as a lot of the symptoms overlap,’ says Dr Lolita Mostert, a specialist psychiatrist at Life New Kensington Clinic. A study published by the Journal of Clinical Psychology confirms this. Researchers surveyed American school teachers for burnout and found that 86% of those so diagnosed also met the criteria for a provisional diagnosis of depression. ‘Burnout can certainly lead to full-blown depression,’ explains Dr Mostert, ‘especially if the symptoms are not addressed’.

So, how do you know if you might be suffering from burnout? Werner explains that the initial symptom is fatigue, but it’s not cured by more sleep.

Soon, one starts to feel ‘tired but wired’; the effect of exhaustion in tandem with elevated cortisol production. Prolonged stress leads to adrenal fatigue, a concept popular in alternative medicine, thought to come from overstimulating hormones like adrenaline that fuel high-energy behaviour. Later on, however, concentration and productivity become impaired, and eventually even the immune system weakens.

What is to be done if you feel you are suffering from burnout or extreme mental exhaustion? Holistic, sustainable lifestyle changes need to be made, usually with the assistance of a coach or psychologist.

Dr Lolita Mostert is a psychiatrist at Life New Kensington Clinic. She is currently working on MMED research on dual diagnosis (substance abuse with co-morbid psychiatric pathology).

ARE YOU SUFFERING FROM JOB BURNOUT? Christina Maslach, a psychologist and professor at the University of California at Berkeley, formulated the Maslach Burnout Inventory (MBI), the most widely used assessment of job burnout.

The MBI measures: • Emotional exhaustion Feelings of being emotionally overextended and exhausted by one’s work.

• Depersonalisation Feelings of negativity, cynicism and vague paranoia.

• Personal accomplishment Feelings of competence and successful achievement in one’s work.

Causes of work burnout include: • A sense that you have limited or no control over your work.

• No recognition for good work.

• Job expectations that are not clear or too demanding.

• Unchallenging or monotonous work.

• High-pressure, chaotic environment.

Werner Teichert is a clinical psychologist at Life Poortview, where he specialises in individual, couples and family therapy. He is currently enrolled for his PhD in psychology and holds master’s degrees in clinical psychology and leadership.

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MIND WISE

Laptops are packed with the holiday luggage and smartphones keep us constantly updated with what’s happening at the office Werner offers some tips: • Seek professional assistance: The patterns of behaviour that led up to burnout are often entrenched dysfunctional coping strategies and you’ll need someone to think out loud with you about consciously changing these behaviours.

• Access social support: Reach out to trusted family and friends who are willing to listen and don’t try to ‘fix’ your stress. Just listening helps, but if you feel a professional would do you good, speak to a psychologist.

• Exercise: Initially, train don’t strain!

Even a 10-minute walk can improve your mood for up to two hours.

• Reframe: Use cognitive strategies to re-evaluate what, when and how you function daily, then develop new strategies to give you a greater sense of control.

• Eat healthily: Cut down on sugar, refined carbohydrates and other mood altering substances such as caffeine. Eat more omega-3 fatty acids – for example, salmon, herring, mackerel, sardines, walnuts, flaxseeds – to give your mood a boost.

Dr Mostert emphasises the importance of a balanced life; finding peace within and not depending on external validation. ‘There is no ready-made solution for this, no one size fits all, but a good place to start is to put away your smartphone and rather connect with the people and nature around you.’ Good advice indeed. *Name has been changed

Dr. Reddy’s N E U R O P S Y C H I AT R Y G O O D

H E A L T H

C A N ’ T

W A I T

HELPLINE 0800 21 22 23 www.sadag.co.za

Dr. Reddy’s Dr. Reddy’s Laboratories (Pty) Ltd. Reg no. 2002/014163/07. Third Floor, The Place, 1 Sandton Drive, Sandton 2196, South Africa.

Tel: +27 11 324 2100, Fax: +27 11 388 1262, www.drreddys.co.za.

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2016/11/18 11:45 AM

DO YOU HAVE

IMPOSTER SYNDROME? Read every statement carefully and indicate which option applies best to you and your feelings, attitudes, behaviours and life in general. After finishing the test, you can sum up your points using the scoring table and view the relevant results for you.

1. I don’t deserve any of the success I’ve attained.

A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 2. Even if people praise my skills, I still don’t believe I am as accomplished as they think I am.

A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 3. I may be given rewards for my hard work, but I don’t feel I have earned them.

A Strongly agree B Agree

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C Somewhat agree/disagree D Disagree E Strongly disagree 4. I am afraid that people will soon realise that I am not as smart as I make myself out to be.

A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 5. Most of my accomplishments were a fluke.

A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree

6. I find it difficult to accept compliments.

A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree 7. I downplay my achievements because I don’t believe they are as amazing as people think they are.

A Strongly agree B Agree C Somewhat agree/disagree D Disagree E Strongly disagree

I M A G E S G ET TY/GALLO I MAG ES, ISTOCK C O P YR I G HT 2016 – WWW.QU E E N DOM.COM

Imagine accomplishing an amazing achievement through a great deal of effort and hard work, yet feeling like you don’t merit the ensuing accolade.

This self-esteem related-issue is known as Impostor Syndrome

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QUIZ

SCORING YOURSELF QUESTION 1.

2.

3.

4.

5.

6.

7.

A 10 10 10 10 10 10 10

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0–28 You take ownership of most, if not all of your success. You believe you have the ability to achieve greatness, and it gives you a deep sense of satisfaction to look back on your life and see tangible proof that you have done many things of value. Although this doesn’t guarantee that you have good self-esteem, it does indicate that you acknowledge your strengths and recognise your worth.

One factor that is often associated with Imposter Syndrome is maladaptive perfectionism. Although striving to put in the best effort possible to produce quality work is important, recognise that everything you do is a work in progress. You will mess up and you will fail from time to time, but it’s all part of the learning experience. So by all means, set your ambitions high and strive for excellence, but don’t make achievement an all-or-nothing endeavour.

Be aware of any perfectionistic tendencies you may have and keep them in check.

B 8 8 8 8 8 8 8

C 5 5 5 5 5 5 5

D 2 2 2 2 2 2 2

E 0 0 0 0 0 0 0

29–49 Sometimes, in spite of all that you have accomplished, you feel like a bit of an imposter.

You want to believe that you are worthy of success, but can’t entirely convince yourself.

You may even look back on some of your successes and think, ‘I just got lucky,’ or ‘That challenge wasn’t as difficult or as impressive as others think it was’. You want to be proud – and part of you is – but it would require a much grander accomplishment to impress yourself!

Make sure that you associate with people who affirm who you are.

Do you have toxic relationships with people who criticise you or make you feel small?

Take a good look at the people you surround yourself with and how they affect your self-esteem. That being said, keep in mind that there is only one person who has the power over how you think and feel about yourself – and that person is you.

50–70 No matter what you manage to accomplish, you are unable to enjoy your success – you see yourself as an imposter.

This could be related to a lack of confidence or a tendency to believe that success is due to factors that you cannot control.

You find it difficult, if not impossible, to take ownership of your achievements, and experience a great deal of self-denigration and self-doubt.

You must own your successes, whether you made the perfect omelette or started your own business.

Aim for doing your best and realise that your best is all you can ever really do, whether you achieve an objective or not.

Most importantly, recognise that while you may have caught a lucky break or were given a hand from others to help you become who you are today, it’s only because you chose to be a better student, worker, parent, friend and human in the first place. It’s all thanks to you.

In the 1970s, researchers Pauline Clance (PhD) and Suzanne Imes (PhD) came up with the term ‘impostor phenomenon’ to describe the behaviour they observed in some of Imes’ students. It seemed that in spite of their top grades and achievements, they refused to take ownership of their success.

This tendency, however, isn’t limited to graduate students. Many people feel like frauds, no matter how many trophies, certificates or accolades they have received. They diminish the significance of their achievements and attribute them to luck or other forces outside their control, rather than their own effort, dedication and even intelligence.

Research has linked Imposter Syndrome to low self-esteem, a tendency towards overachievement and unhealthy levels of perfectionism.

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Let’s ride Don’t let age, size or fitness level deter you from pumping up your bicycle tyres, putting on a helmet and enjoying the great outdoors.

By Erin Coe

T

he sun is shining, after-work drinks are calling and the last thing you feel like doing is sweating it out at the gym, but pedalling your way to fitness is the perfect way to get from A to B while toning up, burning kilojoules and being kind to the environment. Cycling also saves cash, is a fun way to spend time with loved ones and you’ll probably get to know your neighbourhood better too. You may have noticed how many more bike lanes and urban parks have sprung up over the past few years – making it that much easier to get on your bike. Still not convinced? Here are some more benefits.

Mind your tone

Cycling is the perfect way to tone your lower body. Biokineticist Lezandré Wolmarans of the Sports Science Institute of South Africa says that cycling works your quads, glutes, calves and hamstrings. Just bear in mind that the correct seat height is key to uniform toning of the upper and lower leg. Lezandré’s suggestion is that your seat should sit high enough that your knee bends within a 25 to 35° angle.

Smarty pants

Sure, you’re not going to turn into a quantum physicist by cycling every day, but you will get smarter. ‘There is clear evidence to suggest that cognitive performance is directly linked to a physical regimen,’ says biokineticist Luke Saner. ‘Those who exercise regularly show better cognitive performance scores in concentration, memory retention, faster learning, creativity and stress management.’

