SPRING / 2015
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY
PUBLISHED IN THE INTEREST OF YOUR HEALTH BY LIFE HEALTHCARE
• SPRING 2015
PLUS
HEART ALERT THE WARNING SIGNS MOST WOMEN MISS BORN TOO SOON HOW TO CARE FOR YOUR PREEMIE NEW TECHNOLOGY WAGES WAR AGAINST CANCER LIFE_COVER.indd 1
THE JOY OF NEW BEGINNINGS Live Consciously, Make Smarter Health Choices, Feel Happier
2015/09/03 12:32 PM
September is Heart Awareness month. It is very important to
Beyond the Blue PH51980
have your blood pressure and cholesterol checked regularly. Get both tests done at any
of our 155 Clicks Clinics nationwide.
Call 0860-254-257 to book an appointment today.
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ED’S LETTER
Get screened in October, Breast Cancer Awareness Month
LIFE IS...
sprouting all around us, as spring takes hold and Mother Nature primes us for change. To some, change is energising and exhilarating and to others the fear of altered circumstances is paralysing and infuriating, but as one thing ends, another is always beginning – that’s the story of life. Buddhist nun and renowned author Pema Chödrön reminds us that although our mind perceives things as fixed, everything is, in fact, changing all the time. Life is so fluid; it’s more like a river than a rock and it’s this change that offers unlimited possibilities. Whether you’re thinking about getting fit (page 12), planning a trip (page 24), making smart changes for your heart health (page 30) or looking for fresh and wholesome spring recipes (page 52), Life has the prescription to make change gentler. Perhaps one of the most positive things you can do – right now – is make your health a priority. See every daily step you take towards a healthier and happier life as your greatest investment, and make a fresh start with confidence. Here’s to your health!
SAMANTHA PAGE, editor
LIFE
LOOK OUT FOR OUR LIFE PLUS BOXES THROUGHOUT THE MAGAZINE FOR EXTRA INFORMATION AND HEALTH TIPS
IS BROUGHT TO YOU BY THE LIFE HEALTHCARE GROUP EDITORIAL Editor Samantha Page lifehealthcaremag@johnbrownmedia.com Art Director Lois Scallan Copy Editor Raadiyah Abrahams EDITORIAL COMMITTEE Yvonne Motsisi, Denis Scheublé, Dr Nilesh Patel, Lucy Balona (CANSA), Dr Adi Horak, Dr Vash Mungal-Singh (Heart and Stroke Foundation SA), Dr Steve Taylor, Janette Joubert, Dr Sharon Vasuthevan MANAGEMENT Managing Director Lani Carstens Group General Manager Rebecca Smeda Group Account Director Joanne Peltz Account Manager Sumeera Dawood Production Director Nina Hendricks Financial Director Ruschda Ismail Business Development Director Warren Harding Human Resources Director Aashiqa Petersen
ADVERTISING Advertising Sales Manager Tessa Fenton-Wells tessa@tfwcc.net 021 761 2840; 082 320 0014 PRODUCTION Production Co-ordinator Tessa Smith Reproduction Resolution Colour Printing Paarl Media Cape Life 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 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 well-being journal available. Life is distributed quarterly to patients at all Life Healthcare hospitals and to private-sector doctors. It has a guaranteed print order of 90 000 per quarter, with an estimated readership of 240 000. Life 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 magazine.