Social butterfly

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Lezandré also recommends cycling for the social aspect of it. ‘We live in a beautiful country, so grab a friend and go riding. The picturesque surroundings will motivate you more than if you were sitting on an indoor bike. Stop for coffee breaks and really just enjoy our magical country.’

The more people who get on their bikes, the more tolerance and care drivers will take when navigating roads frequented by cyclists.

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JOURNEY

MEET OUR EXPERTS GOING GREEN

There’s no denying that cars are responsible for carbon emissions, which contributes to air pollution. This is why Megan Pringle of the Bicycling Empowerment Network suggests cycling as a fun and eco-friendly mode of transport. She says: ‘A bicycle has virtually no carbon footprint, does not contribute to air, noise or water pollution and emits no greenhouse gases’.

MONEY, MONEY, MONEY

How much money do you spend on transport a week? Cycling is a cheaper, healthier alternative.

To begin with, start small and cycle to work one day a week. With the money you save, buy yourself something nice to motivate you to keep going.

Luke Saner is a clinical exercise specialist with a passion for improving lives through the application of sound exercise science. Luke has an undergraduate degree in human movement science and a postgraduate degree in biokinetics.

Excuses, excuses If you’re prone to talking yourself out of cycling or exercise, here are a few counter-arguments: ‘I’m worried about my safety.’

This is totally understandable, but it should not stop you from riding. Start by riding in a bicycle-designated area to get your confidence up. Once you’re ready to hit the road, avoid peak traffic and always remember to use hand signals to indicate where you’re going. Wearing neon colours to assist with visibility is also a good idea, and a helmet is a non-negotiable.

‘I don’t want to be sweaty.’

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CHALLENGE ACCEPTED

In the spirit of healthy living, four Life Healthcare employees recently participated in a 40km corporate mountain bike challenge at Kloofzicht Lodge and Spa in Joburg. As well as getting a thrill out of the vigorous exercise, the team enjoyed the beautiful view and the feeling of camaraderie. Congratulations to the participants (from left): Francois Theron, Chief Financial Officer, South Africa; Jackie Napier, Group Financial Controller; Tanya Bennetts, National Communications Manager and Christo Lombard, Financial Manager.

Lezandré Wolmarans is a senior consultant at the High Performance Centre of the Sport Science Institute of South Africa. She has been involved in many sporting disciplines on a provincial and national level. She is passionate about motivating people to be the best they can in their sport of choice.

Sure, it sounds idyllic to cycle to work or to a lunch date, but the realities are sweat patches and helmet hair. Slow down, cycle at a moderate pace and carry antibacterial wipes, deodorant or antiperspirant, a towel, and a change of clothing. You can always pick up the pace on the way home instead.

‘I’m too old.’

Age is really just a number. Ask Frenchman Robert Marchand who, in 2014, broke a cycling record in the over-100 category. If there are enough people to fill that category then you definitely have no excuse. Adjust your mindset, get on a bike and start today.

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As you reach life’s financial milestones you will appreciate the value of financial advice.

The journey to financial well-being can take many years to achieve and the goal posts may shift as your needs and priorities change. Your Alexander Forbes accredited financial adviser will help you secure what matters most – when it matters most:

Financial milestones in your 20s You have probably only recently begun your working career. Once employed, it is crucial to adopt good money habits so that you can achieve your short-term and long-term financial goals.

Speak to your Alexander Forbes financial adviser about: ■■starting a savings nest egg ■■creating a good credit profile ■■managing your budget responsibly ■■basic short-term and long-term risk protection.

Financial milestones in your 30s You are probably more settled in your career and you may be thinking about starting a family, pursuing hobbies, travelling or getting additional qualifications.

Speak to your Alexander Forbes financial adviser about: ■■building up short- to medium-term savings for items such as education, holidays and childcare ■■contributing enough towards your retirement savings ■■reviewing your insurance policies ■■maintaining your assets to preserve their value ■■estate planning, making sure your loved ones are taken care of should you pass away.

Financial milestones in your 50s Your retirement is only a few years away. Your children will be older and may be leaving home, giving you more time to focus on goals and dreams that are important to you.

Speak to your Alexander Forbes financial adviser about: ■■retirement planning ■■reducing debt to minimum levels, by retirement date ■■diversifying your investments – consider offshore investments ■■estate planning, an important consideration at this stage of your life.

Financial milestones in your 60s Your retirement is now closer than ever and protecting what you have already saved up will be your top priority. You have spent decades building up your nest egg and the time has finally come to decide how you’re going to use it. This stage of your life is more about fine-tuning your plans than anything else.

Speak to your Alexander Forbes financial adviser about:

Financial milestones in your 40s You may have already been labelled by some as ‘middle-aged’, but this is actually the most exciting time in your life, as you are now experienced and have also acquired significant life skills.

Speak to your Alexander Forbes financial adviser about:

■■making sure that you’re contributing enough towards your retirement savings ■■working on reducing your debt ■■reviewing your insurance to ensure that all policies are at the right level and that you don’t have unnecessary policies ■■diversifying your investment holdings – consider offshore investments ■■estate planning, as it is an important consideration at this stage of your life.

■■deferring your retirement benefit ■■creating extra income streams ■■ensuring you have the right level of healthcare cover in place ■■estate planning, as it might be time for a review.

REMEMBER! People are living longer in retirement than ever before, and you may have to depend on your retirement income for decades, not years!

For further information

Please contact Lesley Naidoo on 011 269 0738 and quote Life Healthcare Summer 2016. retail@aforbes.co.za | www.alexanderforbes.co.za

A licensed financial services provider

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HEALTH ANIMAL-ASSISTED THERAPY / IN UTERO SURGERY / SUMMER ALLERGIES

‘Lean on me, when you’re not strong, and I’ll be your friend, I’ll help you carry on…’

Bill Withers

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ANIMALASSISTED THERAPY TAKES THE BISCUIT For patients stuck in hospital beds or wheelchairs, lost in depressed or vegetative states, visits by Life Healthcare’s therapy dogs can seem like St Bernards in a snowstorm.

By Glynis Horning

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hen Beth Holton’s spirited 16-year-old son Kyle Notley was hit by a car while riding his motorbike in December 2006, terrible head injuries left him in a coma for 12 days.

‘Kyle was essentially brain dead,’ she says. ‘We consented to his life support being switched off and his organs donated.’ But when Beth tearfully took Kyle’s hand, told him this and began to say goodbye, his heart rate sped up. ‘Doctors realised he was responding – it was a miracle!’

A second miracle, she says, came six weeks later at Johannesburg’s Life New Kensington Clinic, a rehabilitation unit for adults and children with physical, neurological and cognitive injuries.

Despite intensive therapy, Kyle was partly paralysed and catatonic, awake but unresponsive. This time the breakthrough came from an unlikely quarter: two golden retrievers named Ben and Bobby.

The clinic’s newly appointed case administrator Charlene Kruger was an animal behaviour specialist who had worked with dogs for 30 years and ran a dog-training school. Noticing how lonely some patients were, it had struck her that a visit from a dog could brighten their day. After researching animal-assisted therapy (see ‘Sit! Stay!’), she shared her idea with Life Healthcare management and, with their support, introduced a dog therapy programme – one of the first in South Africa offered by a rehabilitation unit.

‘Kyle was one of our first patients,’ she says. ‘I asked his mom if I could introduce him to our dogs.’ Charlene decided to let him give the dogs treats and put some in his hand. ‘Bobby was getting them all, so I suggested Kyle give some to Ben. I didn’t think Kyle understood, but when I reached forward to move Bobby aside, Kyle grabbed my arm and fed Ben. That small event was a major breakthrough for someone in Kyle’s state!’

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COVER FEATURE

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COVER FEATURE

FROM LEFT In December 2006, Kyle’s motorcycle was hit hard by a car and the accident left him in a coma with very little chance of a full recovery.

Fast-forward to April this year and Kyle, pictured above with his brothers, is independent and sufficiently healed to live a normal life

Excited hospital staff put through a call to Beth, who wept when her son, who had been unable to string two thoughts together, spoke to her. ‘From then on he made unbelievable progress,’ she says. Three weeks later she took him home. Today, after much therapy and hard work, Kyle lives independently.

He drives, shops and cooks for himself, and is studying IT at Boston College.

‘People need to know you can do anything with the right attitude,’ he says. ‘And those dogs were the start for me.’

Kyle is just one of the success stories the dog therapy programme has had in conjunction with psychiatrists, psychologists, physiotherapists and occupational therapists.

‘Dogs have no inhibitions and don’t judge; they just want and give unconditional affection,’ says Charlene.

‘Therapy dogs don’t heal directly, but

SIT! STAY! WHAT IS IT? Animal-assisted therapy makes use of interactions with animals to improve a patient’s emotional, social and mental functioning and help them recover from or manage physical and mental health problems, explains Charlene Kruger. Dogs are most common, but horses, rabbits, guinea pigs and dolphins are used too.

HOW IT WORKS A therapist with a pet is seen as less of a threat, building rapport with the patient, says Charlene. They can ask a young or mentally impaired patient questions through the animal: ‘How do you think Ben feels when you do X?’ They can also monitor the patient’s behaviour and tone in interactions with the animal, and use the animal to help the patient understand how their behaviour affects others. If they do something a dog likes, for example, it reacts immediately by wagging its tail. Animals can also help comfort victims of sexual assault and trauma through their unconditional acceptance and affection.

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HOW IT BEGAN Research shows animals have given humans social support and relaxation since hunter-gatherer times – our survival depended to a degree on signs from animals around us that they felt safe or threatened by an outside presence.

Animals were first used therapeutically at a retreat in England in the 18th century, where patients were encouraged to interact with domestic animals roaming the grounds. Sigmund Freud liked to have his dog at psychoanalytic sessions, saying patients relaxed and confided more easily, and Florence Nightingale is reported to have appreciated the benefits of pets in the recovery of ill patients.

HOW EFFECTIVE IS IT? There have been relatively few clinical studies on the benefits of animal-assisted therapy. One published in Frontiers in Psychology showed that after 20 minutes with a therapy dog, patients showed a drop in stress hormones and increase in feel-good ones (oxytocin, dopamine and endorphins). At Purdue University in the US, a review of 14 clinical trials

on the effects of animal therapy on children with autism spectrum disorders found statistically significant improvements. So did a review of 28 studies at University of Maryland, involving Down syndrome, schizophrenia, Alzheimer’s and developmental disabilities, as well as a review of 28 studies at Kimmela Center for Animal Advocacy.

But neuroscientist Lee Marino, executive director at the Kimmela Centre, also found that most studies were flawed with little hard evidence of subjects’ improvements having to do with the presence of the animal and not just the animal’s sympathetic handler. Other common flaws are that too few subjects are used and studies lack non-treatment control groups, ‘blind observations’ to control for the unconscious bias of the researchers, and long-term follow up to see if effects lasted beyond the ‘feel-good temporary recreational benefits of interacting with animals,’ said Alan Beck, director of the Center for the Human-Animal Bond at Purdue University in Psychology Today. More and better research is needed.

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COVER FEATURE

Therapy dogs need to be able to meet a huge range of people, some in wheelchairs or on crutches, some withdrawn, others loud and aggressive

ABOVE Charlene and her remarkable team believe that the therapy dogs allow them to build a rapport with a patient and touch them on an emotional level so that they can make physical improvements, which is the power of animal therapy

they engage and break down barriers, soothe and cheer – they make patients more receptive to treatment, therapy and life. But it only works when patients like dogs, and when the dogs are carefully chosen and trained.’

Ben and Bobby, like young Brady, Casey, Bella and Molly, who replaced them this year, were selected for their breed (‘some are frightened of German shepherds, but everyone loves a soft, cuddly retriever’), for their pedigree (‘we must know their history’) and, above all, for their temperament.

‘Therapy dogs need to be able to meet a huge range of people, some in wheelchairs or on crutches, some withdrawn, others loud and aggressive.

And they must be able to cope with being constantly touched and fussed,

and not jump on beds, lick patients or take food unless invited. They must also be able to ride in lifts, be around noisy trolleys, walk on tiled floors and wait patiently in my office each day between visits.’

The Life Healthcare therapy dogs live with Charlene, who brings them to work each day. ‘We do a round of Life New Kensington Clinic most mornings, seeing 40 or 50 patients, and about once a week we visit the other eight Life Healthcare hospitals around Gauteng. We visit general and medical wards, and wellness clinics for patients with mental health problems. Occasionally, we also visit ICU to help with comatose patients, depending on requests from doctors and therapists. And, of course, hygiene is essential – our dogs are bathed weekly,

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ABOVE Charlene Kruger with Ben and Duncan and one of their other four-legged friends. Ben and Duncan have retired after 10 years of loyal service and this year they passed the baton to Brady, Casey, Bella and Molly, who will continue to do their sterling work

Stroke patients open up and cheer up when a dog breaks the ice their nails are kept short and we brush their teeth daily. When they’re doing their rounds, their coats and paws are wiped down with disinfectant.’

‘We can see the difference the therapy dogs make,’ says psychiatrist Dr Ryan

Little Molly in her uniform, ready to assume her duties as one of Life Healthcare’s newest therapy dogs 36

Fuller. ‘Stroke patients with paralysis are often stressed and depressed, grieving the death of function, but they open up and cheer up when a dog breaks the ice.

It makes our job much easier.’

Occupational therapist Gillian Alexander says agitated patients with dementia who like dogs ‘are soothed by visits’. She also uses Charlene’s dogs to motivate children to exercise: ‘To see the dogs, they must walk with me down a garden path to Charlene’s rooms.’

Charlene reports that children with walking or balance problems often benefit from walking a dog on a leash, using the leash for support. She tells too of a toddler with a head injury and semi-paralysed arm who was persuaded to exercise the arm by brushing a therapy dog’s coat and reaching up to feed it some treats. But, Kyle aside, one of her most moving successes was a security guard who was shot on duty and had become totally unresponsive.

‘He was about to be committed to a home when I asked for a chance with our dogs. Ben and Duncan jumped on his bed and licked his hands and he started to smile. His wife burst into tears. She says he came back to her from that day.’

WE’RE ON INSTAGRAM! The Life Healthcare therapy dogs now have an Instagram account.

Follow their adventures: @lifeoftherapydogs

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Summer Sale

We speak German!

While stock lasts

Healthsmart Rollator: R 3299 R 1999

Rollator with loop brakes: R 1899 R 1195

Action 1 Wheelchair: R 7795 R 5950

Standard Wheelchair: R 2199 R 1499

SpitFire Mobility Scooter: R24500 R 18950

Electric Bath Lift: R 16999 R 9950

Shower chair: R 1399 R 899

Commode with wheels: R 1499 R 899

Raise up recliner: R 22000 R 14950

Ripple mattress: R 9960 R 4850

Electric Home Care Bed: R24950 R 19950

3 Crank Hospital bed: R 13950 R 9750

country wide delivery

Prices are subject to change without prior notice Tel. SA : 0861 PRIMACARE 0861 77462 2273

info@primacare.co.za

www.primacare.co.za

PRENATAL SURGERY:

SAVING A BABY’S LIFE IN UTERO I

n July 2015, Eunice and Nathi Motha finally became pregnant via in-vitro fertilisation. Their joy turned to elation when they found out they were pregnant with twins; a boy and a girl.

After an uncomplicated pregnancy until 18 weeks, the couple readied themselves for the arrival of their babies. Then the unexpected happened – the amniotic sac of the male foetus ruptured and his leg protruded through the cervix. For the boy, life in the womb became unviable and the pregnancy had to be terminated – or did it?

According to gynaecologist obstetrician Dr Deon van der Merwe at Life Midmed Hospital, the female foetus could be saved and pregnancy for one of the twins could continue. But the boy had to be removed from the uterus.

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NOT JUST ANOTHER DAY AT THE HOSPITAL

It was the second time in 15 years that Dr Van Der Merwe performed an operation of this nature and he consulted with colleagues to gauge their informed opinions. ‘It is not an operation that is undertaken lightly as the dangers are immense: there is the risk of uterine rupture to carry the second twin to term after a caesarean at 19 weeks, there is also the risk of bleeding and sepsis and, lastly, miscarriage, as the cervix was already dilated to three centimetres,’ said Dr Van Der Merwe. ‘Even with all these risks, I had to help Eunice as she had conceived under trying circumstances through IVF and she wouldn’t entertain me terminating the pregnancy.’

Eunice relates how Dr Van Der Merwe explained the termination procedure and how she refused to listen. She believes that after seeing their desperation and sadness in addition to her husband Nathi’s pleas to save one of the babies, he decided to do the work. ‘Even before Dr Van Der Merwe saw that my son’s leg was protruding through my cervix, I just knew something was wrong. For me, his little leg kicking felt like a wriggling worm – a feeling I would never wish on anyone.

It broke my heart to know that he would not make it,’ says Eunice. ‘When they did the scan, I could still hear his heartbeat and I was so worried about him being hurt when the procedure was done. But there was no time for me to process all of these thoughts and we had to make the

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A Life Healthcare gynaecologist obstetrician at Life Midmed Hospital saves a baby’s life before it’s born by performing a caesarian on its mother – twice.

By Charlene Yared-West

I N N O VA T I O N

incision was followed by the removal of the male infant with the ruptured sac and then putting the undamaged sac back into the mother’s uterus to enable her to continue with the pregnancy,’ he added.

A stitch was also made around the cervix as the pregnancy needed to continue, and because she had already dilated to three centimetres. ‘The risk of preterm labour of the other baby increased, as well as the chances of infection, so we had to be very cautious after the operation. The longer the foetus could stay in the mother’s womb the better for it’s overall health and development,’ said Dr Van Der Merwe.

LEFT Thembelihle at three months old; THIS PAGE, FROM TOP LEFT The miracle baby in the Life Midmed Hospital NICU shortly after her birth; with proud mom Eunice and dad Nathi – growing and thriving

decision to save one baby or risk losing both... We chose to save our daughter.’

The membranes were already ruptured for one week and the decision could not be delayed any longer.

Emphasising that the operation was not an everyday procedure, Dr Van Der Merwe got to work,

IMAGES SUPPLIED

We had to make the decision to save one baby or risk losing both... We chose to save our daughter trying to remove the male foetus vaginally – it proved impossible and so a caesarean was performed. ‘We put the patient under general anaesthetic and after trying to remove the foetus through the cervix, which would not open enough, we knew the only way to save the second foetus’ life was to remove the first one via caesarean,’ he said.