IMAGE ANGIE LAZARO
Endorsed by
GO TO WWW.LIFEHEALTHCARE.CO.ZA FOR THE LATEST VERSION OF THE MAGAZINE
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THIS MONTH’S FOCUS… NEW BEGINNINGS
24 STOP AND SMELL THE WILD FLOWERS
CONTENTS Life 01 Life is…
A note from the editor
04 Over to You
Letters from our readers
08 Life News
Medical innovations, what’s new at Life Healthcare and latest reads
12 Fit and Healthy at Any Age
16 What (Hormones) to Expect When You’re Expecting The wondrous role hormones play when you’re pregnant PLUS: How a midwife can help you through your pregnancy By Catherine Eden
18 10 Smart Food Swaps
08
INNOVATIVE SURGERY
20 Overcoming the Noonday Demon Tips and techniques that offer hope for those struggling with depression By Vivian Warby
14 Having a Baby Saved My Life
22 How Resilient Are You?
LIFE_UPFRONT_Contents.indd 2
Your guide to spring flower season in South Africa By Bridget Hilton-Barber
Simple dietary changes that pack a powerful punch By Norma Young
Whether you’re 25 or 50, the time to get fit is now By Norma Young Chantal Sham decided to become a single mom. She didn’t know this would save her life As told to Lynne Gidish
24 Stop and Smell the Wild Flowers
Take Life’s quiz and find out how you fair when the going gets tough
2015/09/03 2:15 PM
Health
30 Women: Know Your Heart
Heart disease in women: the risks, the realities and the good news By Charlene Yared-West
36 New Technology Wages War Against Cancer
Life Vincent Pallotti Hospital’s upgraded Novalis Tx radiotherapy equipment is saving lives without scalpels By Charlene Yared-West
30 GET HEART SMART
39 Everybody’s Talking About … Vaccinations
There’s growing resistance to vaccination, but what are the facts? By Jamie Parker
40 Weighing Up Your Options
How to maintain a healthy weight when your medication adds kilos By Lisa Witepski
44 Born Too Soon
What you need to know when your baby is born prematurely By Jamie Parker
47 Clean Hands Save Lives
Five ways to implement this important hygiene habit
Care
50 20/20 Facts About Your Vision
It’s Eye Care Awareness Month – here’s some information about your eyes and how to care for them By Lisa Witepski
52 Chef’s Special
Reuben Riffel shares his picks of the healthiest and freshest recipes for spring
57 How to Stay Sane in a Crazy World
What does it take to turn your life around? Sometimes it’s just an attitude adjustment By Sophia Stuart
59 The Healing Power of Touch
Exploring the many properties of this primary sense By Vivian Warby
60 Hero of the Month
Life Healthcare nurse Patricia Mashele comes to work, no matter what
52 RECIPES BY CHEF REUBEN RIFFEL
61 Inspired Thinking
Pocket-sized cards offer hope, healing and inspiration
62 Mind Games
Take a break with our puzzles and crossword
64 Begin Again
Getting through the first 30 days of any change is make or break By Ariane de Bonvoisin
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54 2015/09/03 2:15 PM
LETTERS
OVER TO YOU We’d love to hear from you
WINNING LETTER
LEAN ON LIFE
HELPING HANDS My wife and I are resident in Pretoria, but we have a holiday cottage in Kei Mouth in the Eastern Cape, where we try to spend about two months, twice a year, to get away from the Gauteng rush and unwind with our friends and neighbours. On Wednesday 24 June, my wife started feeling unwell and during the early evening became extremely nauseous, vomiting frequently. After a telephone consultation with Dr Dalgleish in Morgan Bay, I decided to take her to the hospital. We arrived at Life Beacon Bay Hospital at about 9:30pm. The assistance we received from security personnel on arrival set the tone for the entire experience. They were helpful and patient, quickly bringing a wheelchair and transporting my wife inside. She was moved to the ER ICU and was attended to without delay. Later, the security staff showed me where to park my vehicle and ensured that I got back to the entrance safely as it was already very dark. At about 2am, a decision was made to admit my wife to the hospital. The next day she was placed under the care of Dr Mike Webb, who later instructed she be transferred to Life St Dominic’s Hospital for a gastroscopy, which was carried out late the evening of 25 June. I brought her home on Saturday 27 June, and we are reassured she will make a full recovery. Both of us would like to express our sincere thanks to the ER personnel on duty the night of the 24th. I neglected to write down their names, but their care and dedication during an anxious and traumatic time meant the world to us. Leon and Margaret le Roux, Gauteng