Eunice remembers how she felt after the first operation. ‘I did not expect to have the burning sensation in my belly, as I assumed they would be able to remove him vaginally. I was denied

D-DAY

pain medication so that they could do a scan after the operation was done to make sure my daughter was okay,’ she says. ‘I knew I could endure anything for her wellbeing, so when I heard her heartbeat on the scan I was so happy, but it was also mixed with a deep sadness for the loss of my son, who I had never met but only felt in my cervix. I still wish I had the opportunity to see him with my own eyes, just to say goodbye – and for that I was sorry.’

A CHALLENGING CAESAREAN SECTION

Dr Van Der Merwe explained how the incision was made only after carefully ascertaining where the female foetus’ placenta was. It was imperative not to accidentally rupture the amniotic sac of the second baby, as that would mean a complete termination of the pregnancy.

‘There would be no way to save the female baby if the membranes ruptured, so we had to be extremely careful. The

MEET OUR EXPERT

Eunice’s pregnancy progressed to 35 weeks when she went into natural labour. She underwent a second caesarean 17 weeks after her first. ‘The second one was far less complicated as the baby was ready to be born, although five weeks premature,’ said Dr Van Der Merwe. ‘There was absolutely no way we could attempt a natural birth, because of the danger of uterine rupture as a result of the very recent previous caesarean earlier in her pregnancy.’

Eunice remembers meeting her daughter a day after she was born, as she was admitted to the neonatal unit for what became 13 long days after the birth.

‘After the caesarean, I was so confused and exhausted, so I slept a little while. On that same evening, I got up, had a shower and felt better. After getting dressed, I took a wheelchair up to see my baby girl and I could not stop staring at her beautiful face,’ says Eunice. ‘She was so amazing and just so beautiful and I will always be grateful to Dr Van Der Merwe who saved my baby’s life. My husband and I cannot be more thankful. We named her Thembelihle, which means “good hope” because she gave us hope when we had almost lost everything.’

Dr Deon van der Merwe has been practising as a gynaecologist and obstetrician in Middelburg, Mpumalanga, since 1992. He is an avid mountain climber and has climbed Kilimanjaro and various places in the Himalayas.

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EPILEPSY AND PREGNANCY: THE LOW-DOWN

P

regnancy can be an anxious time, particularly for women who have some sort of chronic condition or illness. There’s always a concern that any medication taken will affect the unborn baby or, if the medication has to be halted altogether, it could have ill effects for the mother.

Epilepsy is no exception. Given that it is the most commonly occurring condition that involves the brain in pregnancy, it’s something that both patients and healthcare providers have to manage very carefully. ‘The control of seizures during pregnancy is of vital importance as it can have a negative effect on the foetus,’ says Delyne Subrayen, clinical pharmacist at

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Life Flora Hospital. ‘If, while pregnant, a woman has a seizure and stops breathing, the oxygen supply to the foetus is reduced and this could compromise the health of the unborn child.

‘If her epilepsy is well controlled, changing the drug may not be necessary unless she is taking valproate, in which case the change to an alternative is recommended.’

Most anti-epileptic drugs aim to normalise the electrical activity in the nerve cells of the brain via several different mechanisms, says Delyne.

‘As you can imagine, the seizures caused by hyperactivity will be treated differently to those caused by decreased signalling.

Higher doses of anti-epileptics are

associated with higher risks of foetal abnormalities, so your doctor will try to reduce the doses during pregnancy.’

She adds that multiple medications for the control of epilepsy before and during pregnancy are not recommended unless absolutely essential, so your doctor may also change your therapy to just one drug.

If you have epilepsy, don’t just stop taking your medication. It’s vital that you speak to your gynaecologist and/ or neurologist about your medication early in the pregnancy. In fact, if you’re planning on getting pregnant, it’s worth talking to your doctors at that point.

Because, while no single medication has been shown to be the best in terms

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Women with epilepsy may feel anxious about the potential risks to their unborn baby, but in most cases the condition can be well managed without any ill effects to the foetus. By Mandy Collins

GOOD MEDICINE

of safety during pregnancy, says Delyne, valproate – a commonly prescribed anti-seizure drug – has consistently been linked with autism, as well as impaired cognitive and motor development in the child, and should therefore be avoided.

A British study has shown that pregnant women who take the new epilepsy drugs, levetiracetam and topiramate, don’t run the risk of harming their infant’s mental development. ‘Levetiracetam and topiramate had been shown to have a lower rate of congenital malformations when compared with valproate prior to the study in question,’ says Delyne.

It’s vital that you speak to your gynaecologist and/or neurologist about your medication early in the pregnancy

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‘It is, however, encouraging to note that children whose mothers took topiramate and levetiracetam during pregnancy showed no signs of cognitive impairment when compared to those born from mothers who did not have epilepsy.’

These may be a good option for women with epilepsy during pregnancy, so it’s vital to ask your doctor about all of your options.

It’s also important to know that epilepsy is a prescribed minimum benefit condition

MEET OUR EXPERT

What is epilepsy?

Delyne Subrayen explains that epilepsy is a term used to describe a group of seizures that are caused by disturbed electrical activity in the nerve cells of the brain. ‘Epilepsy occurs in approximately 44 out of every 100 000 people and is slightly more common in males,’ she says.

Seizures can be caused by hyperactive signalling, which could result in twitching of certain muscle groups and/or loss of consciousness, or by reduced signalling, which could cause staring spells that last from just a few seconds to 30 seconds.

‘Seizures are classified based on clinical features (what physically happens during a seizure) and a test of electrical activity in the brain known as an EEG,’ she says. ‘The type of seizure that a person develops depends on the area of the brain affected by the abnormal electrical activity in the nerve cell.’

in South Africa, which means that your medical aid is required by law to cover its treatment. ‘Some medical schemes have formularies that dictate how a patient’s condition such as epilepsy should be managed,’ Delyne points out. If these newer drugs are not part of your medical scheme’s formulary, your doctor can motivate to get these drugs approved for use during your pregnancy, in light of the new evidence regarding their safety.

‘Many women who have been diagnosed with epilepsy worry about conceiving, but the good news is that approximately 90% of all pregnant women who are epileptic have

a normal pregnancy,’ says Delyne. The key is to manage your condition well and plan your treatment regime with your healthcare professionals before and during your pregnancy.

Delyne Subrayen has been the clinical pharmacist at Life Flora Hospital since July 2016. She has experience in critical care and antibiotic stewardship.

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ARE WE

THERE YET? W

2

1

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hile they say that getting there is half the fun, all too often the stress of being away from home and the frustration of confinement to a car, plane or hotel room combine to turn a much-needed holiday into a painful experience for parents and kids alike.

Here are 11 ways to make your trip a rewarding adventure for everyone.

DON’T RUSH Whether at the airport, getting from one point to another, or simply sightseeing, the best thing you can take is extra time. Young children are blissfully unaware of the scheduling pressures of travel so you’re more likely to keep your cool if you factor everything from toilet stops to tantrums into your time frame.

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PACK SNACKS A hungry tot is bound to get grumpy so make sure you have plenty of snacks at the ready. Cut up fruit and vegetables and have them on hand to offer both sustenance and distraction. But go easy on the sugar – hyperactivity and cramped spaces, like a car or plane cabin, generally don’t mix well.

BOOK THE BED On many (although, not all) international flights you can get a bassinet – a little cot for infants up to a certain age and weight, depending on the airline – that attaches to the wall in front of the bulkhead seats. They’re free, but you have to reserve them in advance.

Rest assured, the payoff for your arms is worth the extra legwork.

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Factoring a child’s needs into your holiday plans involves more than popping in a CD of nursery rhymes and scheduling toilet stops.

Follow these tips for making memories, not migraines.

By Jocelyn Warrington

THE BABY FILES

Go easy on the sugar – hyperactivity and cramped spaces generally don’t mix well

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COME CLEAN If you have to sterilise things regularly, consider taking a portable steam steriliser; they work well and with minimum fuss. For sterilising small items on the move, such as dummies or teething toys, use sterilising tablets in a watertight screw-top container.

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PERFORM UNDER PRESSURE Barring outbursts, the most difficult parts of the flight are take off and landing, when the change in altitude causes pressure to build up in the ears. Play a game of making funny faces or yawning at each other in order to stretch your little one’s facial muscles to relieve ear pain. Encourage him or her to nurse if breastfeeding, or have a bottle, sippy cup or juice box ready as swallowing helps too.

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CURB QUEASINESS Children aged two to 12 are particularly susceptible to car sickness, which is caused when mixed signals are sent to the brain by the eyes and inner ear. In addition to fresh air and frequent stops, a light snack before the trip may help to lessen symptoms of nausea, dizziness and fatigue. Also, have your child look at things outside the car, not books or games. In severe cases, medication is available but consult your paediatrician before taking this route.

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REMEMBER THE MEDICINE It should already be on your travelling list, but having kids along makes carrying a small first-aid kit all the more vital: plasters, antihistamines and a bottle of paracetamol can avoid a lot of stress.

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KEEP BUGS AT BAY If you’re travelling to a country in which malaria is endemic (check the list of affected countries

APPY FAMILIES

Child-friendly apps keep your tot busy and free up space in your luggage. Here are a few suggestions but you can search for age-appropriate options on your mobile device.

• Avokiddo Emotions (R59.99): Cheer up a sad sheep or put a smile on a giraffe’s face!

Kids interact with four cartoon characters using a variety of props, helping them to learn about emotions and body language.

• Baby Piano (R3.99): This app functions as an eight-key portable piano that can play notes and animal sounds (each key has a cartoon animal on it). Children can even play a nursery rhyme.

• BabySitter2Go FREE (free): Transform your phone into a tambourine or bell and let your child shake it. Switch to drawing mode and let their imagination run wild. It’s crammed with games and activities, all with enticing music and graphics.

at who.int/malaria/travellers/en), you’ll need specialist advice on the appropriate antimalarial medication.

You’ll also need to take ample supplies of insect repellent, clothes to cover everyone up in the evenings and, if the place you’re staying in doesn’t have them, mosquito nets.

9

BE SUN SAVVY Children often get more exposure to sunshine than adults, especially if they’re strapped into carriers or on to a child seat at the front of a bike. Don’t skimp on the sunscreen.

10

DRINK UP Kids dehydrate easily, mainly because they don’t drink unless they’re thirsty. Carry bottled water with you at all times and check your child’s urine every now and then – if it’s darker than usual, cloudy or particularly strong smelling, they’re not getting enough fluids.

And, particularly if you’re breastfeeding, make sure you drink up too.

11

ABOVE ALL, KNOW THY OWN CHILD If you know your kid doesn’t do well in the pram all day, build long play breaks into your travel itinerary.

If your child is fussy without a nap, don’t try to do without just so you can see the sights. Avoid forcing your little one to behave differently just because you are on holiday – it’s a recipe for misery all round.

• Busy Shapes (R59.99): Help young children gain spatial awareness and problem-solving skills with this super smart app, which allows them to drag objects across the screen and drop them into the appropriate holes.

• Toddler Flashcards (free): The interactive flashcards in this app use spoken audio, animal sounds and real pictures (not cartoons) to help you teach your little one the names of animals, food, objects, letters and numbers.

WWW.LIFEHEALTHCARE.CO.ZA

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2016/11/17 11:43 AM

Are you at risk of

LIFE HAP

PENS. Be

Prepared ™ .

ANAPHYLAXIS? What is ANAPHYLAXIS? Anaphylaxis (a-na-fi-LAX-is) is the medical term for a life-threatening allergic reaction that can occur within minutes to several hours after your immune system reacts cts inappropriately to the presence of a substance that it wrongly perceives as a threat. 1 What causes anaphylaxis?

Anaphylaxis can be caused by a number of allergens, including: Peanuts, tree nuts, milk, eggs, stinging insects, medications, shellfish, fish, wheat, soy, latex and exercising. 2 Examples of the more common allergens have been listed and are not limited.

ALLERGY RISK TEST Anaphylaxis is a severe, potentially fatal allergic reaction. 1 To help determine your risk, tick all the boxes that apply to you.

I had a reaction shortly after exposure to even a small amount of: 2

It included the following symptoms: 2

Peanuts

Tree nuts

Mouth: itching, swelling of the lips and/or tongue

Latex

Exercise

Throat: itching, tightness/closure, coughing

Soy

Insect stings

Skin: itching, hives, redness, swelling

Egg

Medications

Wheat

Fish

Milk

Shellfish

Stomach: vomiting, nausea, diarrhoea, cramps Lungs: shortness of breath, cough, wheeze Heart: chest pain, weak pulse, dizziness, passing out

Sesame

If you ticked at least 1 box in each section, you could be at risk for anaphylaxis.

Your risk is even higher and reaction could be more severe if you: • Have had a previous reaction (even if mild) 3 • Have asthma 2 • Have cardiovascular (heart) problems 2

Take this allergy test to your doctor to find out if you should be carrying an Adrenaline Auto-injector References: 1. Kemp SF, Lockey RF, Simons FER, on behalf of the World Allergy Organization ad hoc Committee on Epinephrine in Anaphylaxis. Epinephrine: the drug of choice for anaphylaxis.

A statement of the World Allergy Organization. Allergy. 2008:63:1061-70. 2. Simons FER, Ardusso LRF, Biló MB, El-Gamal YM, Ledford DK, Ring J, et al. World Allergy Organization guidelines for the assessment and management of anaphylaxis. WAOJ. 2011;4:13-37. 3. Vander Leek TK, Liu AH, Stefanski K, Blacker B, Bock SA. The natural history of peanut allergy in young children and its association with serum peanut-specific IgE. J Pediatr. 2000;137(6):749-755.

Marketed by: Mylan (Pty) Ltd. Reg. No.: 1949/035112/07. Building 6, Greenstone Hill Office Park, Emerald Boulevard, Modderfontein, 1645.

Tel: (011) 451 1300. Fax: (011) 451 1400. www.mylansa.co.za for Merck (Pty) Ltd. M0990 Aug-16.

22665 Mylan Epipen AllergyRisk 276x210Ad rF.indd 1

2016/08/19 2:08 PM

hot topic

her son was only good for six months. She now pre-orders them to minimise delays. Promisingly, Mylan, the manufacturers of the EpiPen, recently committed to extend its shelf life to 24 months but it is not known when this will take effect.

Medical-aid cover

everybody’s talking about…

EpiPens

Who decides the price?

T

i mag e getty/gallo images

How do we hirty-three-year-old Liezel Fookes’ son is severely allergic to dairy and eggs. ensure life-saving This means he often can’t attend play medicines are dates or birthday parties and must carry an EpiPen with him at all times, just in affordable? This is the question case the preventative measures his mom has put into place fail and he comes into contact with one that arose when of his allergens. Should this happen, he could the EpiPen made go into anaphylactic shock, an extreme allergic that can be fatal if not quickly treated headlines with its reaction by using an EpiPen to auto-inject adrenaline $300 (more than (also called epinephrine) into his thigh muscle.

R4 000) price tag in the US The true expense earlier this year. While the cost of an EpiPen locally is not as high Pippa Naudé as it is in the US ($300), at around R1 100 it is still expensive, especially considering: investigates • It is the only device of its kind; there is no

generic alternative.

• It is recommended sufferers carry two, due to the risk of secondary anaphylactic shock.

• The period until expiry can be limited.

For this last point, Professor Michael Levin, CEO of the Allergy Foundation South Africa, explains: ‘Although the EpiPen shelf life is 18 months from the date of manufacture, by the time it is shipped, clears customs and reaches South African consumers, it is less.’ Liezel admits the first EpiPen she bought

45_HEALTH_ETA_EpiPen_Dec16.indd 45

‘Prescribed minimum benefits (PMBs) are a list of conditions and treatments that medical aids are obliged to offer their members, regardless of the benefit option they are on,’ says Dr Elsabé Conradie, General Manager of Stakeholder Relations for the Council for Medical Schemes.

‘Anaphylactic shock is on the PMB list. This means once you have had this reaction, your medical aid must fund the treatment thereof.’

However, medical aids are not compelled to fund the EpiPen to members at risk of anaphylaxis as a PMB or otherwise, says Dr Conradie. Some medical aids may cover this cost in a premium plan but if not, you will have to pay out of pocket from day-to-day benefits or by using your medical savings account.

Fortunately, in South Africa we are protected from unrestricted medicine costs and increases as all medicine prices are regulated by a pricing committee (as per the Medicines and Related Substances Act 101 of 1965). They set a single exit price (SEP) for each medicine sold in the country, which is the maximum price that it can be charged. These can be found in the Medicine Price Registry (MPR). While this does not mean that medicines are necessarily cheap, it does offer consumers some protection.

life plus Getting help

• Allergy Foundation South Africa: Free resources and information on allergies, including personalised action plans. www.allergyfoundation.co.za • Allergy Alive: Information and support for those with severe allergies. www.facebook.com/allergyalive • Council for Medical Schemes (CMS): Assistance for claiming prescribed minimum benefits.

Helpline 0861 123 267 or www.medicalschemes.com • Medicine Price Registry (MPR): Searchable database with the single exit price of all medicines. mpr.code4sa.org www.lifehealthcare.co.za

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2016/11/17 11:44 AM

POWER OF FIVE

ALLERGY ALERT

Here comes the summer sun … and with it a host of unwanted allergens. Experts discuss five of this season’s most common allergy triggers and how to treat them

MOULD

Many allergy sufferers assume their symptoms are caused by pollen when they’re actually allergic to mould.

Inhaling these tiny fungal spores – most commonly from Cladosporium herbarum, according to the Allergy Society of South Africa (ALLSA) – triggers watery eyes, nasal congestion, itchy mouth and lips, and even asthma, hay fever and eczema. Symptoms can be relieved with an antihistamine, but seek medical treatment from a professional for allergic diseases such as allergic rhinitis and asthma.

Manage your allergy by using dehumidifiers indoors and ensuring proper ventilation.

ANAPHYLAXIS is a serious, life-threatening allergic reaction most common to foods, insect stings, medication and latex.

It requires immediate medical treatment, including an injection of epinephrine. If not treated properly, anaphylaxis can be fatal.

46

INSECT BITES AND STINGS

In SA, honeybee venom allergy is more common than wasp sting allergy, causing swelling and pain that resolves within hours. Allergic persons experience a longerlasting reaction with swelling, itching, tight chest, vomiting, sweating, headache and even anaphylactic shock resulting in death. ‘For severe allergies of a lifethreatening nature, an adrenaline auto-injector (EpiPen) should be prescribed by your GP (see page 45).

‘Cortisones take a few hours to work, so are not the first choice in an emergency,’ Dr Morris says. Taking vitamin B1 supplements could also act as a natural insect repellent, he adds.