AN OUTPOURING OF GRATITUDE On behalf of our beautiful daughter Elna and our family, we would like to thank the ICU staff at Life Kingsbury Hospital for their professionalism, patience and kindness during the 12 days we spent in your unit. Words cannot express our appreciation for everything you did for us. Boet and Tracy Troskie, Cape Town
Our brother, dad and husband Paul Engel was hospitalised at Life St George’s Hospital’s ICU unit in June 2015. A group of family members decided to overnight at the hospital in the visitors’ lounge, and the generous and considerate staff treated us to hot tea and coffee, and made us comfortable with blankets and pillows. We were allowed to visit the patient throughout the night, giving him spiritual and emotional comfort. Even the day when life support could no longer sustain him, the staff made sure we had everything we might need. Many thanks to all the staff in cardiac intensive care for going that extra mile. Your excellent care helped lessen our pain. The Engel family, Port Elizabeth, Cape Town and England
FIRST IMPRESSIONS I wanted to give Life St Dominic’s Hospital a shout-out for their wonderful and friendly staff member, Sylvia Soxokashe, at the hospital’s entrance. Generally, when you walk into a hospital, it’s because you or someone you love is ill, so to be greeted by Sylvia is such a blessing. She is an incredible asset to both the Life Healthcare Hospital Group and the Life St Dominic’s Hospital team, as she is the face of the hospital when you enter. I have been there regularly for the past three weeks and every time I come in, she greets with a beautiful smile and a warm ‘hello’. I want to commend Sylvia and honour her for her joy and enthusiasm in her job. Melanie Gobel, East London TWEETS OF THANKS The treatment at Life Brenthurst Clinic was excellent. The renovations are great, the facility is clean and the staff and doctors are friendly. I love everything about the hospital. Keep up the good work! Ratshinang Mulwell, via @HiHelen My wife underwent treatment at the Life Little Company of Mary Hospital on 26 May. We were impressed with the hospital’s cleanliness, as well as the friendly staff members and attending physicians. We strongly recommend this facility. Hannes Smit, Gauteng
04
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IMAGES SUPPLIED
WIN A EUCERIN HAMPER VALUED AT R1 000
Eucerin AtoControl offers effective, long-lasting relief from symptoms of atopic dermatitis (AD) and is proven to decrease the use of cortisone during flare-ups. All products are cortisone-free and clinically proven to be well tolerated by babies and children. The range includes daily cleansing and moisturising products for maintenance between flare-ups, as well as acute care to relieve the itch-scratch cycle. The products are perfume, colourant and preservative-free, and clinically proven to be effective in improving general skin status in atopic dermatitis and itchy skin conditions. Email your thoughts on life, health or care to lifehealthcaremag@johnbrownmedia.com, and you could win. SPRING 2015
2015/09/03 2:18 PM
National Physiotherapy BackWeek
7 - 13 September 2015
The Difference is in our HandsTM
Movement for Good Health – Exercise
Physiotherapists are exercise experts and therefore play an important role in the health care of people of all ages and in any condition. Physiotherapy is aimed at prevention of injury or illness, promotion of better health, diagnosis and treatment in order to live as independently as possible. A qualified physiotherapist is a trained medical practitioner and you do not need to be referred by a doctor to see a physiotherapist.