LIFE PLUS

FRUIT

‘Some seasonal fruit could elicit an allergic reaction in those who are susceptible,’ says Mariska van Aswegen, spokesperson for Pharma Dynamics.

‘Oral Allergy Syndrome (OAS), or Pollen Food Syndrome (PFS), usually occurs in people who are allergic to pollen. Pollen from trees, grasses and weeds contain proteins that are similar in structure to those in different fruit and veggies. These proteins are recognised by the immune system of a nasal-allergy sufferer and could trigger an allergic reaction. The most common foods involved in PFS are apples, peaches and kiwi.’

SUN

It’s not clear why some people have a sun allergy, says the Mayo Clinic, but certain medications, chemicals and medical conditions can make skin more sensitive to sunlight. ‘First exposure to sunshine can result in polymorphic light eruption (PLE), a sensitivity to ultraviolet light and heat. Sweating can also cause a fine itchy rash called cholinergic urticaria,’ says Dr Morris.

‘Some sunscreens can cause contact dermatitis and rashes due to chemicals like parabens and titanium dioxide.’

Mild cases of sun allergy may clear up without treatment, while a more severe case can be managed with steroid creams or pills, and consulting a doctor.

Life Healthcare paramedic service employs paramedics in fully equipped response cars and offers free emergency paramedic assistance to their communities. There is only a cost if an ambulance is dispatched. Life The Glynnwood, 078 137 4304; Life Springs Parkland Hospital, 082 504 8500; Life Flora Hospital, 011 470 7744; Life Fourways Hospital, 0860 444 044; Life Rosepark Hospital, 0800 22 22 22; Life Vincent Pallotti Hospital, 0860 532 532

I M A G E ISTOCK C O M P I L E D BY R AADIYAH AB R AHAMS

POLLEN

Grass, weed and tree pollens are the most common summer allergens, says Dr Adrian Morris of The Allergy Clinic in Cape Town.

Symptoms include allergic rhinitis (hay fever) or runny nose, red skin rashes, itchy eyes and skin, nasal congestion and sneezing.

‘Antihistamine is the mainstay of allergy treatment,’ Dr Morris says. ‘Texa, Allaway, Fexo and AP Loratadine are well tolerated. If symptoms persist, antiallergy eye drops and nasal sprays can be used too.’ Take precautions by staying indoors at 11am and 6pm when outdoor pollen levels peak, wearing wraparound sunglasses and using the aircon when driving.

SUMMER 2016/17

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2016/11/17 11:44 AM

Mental illness

Your journey in overcoming mental illness starts here

We assist your patients with: • •

Acute psychiatric conditions Substance dependence or other addictions associated with psychiatric disorders

Our treatment programmes are facilitated by multidisciplinary teams: • • • • • •

Psychiatrists Psychologists Occupational therapists Physiotherapists/Biokineticists Social workers/Counsellors Mental health nursing practitioners We also have two facilities licenced by the Department of Health to provide assisted or involuntary admissions.

For more information contact us on 011 219 9620 Mentalhealth.headoffice@lifehealthcare.co.za www.lifehealthcare.co.za

CARE PUTTING PATIENTS FIRST / SKINCARE ADVICE / RECIPES FOR CONNECTING / OUR HERO

‘All the beautiful sentiments in the world weigh less than a single lovely action.’

James Russell Lowell

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2016/11/17 11:45 AM

You can see we CARE Since introducing its CARE programme to all staff members, Life Healthcare Group has created a more patient-centred experience. Melanie Farrell asked four patients about the CARE programme and looks at the next step

50

50_CARE_ReachOut_Dec16.indd 50

patient-centred care. The Institute of Medicine (IOM) defines this as: ‘Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.’ It is the practice of caring for patients (and their families) in ways that are meaningful and valuable to the individual patient. It includes listening to, informing and involving patients in their care.

This model encourages a consultative approach to care and research has shown that patients are happier, more satisfied, heal more quickly, are in less pain and stay healthier.

Caring employees

As part of its more patient-focused approach and commitment to enhancing patient experience, the Life Healthcare Group of hospitals launched the first phase of its CARE programme in October last year. It involved all 13 000 permanent employees, who received a full day’s training in the principles and behaviours required of the CARE programme.

This phase was completed at the end of August 2016.

Life Healthcare Group’s Quality Systems Specialist Michele de Kock explains that the CARE programme entered Phase 2 during September 2016, with training being extended to staff from outsourced

summer 2016/17

2016/11/17 11:46 AM

i mag e getty/gallo images and supplied

W

hen you’re anxious – perhaps feeling a little scared – and in hospital, it’s the small things that can make a big difference. A kind word and a clear understanding of your medical treatment can calm, reassure and even speed up your recovery time.

Dr Sharon Vasuthevan, Nursing Executive at the Life Healthcare Group, is a firm advocate of

REACH OUT

service providers. ‘Outsourced service providers “touch” or interact with Life Healthcare patients (and their family members) almost as many times during a patient journey as our permanent staff,’ says Michele. ‘There is enormous potential, therefore, for the patient journey to be impacted by this staff’s behaviour (both positively or negatively).

‘The training for CARE Phase 2 will be the same as it was for CARE Phase 1 but the material will be adapted depending on the roles of the outsourced service providers. The main aim will be to ensure that the message is easy to integrate into daily routines,’ says Michele.

Life Healthcare hospitals are focused on improving the patient experience by making sure he or she is the centre of everything.

WHAT OUR PATIENTS SAY

‘Experience was superb’ Dr Chris Mulder, a Knysna resident and CEO of CMAI Architects, was impressed by the smooth, caring treatment received when he was admitted to Life Knysna Private Hospital in June 2016 for a routine procedure.

‘I’ve been living in Knysna since 1999, when we started with the development and construction of Thesen Islands, and I’m a staunch and proud Knysna supporter,’ says Dr Mulder.

‘My experience at Life Knysna Private Hospital was superb. From pre check-in to check-in, preparation, theatre staff,

post-procedure care and discharge, it all ran like clockwork. I was continuously informed, in a very reassuring manner, about what was going to happen next and when and what to expect. At no point did I feel concerned or uncomfortable.

The hospital is a real asset to Knysna.’

I appreciated that they always ask permission to touch a patient, and they always show respect by listening, being punctual and addressing individuals in a respectful manner ‘Always showed respect’ Kakabalo Thipampeng, who works in information management, was treated at Life Anncron Hospital in July 2016.

Mr Thipampeng says: ‘My stay at Life Anncron Hospital was amazing. The nurses and doctors were very friendly and they made me feel at home and comfortable. They always smiled and greeted everyone.

‘I appreciated that they always ask permission to touch a patient, and they always show respect by listening, being punctual and addressing individuals in a respectful manner. They always said thank you.

‘They are caring, responsible, trustworthy, focused on the strength of patients and committed to their work.’

I MAG E GETTY/GALLO IMAGES AND SUPPLIED

‘Made a lasting impression’ Johannes Bester, who was treated at Life Anncron Hospital in July 2016, says, ‘I was a hospital manager a couple of years ago and I was really pleasantly surprised by the friendly reception from all the staff at Life Anncron Hospital.

‘They were all helpful and professional.

What more can I say? The way in which everyone treated me enabled me to feel relaxed, and this has made a lasting impression on me.’

‘Number-one choice’ Candice-Lee Sutton has a daughter, Astara-Ann, who sustained serious burns in an accident when she was 13 months old, necessitating multiple surgeries.

Candice-Lee says, ‘People ask me why I choose to drive across town to Life Fourways Hospital every time my child needs to be admitted. Quite simply, it’s because of their CARE approach.

‘From reception to kitchen staff and paediatric nurses to doctors, everyone is welcoming, efficient and caring. The nurses show empathy and understand that it’s less traumatic for the child when mommy gives the medicine or it’s time to nebulise. The doctors that I have dealt with have been wonderful.

‘The main reason I choose Life Fourways Hospital over any other is because they issue the child with a proper bed and allow you to sleep in bed with your child. (Sick children want their mommy and there’s nothing more healing than sleeping with mom.)

‘As a mother, Life Fourways Hospital is my number-one choice of hospital in the country.’

WWW.LIFEHEALTHCARE.CO.ZA

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2016/11/17 11:46 AM

What you need to know about

Summer in South Africa means a lot of time spent outdoors.

When the sky is blue and the days are hot, it’s hard to ignore the call of the beach, or the allure of a dip in the pool while the braai heats up. Meg de Jong presents a guide to taking care of your skin

W skin

care

CANSA provides the following advice: • Avoid direct sunlight between 10am and 3pm.

• Stay in the shade or under an umbrella as much as possible.

• Wear protective clothing such as wide-brimmed hats and UV-protection clothing and swimsuits.

• Wear sunglasses with a minimum UV-protection rating of UV400.

• Always apply sunscreen regularly (SPF 20–50) according to skin type.

Anyone can get skin cancer, regardless of race, age or sex. People with fair skin have a higher chance while dark-skinned people are still at risk.

• Avoid sunbeds and sunlamps.

• Check your skin carefully on a regular basis.

How should You care for your skin?

Dr Irshad Mohummed Essack, a dermatologist at Life Flora Hospital, suggests keeping your approach simple when it comes to skincare. ‘The less products the better,’ he says. ‘Rather spend money on a few good-quality products and multitudes of everything.’

The bare necessities he recommends are a good cleanser, moisturiser and sunscreen. As everybody’s skin is different, there really is no one-size-fits-all approach – your routine should be tailored to your age, skin type, complexion and sun exposure patterns, among other things.

im a g es g e t t y / g a l l o i m a g e s a n d i s t o c k

THIS SUMMER

hile there are a wide range of side effects from over-exposure to the sun, including everything from fine wrinkles to freckles, benign tumours and skin lesions, the most serious by far is the danger of skin cancer.

Frighteningly, skin cancer is one of the most prevalent forms of cancer, with the numbers of those it affects rising year on year.

One of the most tricky things about sun damage is that the effects often only start to show later in life. According to the Cancer Association of South Africa (CANSA), at least 80% of sun-induced skin damage occurs before the age of 18. This means that taking care of your child’s skin is one of the most important things you can do for them. So, what should you keep in mind to reduce both your and your family’s risk of sun damage?

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summer 2016/17

2016/11/17 11:47 AM

MY HEALTH

HOW OFTEN SHOULD YOU CHECK YOUR MOLES AND BLEMISHES?

Examine yourself every four to six weeks, recommends Dr Essack. Checking more frequently is like watching grass grow, he says. ‘You’ll miss any changes.’

It’s a good idea to consult with a dermatologist. They’ll be able to guide you on surveillance protocols tailored specifically to you after examining your skin and taking into consideration your history. CANSA also offers mole mapping and skin evaluations. Contact a CANSA Care Centre to find out more (toll free on 0800 22 66 22, or you can email info@cansa.org.za).

WHAT TO LOOK FOR WHEN YOU CHECK YOUR SKIN When examining your moles and blemishes, or those of your family, CANSA advises looking out for the following: • Asymmetry. Common moles are round and symmetrical.

• Irregular borders. Common moles are smooth and have even borders.

• Colour changes. Common moles are ordinarily a single shade of brown or black.

• Moles larger than six millimetres.

• Moles that change in size.

WHAT DOES IT MEAN?

I MAG ES GETTY/GALLO IMAGES AND ISTOCK

You will encounter terms like ‘SPF’, ‘UV’ and ‘UPF’ when looking for quality skincare products, but do you know what these terms mean? CANSA gives us this easy guide: • SPF stands for sun protection factor and is usually found on sunscreen bottles.

It’s a measure of how well the product protects your skin against UV rays, and indicates how long you could spend in the sun before burning when protected

One of the most tricky things about sun damage is that the effects often only start to show later in life by sunscreen, compared to when you have not applied any sunscreen. So, if it takes three to four minutes for your unprotected skin to start turning red, using an SPF 30 sunscreen theoretically prevents reddening 30 times longer (one and a half to two hours on average). CANSA encourages the use of SPF 20–50, according to skin type.

• UV refers to ultraviolet light emitted by the sun. UV rays have disruptive effects on skin cells which cause sunburn and can result in skin cancer.

MEET OUR EXPERT

• UPF is similar to the SPF indication on sunscreen, but UPF is usually found on clothing. It indicates the ultraviolet protection factor of clothing, sunglasses and hats, to protect you against the UV rays of the sun. A garment rated UPF 30 will protect the skin 30 times longer – if it takes three to four minutes for your unprotected skin to start turning red, using a UPF 30 garment theoretically prevents reddening 30 times longer (one and a half to two hours on average).

Dr Irshad Mohummed Essack is a registered dermatologist in private practice at Life Flora Hospital in Johannesburg. He is a member of the Dermatology Society of South Africa and an executive member of the Skin Cancer Foundation of South Africa.

WWW.LIFEHEALTHCARE.CO.ZA

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For

FRIENDS &FAMILY In this collection of recipes, Nicky Stubbs gathers her favourite dishes in a celebration of food and cooking. From the simplest meals and childhood favourites through to Sunday lunches and festive feasts, she shares heirloom recipes, takes modern twists on old-fashioned classics, and gives invaluable tips for preparing delicious meals at home. The book is a tribute to all who value the joy and community of meals prepared with love

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SUMMER 2016/17

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2016/11/17 11:49 AM

cook’s corner

Tomato and Pesto Quiche Serves 4 • 1 quantity shortcrust pastry Filling • handful of rosa tomatoes, washed • handful of basil leaves • 30ml (2 Tbsp) basil pesto • 100g Parmesan cheese, grated • 3 extra-­large eggs • 250ml (1 cup) fresh cream 1 Preheat the oven to 190°C. 2 Line a 23­cm quiche dish with the pastry and prick the bottom with a fork.

3 Bake in the oven for 10 minutes to partially cook the pastry (it shouldn’t brown).

4 Remove the pastry shell from the oven. Arrange the tomatoes in the pastry shell.

Scatter over the basil leaves.

5 Mix the remaining filling ingredients together and pour over the tomatoes and basil to fill the pastry case.

6 Bake for 35–40 minutes until slightly browned on top and set.

7 Serve hot or at room temperature.

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www.lifehealthcare.co.za

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Pressed Picnic Loaves

1 Cut the ciabatta loaf in half horizontally.

2 Drizzle olive oil on both sides and rub with the garlic. Discard the used garlic.

3 Assemble the sandwich in layers, closing it off with the top half of the ciabatta.

4 Tightly wrap the whole sandwich in plastic wrap, making sure to press it together as tightly as possible.

Store overnight or for at least 4 hours under a heavy weight in the fridge. Putting a baking tray between the sandwich and the weight helps to distribute the weight evenly.

5 Transport the sandwich in the plastic wrap. Just before serving, transfer to clean brown paper or greaseproof paper, or slice on a wooden board with a sharp knife.

58

‘I have made these pressed sandwiches for beach picnics, mountain walks, camping trips and road trips. Country bread is traditionally used in France, but I find ciabatta extremely good as it is not too bready, absorbs olive oil well and is a convenient size and shape to press, transport and slice. The filling can be adapted to your taste, as long as it shouts summer and fun.’

i m a g e S f o r f r i e n d s & fa m i ly ( h u m a n & r o u s s e a u )

Serves 6 • 1 large ciabatta • olive oil for drizzling • 1 clove garlic, peeled • grilled mixed peppers • ½ red onion, sliced, or 1 bunch spring onions, sliced • torn basil leaves or basil pesto • stuffed or pitted green olives, drained • 2 balls mozzarella, sliced • 3 Roma or other Italian tomatoes, thinly sliced • 12 slices salami or other flavourful cured meat • salt and pepper • drained capers, anchovies, sliced boiled egg • chopped fresh parsley (optional)

summer 2016/17

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2016/11/17 11:50 AM

cook’s corner

Mango and Yoghurt Dessert Serves 8 • 8 fresh mangoes, peeled and sliced • 500ml (2 cups) double ­cream Greek yoghurt (if not available, use 250ml [1 cup] plain low­-fat yoghurt folded together with 250ml [1 cup] whipped cream) • 60ml (¼ cup) treacle sugar

1 Place the mangoes in a glass serving dish.

2 Spoon over the yoghurt and smooth the surface.

3 Sprinkle evenly with the sugar and refrigerate for 3–4 hours. The sugar will melt and form a crunchy crust on top of the yoghurt.

4 Serve chilled.

i m a g e S f o r f r i e n d s & fa m i ly ( h u m a n & r o u s s e a u )

Tuna Fishcakes Makes 12 fishcakes • 4 potatoes • 2 tins (170g each) tuna • ¼ onion or 4 spring onions, very finely chopped • 2 extra-­large eggs • 30ml (2 Tbsp) Dijon mustard • chopped fresh parsley (optional) • salt and pepper • 125ml (½ cup) cake flour • 15ml (1 Tbsp) butter • 30ml (2 Tbsp) olive oil (or other oil) • paper kitchen towel, for draining 1 Peel the potatoes and boil for about 25 minutes until soft.

2 Drain the tuna.

3 Mash the tuna and potatoes together with a fork.

4 Add the onion, eggs, mustard, parsley, salt and pepper.

5 Using your hands, form the mixture into 12 balls, place on a baking tray and then flatten slightly. Cover with a wet tea towel and place in the fridge for 30 minutes.

6 Put the flour into a shallow plate. Roll each fishcake lightly in the flour.

7 Melt the butter and oil together in a frying pan.

8 Fry the fishcakes on both sides, turning once, until golden brown.

9 Place the fishcakes on paper kitchen towel to drain off the excess oil, cover and keep warm until needed.

Do not keep in a warming drawer for longer than 1 hour. If you are not eating them immediately, allow to cool and keep in the fridge until required. The fishcakes can also be eaten cold or heated up in the microwave oven.

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www.lifehealthcare.co.za

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2016/11/17 11:50 AM

COOK’S CORNER

Bulgur Wheat Salad Serves 6–8 • 375ml (1½ cups) bulgur wheat (cracked wheat) or stampkoring • 1 bunch spring onions, finely chopped • 375ml (1½ cups) chopped fresh parsley • 125ml (½ cup) chopped fresh mint • 1 large ripe tomato, chopped • 125ml (½ cup) olive oil • 80ml (1/3 cup) lemon juice • salt and pepper, to taste

1 If using bulgur wheat, pour over hot water and allow to stand for 2 hours.

If using stampkoring, boil in salted water for 30 minutes until chewy.

2 Combine all the ingredients in a large bowl and mix well.

3 Serve chilled.

4 This salad will keep for 3 to 4 days, covered, in the fridge.

This is an extract from For Friends & Family by Nicky Stubbs, published by Human & Rousseau and retailing at R385.