The South African Society of Physiotherapy Tel: 011 615 3170 | www.saphysio.co.za
0415 3881_NovoNordisk_210x276_Layout 1 2015/08/19 1:10 PM Page 1
Amara de Abreeu, Type 1 Diabetes, South Africa
Of the estimated 387 million people with diabetes3
About 50% are diagnosed1,2
Of whom about 50% receive care1,2
Of whom about 50% achieve treatment targets1,2
Of whom about 50% achieve desired outcomes1,2
the one rule we have to change Diabetes affects 387 million people worldwide.3 According to the ‘rule of halves’, only half of them have been diagnosed and only about half of those diagnosed receive professional care. Of the people receiving care, only about half achieve their treatment targets and of those, only about half live a life free from diabetes-related complications.1,2
DIABETES
DIAGNOSED RECEIVE CARE
ACHIEVE TREATMENT TARGETS
ACHIEVE DESIRED OUTCOMES
Through our Changing Diabetes® partnerships and programmes, we are working with communities around the world to break this rule by increasing diabetes awareness and improving access to care and treatment options. Learn more about how we are changing diabetes at www.novonordisk.com
Actual rates of diagnosis, treatment, targets and outcomes vary in different countries.
References: 1. Hart JT. Rule of halves: implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care. British Journal of General Practice 1992; 42:116–119. 2. Smith WCS et al. Control of blood pressure in Scotland: the rule of halves. Br Med J 1990;300:981–983.3. International Diabetes Federation. IDF Diabetes Atlas, Sixth edition. 2014 Update. Online version of IDF Diabetes Atlas: Available from www.idf.org/diabetesatlas. Accessed 15 April 2015. Novo Nordisk (Pty) Ltd. Reg. No.: 1959/000833/07. 345 Rivonia Boulevard, 2nd Floor, Building A, Rivonia, 2128. Tel: (011) 202 0500 Fax: (011) 807 7989 www.novonordisk.co.za CD RLC 0415 3881 0416 ver2
LIFE A MIRACLE SURGERY / HILTON’S GREEN HOSPITAL / BANDANA DAY / ICU INTENSIVISTS
‘THERE ARE A THOUSAND THOUSAND REASONS TO LIVE THIS LIFE, EVERY ONE OF THEM SUFFICIENT.’
I M A G E G R EATSTOCK/COR B IS
MARILYNNE ROBINSON
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LIFE NEWS
Medical innovations and Life Healthcare news
FOLLOW YOUR MIND According to scientists at Rush University Medical Centre in Chicago, a diet rich in green, leafy vegetables, beans, berries, whole grains and wine can help to slow normal brain ageing and cognitive decline. The study showed elderly adults who strictly followed the MIND diet were 7.5 years younger, cognitively, over a period of nearly five years, than those who adhered the least. www.medicalxpress.com
Tyler’s team, from left to right: Dr Rinus Wiersma (paediatric surgeon); Dr André Botha (paediatrician) and Dr Jack Margolis (obstetrician/gynaecologist)
Baby Tyler in safe hands Tyler Walter Lloyd had no ordinary birth. When he was born at Life Westville Hospital, he had a surgical team ready and waiting to take him straight into an operating theatre. At 12 weeks, Tyler’s mother, Monique Boucher, 23, had a routine scan that revealed her baby had gastroschisis, a congenital birth condition. Tiny Tyler’s intestines had developed outside his abdominal cavity and required immediate surgery when he was delivered by caesarean section. ‘When I found out about Tyler’s condition, I was devastated,’ says Monique. ‘We weren’t sure what to expect and I cried about it until the day we met with our paediatrician, Dr André Botha, and paediatric surgeon Dr Rinus Wiersma. They made us feel very positive and explained the procedure in detail. We felt so much better after seeing them.’ Gynaecologist obstetrician Dr Jack Margolis delivered Tyler by caesarean section, attended by Dr Botha. Then it was Dr Wiersma’s turn to surgically repair the gastroschisis. Tyler spent two weeks in the NICU before he was able to go home. ‘He is now five weeks old and he’s doing so well,’ says Monique. ‘He sees Dr Botha every three weeks and the way things are looking, he won’t need any more treatment; his bowel is working perfectly.’ Monique says proudly, ‘Dr Botha says Tyler is a fierce, strong little man. The experience really made us stronger as a family’. 08