Giveaway!

Life Healthcare magazine is giving away two signed copies of For Friends & Family (Human & Rousseau).

Email lifehealthcaremag@johnbrownmedia.com with ‘For Friends & Family’ in the subject line by 31 December 2016 and stand a chance to win.

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SUMMER 2016/17

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2016/11/17 11:50 AM

OUR HERO

OUR HERO

CLINICAL PHARMACIST

SHARIFA ESSACK

A passionate and caring pharmacist shows that quick thinking can save the day. By Melanie Farrell

O

IMAGE SUPPLIED

ur hero, Clinical Pharmacist Sharifa Essack, 28, from Life Brenthurst Hospital in Johannesburg has a reputation for thinking

on her feet.

Sharifa was on call at home at 10pm one evening when a specialist physician made an emergency call for medication for a haemophiliac patient in ICU. Sharifa immediately tracked down the closest source of the medicine at Charlotte Maxeke Johannesburg Academic Hospital. However, instead of sending someone to fetch it, she jumped into her car to collect it personally.

‘I am usually a “panic pants” but working at Life Brenthurst Pharmacy has taught me otherwise,’ says Sharifa.

‘When the doctor explained that the patient would die without the treatment, I understood the urgency of the situation and knew that something had to be done immediately. I could not say “we will order tomorrow”, so I started calling around to other hospitals.

‘When I got in touch with Charlotte Maxeke and the on-call pharmacist said they had stock, I immediately decided to collect it myself. Charlotte Maxeke is a bit of a maze. My husband was with me so that helped,’ laughs Sharifa.

Despite getting lost once or twice inside the hospital, she persevered, eventually getting her hands on the stock and returning to Life Brenthurst Hospital in time for the patient to receive her first dose by midnight.

‘I care very much, not only for our patients, but my colleagues too,’ says

Caring is good for people as a whole, and good for business Sharifa. ‘In the work environment, I believe that in order to achieve a great (not just good) patient outcome, all units in the hospital need to work together efficiently for the common goal, and this can only work if we care for each other on a basic human level.’

Sharifa’s caring and observant eye has also assisted other doctors in the hospital. On one occasion, the fridge in an oncologist’s rooms lost power during a power failure and Sharifa, together with a pharmacist assistant, retrieved the expensive medication and placed it in the pharmacy’s fridge for safekeeping,

saving the doctor hundreds of rands.

‘Oncology medication can cost R15 000 for one vial,’ explains Sharifa. ‘When I realised that the fridge was not functional, I was concerned about the integrity of the medication, as well as the financial loss that would be incurred by the doctor’s rooms. Thanks to Jerry, who assisted me, we avoided disaster: he said we should do the right thing, although it was a daunting task.

‘If the medication was used, it may have lost efficacy, or become harmful due to poor storage conditions, and the patient would have suffered the consequences.

‘I believe that if people see I care, they will care and someone else will see that they care, and so it will hopefully perpetuate a positive feedback system that will provide service excellence and quality to our patients. Caring is good for people as a whole, and good for business!’

Sharifa is committed to the CARE programme at Life Healthcare (see page 50). ‘The CARE programme is everything I stand for, and it is a crucial part of what we do. Sometimes we forget the most basic part of why we are in the health sector, and I think it’s great that Life Healthcare has implemented this to remind us of the most important aspect of our jobs: the patient.

‘During our monthly meetings in the pharmacy, the pharmacy manager organises CARE huddles and we share both good and bad experiences. This allows us to guide each other in improving the quality of our service for our patients.

‘I love my profession but my passion is for people. The field I am in allows me to express that passion.’

WWW.LIFEHEALTHCARE.CO.ZA

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2016/11/17 11:51 AM

puzzle this...

Test your mental agility with our brain-teasers

1 CROSSWORD PUZZLE 2 SUDOKU

ACROSS

1 Adversary 4 Amorphous mass 8 Leading man 12 Legislation 13 Teeny bit 14 South American capital 15 Dined 16 Earth 17 Squared 18 Sitcom that debuted in 1977 21 Expert 22 Fed. Med. research group 23 Tin Man’s want 62

26 Shriner’s chapeau 27 PETA concern 30 Primary 31 Emcee before and after Conan 32 Secure 33 Silent 34 Indulge in pugilism 35 Church council 36 Blonde shade 37 Baltimore newspaper 38 Outing for co-workers 45 On 46 Pigeon-hole 47 Prior to

48 ‘___ never work’ 49 Hydrox competitor 50 Trinity member 51 Bump 52 ____-do-well 53 Potent chemical DOWN

1 Apartment 2 Inauguration 3 Basin accessory 4 Halve 5 Slack 6 Ear-related 7 Hogwash

8 Beth preceder 9 Prima donna 10 ‘So be it’ 11 Billions and billions 19 Deserve 20 ‘Les ____’ (B’way hit) 23 ‘Good question’ 24 Perfume-label 25 Intention 26 Office machine 27 Enthusiast 28 E.T.’s craft 29 Kind of carpet 31 Boswell’s subject 32 Harmonisation

34 Medal-giving org 35 Wannabe spouse 36 Mac maker 37 Binge 38 Actor Dean 39 Sgt. Snorkel’s dog 40 Aspic need 41 Bygone times 42 Fit in snugly 43 Press agent?

44 Minimal change

summer 2016/17

62_CARE_MindGames_Dec16.indd 62

2016/11/17 11:51 AM

I M A G E i s t ock PUZZLE S p r e s s / m aga z i n e f e a t u r e s ( p t y ) l t d

Difficulty level ***

mind games

3 WORD SLEUTH

solutions

Find the hidden words in the diagram.

They run in all directions

1

Closet Desktop Flowers Funeral

Furniture Hair Meeting Music

Pencils Pictures Schedule Shoes

Thoughts Tour Wedding 2

A X Y D L B A A X R is L O N G F E L L O W One letter stands for another. In this sample, A is used for L, X for O, etc. Single letters, apostrophes, the length and formation of the words are all hints.

Spring:

62_CARE_MindGames_Dec16.indd 63

4 CRYPTOQUOTE ‘READING FURNISHES THE MIND ONLY WITH MATERIALS OF KNOWLEDGE; IT IS THINKING THAT MAKES WHAT WE READ OURs.’ – JOHN LOCKE

‘W A B U F O Y P J W O F K G A K Q G A LFOU ROCE TFQG LBQAWFBCK RP H O R T C A U Y A; F Q F K Q G F O H F O Y Q G B Q L B H A K T G B Q T A W A B U R J W K.’ -NRGO CRXHA

3

I M A G E istock P U Z Z L E S press / maga z ine features ( pty ) ltd

4 CRYPTOQUOTE

www.lifehealthcare.co.za

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2016/11/17 11:52 AM

SOUL FOOD

HERE’S TO YOU, 2017!

A

new year is as challenging as it is exhilarating, as frightening as it is liberating, so it’s comforting, amid the trepidation, to know that there are always a few sure things along this uncharted course: famous people will die and give birth, there’ll be triumphs and tragedies, court cases will make headlines, great men and women will fall from grace, new fashion trends will cancel out some of 2016’s purchases and leaps in technology will leave us panting to keep up – in real time – with the Jones’s.

Despite an ever-booming self-help industry encouraging the pursuit of happiness at all costs – and perhaps because of the strides we have made as a society – finding real joy and contentment remains ever elusive.

But it is still on everyone’s list of resolutions, and figuring out how to sustain it once you think you’ve found it is like trying to draw warmth from a feeble winter sun.

While you can’t avoid the darkness, you cannot strive to live solely in the light. Bad, unexpected things will happen that will shock and shake your world and during these turbulent times you need to keep

64

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your expectations grounded in realism and try to develop a resilience to tragedy that will protect you from hopeless despair, says author and philosopher Dr Gordon Livingston. He adds with erudite simplicity – much like M Scott Peck’s now-famous declaration that ‘life is difficult’ – that we need to attune ourselves to the good news/

Perhaps because of the strides we have made as a society, finding real joy and contentment remains ever elusive bad news paradox and develop a capacity for accepting what we must.

Getting retrenched can leave you shattered and unhinged. Navigating a new reality can be daunting. A sudden death, a devastating diagnosis or a spouse’s infidelity can leave you raw

and the senseless extermination of viable human lives cut short by terrorism can make you bitter and cynical. But these things cannot be fixed, as journalist and psychotherapist Tim Lawrence wrote on his blog recently, they can only be carried and grieved because ‘not everything happens for a reason’.

At some point, each of us will cease to exist and this reality could fill you with despair or it could be the emotional, physical and mental juice you need to catapult you through the 365 days ahead with renewed purpose to serve, to seek and to not just survive but thrive. It’s all a matter of individual choice and attitude.

Like reluctant voyeurs, we peer into the 12 unwritten months and by the looks of the configuration of digits that make up the numeral of this year (2017), it’s set to be both lush and lean, but don’t be incarcerated by fear. Rather do as the swallows do. They fly fearlessly and confidently despite the great distances they know they must travel, and they weather the hardships they will no doubt encounter along the way with a firm belief that at the end of the day, they will find the sun.

I MAG E GETTY/GALLO IMAGES

As we approach the new year, do as the swallows do and fly fearlessly, but confidently, into the unknown, says Samantha Page

SUMMER 2016/17

2016/11/17 11:52 AM

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Nicole, 35

life cover premium

R2 million R310 p.m.

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