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A top-of-the-range angiography system, installed in Life Kingsbury Hospital’s vascular surgery theatre in April, has robotic capabilities, making it more user-friendly for staff. This means shorter surgery times and fewer patient complications. The new system gives surgeons a clearer, more detailed view of the workings of the vascular system while performing surgery. ‘The new theatre is cutting edge and cements Life Kingsbury Hospital as the place to go for relief from any problems affecting the veins and arteries,’ says Dr Philip Matley, a vascular surgeon at the hospital. These conditions include varicose and spider veins as well as deep vein thrombosis and a range of arterial problems. Dr Matley, however, says he and his partners are seeing a growing number of diabetics in the practice. ‘We expect the new equipment to help us save many diabetic limbs,’ he adds. www.cbn.co.za/component/k2item/2900-kingsbury-hospital–invests-in-3d-robotic-surgical-technology
LIFE PLUS If you’re feeling a little jittery after your second cup of coffee, you might want to consider switching to red espresso. It’s an excellent alternative to tea and coffee, and the Cancer Association of South Africa has awarded this frothy rooibos drink its Seal of Recognition. In addition to being caffeine-free, red espresso concentrates the antioxidants and health benefits of rooibos tea to a level where one serving (60ml) equals 10 times the antioxidants of traditionally brewed rooibos and five times that of green tea. www.cansa.org.za/cansa-seal-of-recognition
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2015/09/03 2:19 PM
I M A G E S G ET TY/GALLO I MAG ES, JOH N E R I MAG ES; ISTOCK; SU PPLI E D; COM PI LE D BY M E LAN I E FAR R E L
X-ray vision gives surgeons the edge
150min
The amount of weekly moderate-intensity aerobic physical activity for adults (aged 18 to 64), according to guidelines from the World Health Organisation
We HEART Bandana Day, do you? Show you care about people with serious blood disorders like leukaemia. Buy and wear a bandana on 12 October and contribute towards saving a life. Purchase bandanas from Pick n Pay, Round Table, selected Makro stores and online at Zando.com, for only R25. For more information, call 0800 12 10 82 or visit www.sunflowerfund.org.za.
I M A G E S G ET TY/GALLO I MAG ES, JOH N E R I MAG ES; ISTOCK; SU PPLI E D; COM PI LE D BY M E LAN I E FAR R E L
START YOUR DAY WITH A
NEW HOSPITAL GOES GREEN Green hospital design has been linked to healthier patients, and the new Life Hilton Private Hospital flies its green flag proudly. ‘Green design is associated with better patient outcomes, increased staff retention, and a reduction in long-term energy costs,’ says André Meyer, CEO of the Life Healthcare Group. The state-of-the-art facility in Hilton, Pietermaritzburg, in KwaZulu-Natal, was designed to minimise the hospital’s carbon footprint after extensive research into global healthcare facility trends, with a strong focus on ergonomics and environmental impact.
GREEN SMOOTHIE The freshest and fastest way to get your required daily fruit and veggie content is with a delicious green drink. This recipe will get you started.
KALE SMOOTHIE WITH PINEAPPLE AND BANANA INGREDIENTS
½ cup coconut milk 2 cups stemmed and chopped kale or spinach 1½ cups chopped pineapple 1 ripe banana METHOD
WHAT MAKES A HOSPITAL GREEN? • An environmentally friendly site • Sustainable and efficient design • Inclusion of green building materials and products • Ecological construction process
Combine all the ingredients in a blender and purée until smooth, about 1 minute, adding more water to reach the desired consistency. TIP For a zesty boost, add a thumb of ginger. WWW.LIFEHEALTHCARE.CO.ZA 09
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BITS & BY TES
ETHICAL DILEMMA COMES TO A HEAD A surgeon in America has raised a heated ethical debate after he claimed he thought he would be able to carry out a human head transplant within two years. Experts say even if a head transplant is medically possible, it poses major ethical issues. Italian neurosurgeon Dr Sergio Canavero outlined his project in the June issue of Surgical Neurology International. In the paper, Dr Canavero explains: ‘The greatest technical hurdle to such an endeavour is, of course, the reconnection of the donor’s and recipient’s spinal cords. It is my contention the technology only now exists for such linkage.’ ‘I think it’s ludicrously stupid,’ Arthur Caplan, a bioethicist from NYU, told Live Science. ‘You’d probably be charged with homicide if you chop somebody’s head off before they’re dead.’ Dr Canavero gave a nod to the ethics of the procedure in his paper. ‘A risk could develop whereby people with adequate funds try to secure the bodies of healthy young individuals on the black market and have them transplanted by dishonest surgeons.’ www.livescience.com/50074-head-transplants-wont-happen.html
Sharkskin takes a bite out of superbugs
Dr Anthony Brennan, a material science and engineering professor at the University of Florida, has developed a coating based on the texture and pattern of sharkskin that inhibits the growth of bacteria. Brennan noticed that sharkskin is always clear, unlike whales and other marine animals that have algae and barnacles sticking to them, thus the Sharklet micropattern was born. The texture, resembling the diamond-patterned dermal denticles of sharkskin, makes it difficult for bacteria to take root and establish colonies. The coating could be applied to the surfaces of plastic products that surround patients in hospital. www.labcritics.com/sharklet-micropattern-thenew-antimicrobial- technology-3906/
Life The Glynnwood offers round-the-clock ICU expertise A dedicated team of nine intensivists, who work around the clock in the intensive care unit at Life The Glynnwood, met at Wits Medical School. When they took a collective decision to specialise in intensive care, the Glynnwood intensivists were born. The team talks fondly of a recent success story with a patient: A 28-year-old HIV-positive mother and wife was brought in with severe pneumonia. She was on a ventilator for 57 days and went into cardiac arrest on numerous occasions. After months in ICU, the intensivist team got her back on her feet, and six months later, she walked up the stairs into the ward to say ‘thank you’. This is one of the many inspiring stories to emerge from the unit in the last 18 months. LIFE THE GLYNNWOOD’S INTENSIVIST TEAM:
Dr Lliam Brannigan, Dr Bridget Madlener, Dr Mark Eager, Dr Glenn de Wet, Dr Gary Katzman, Dr Will Robertson, Dr Rob Morgan, Dr Andrew Griffiths, Dr Steven Toich WHAT IS AN INTENSIVIST?
Intensivists are super specialists who are trained and dedicated solely to the care of the critically ill in ICU. They provide round-the-clock ICU care.
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Scientific evidence supports the fact that 100% oxygen, inhaled at increased pressure elevates the body’s ability to heal. ‘All patients have to do during treatment in a hyperbaric oxygen therapy chamber is breathe normally and allow the oxygen to do its work,’ says Dr Weir, who runs the Vascular and Hyperbaric Unit at Life Eugene Marais in Pretoria. When 100% oxygen is administered under pressure, 15 times more oxygen is dissolved in the blood allowing injured or infected tissue to heal. Various clinical conditions have been accepted, internationally, as indications for hyperbaric oxygen therapy, including diabetic foot ulcers, complex wounds and radiation-induced complications. www.hbo.co.za
I M A G E S G E T T Y / G A L L O I M A G E S , I LYA S T ; S U P P L I E D
COME UP FOR AIR
BOOKS
SHELF HELP
MUST READ
The latest reads to nurture your mind, body and soul
TIP Stop this egg-white omelette nonsense. Yolks are packed with satiating nutrients, so put them back on your plate and feel fuller longer.
See www.harrietbrown.com
Midwest Book Review, June 2015 ‘Exceptionally well written, organised and presented…’
Happy Is the New Healthy by Dave Romanelli (Skyhorse Publishing) Daily life can sometimes go by in a bit of a blur and you’re so busy doing things that you forget to enjoy life. This is where lifestyle and wellness innovator David Romanelli (aka Yeah Dave) steps in with simple, immediate tips to help you relax and feel better. Dave’s fresh take on wellness in Happy Is the New Healthy: 31 Ways to Relax, Let Go, and Enjoy Life Now! reminds us to slow down, stress less and smile more. See www.yeahdave.com
WORDS OF WISDOM IMAGES SUPPLIED
I M A G E S G E T T Y / G A L L O I M A G E S , I LYA S T ; S U P P L I E D
The New Health Rules by Dr Frank Lipman and Danielle Claro (Artisan) Dr Frank Lipman focuses on the root causes of illness and guides his patients to lasting wellness. In this book, he and co-author Danielle Claro take us through the often-contradictory information that bombards us daily, and deliver more than 100 illuminating, health-improving tips.
Body of Truth by Harriet Brown (Da Capo Press) ‘Over the past 25 years, our quest for thinness has morphed into a relentless obsession with weight and body image. In our culture, “fat” has become a four-letter word,’ writes Harriet Brown. Science journalist Brown investigates and systematically unpacks what’s been offered as the ‘truth’ about weight and health. She also offers practical ideas for how to sort through the lies and misconceptions and make peace with yourself and your body image.
‘Part of the goal in taking responsibility for your health is getting to know yourself better. Not just the aches and pains but also the peaks and triumphs.’ FROM THE NEW HEALTH RULES BY DR FRANK LIPMAN AND DANIELLE CLARO (ARTISAN)
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FIT FOR LIFE
FIT AND HEALTHY
AT ANY AGE
I MAG E GETTY/GALLO IMAGES, LIAM NORRIS
Your guide to peak physical strength, no matter the decade. By Norma Young
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L
IFE CAN GET in the way of personal goals, but being fit at 22 is just as important as it is at 47. According to the American College of Sport Medicine, there are basic exercise guidelines to consider no matter what your life stage: Cardio-respiratory exercise, for at least 150 minutes a week, resistance exercise, focusing on your major muscle groups, two to three times a week, flexibility exercises, two to three times a week, and neuromotor exercise, which focuses on aspects like balance, agility, coordination and gait, two to three times a week. With these basics in mind, you can tailor your workout according to your body’s needs.
IN YOUR
20s
30s
You may have had children and your body would have undergone change. But, while running after toddlers can be exhausting, it’s not the only exercise you need. ‘Nowadays, 30 is the new 20, so your fitness goals should be pretty much the same as when you were in your 20s,’ says Naicker. Responsibilities and lifestyle may differ between the two decades, but it shouldn’t show in your fitness levels. In fact, because a senior management role at work, for example, may be more mentally and emotionally demanding, you need exercise more than ever before. Take the test You should be able to run 5km in 30–40 minutes.
IN YOUR
40s
Now is the time to set the habit if you’ve never been able to develop a regular exercise pattern. If you already have one, maintenance is critical. ‘At this age, you should stick to a great aerobic routine to give you a good cardiovascular workout. You should be doing mild resistance training and stretching regularly to ensure you don’t lose flexibility. Recommended regular exercises include walking or jogging, cycling and using strength equipment, such as dumb-bells.’ Take the test You should be able to run 5km in 30–45 minutes.
IN YOUR
50s
While it’s important to remain active at this age, there are some changes you need to make to how you exercise. ‘To avoid pounding on your joints, cardiovascular exercise can include walking, cycling, swimming and water-based classes, such as aqua aerobics. When it comes to resistance training, opt for lighter weights so you can do more reps. Exercise that focuses on maintaining your balance is important.’ If you’ve never been a gym-goer, it may be intimidating and difficult to start now, but your health is non-negotiable. Find a friend or two in a similar position and schedule gym visits together, or get exercise DVDs to do at home Take the test You should be able to run 5km in 35–50 minutes.
FROM YOUR
60s
ONWARDS
Even though you may be in the last batch of finishers at your local park run, it’s worth celebrating every time you complete a race. ‘In addition to cardiovascular exercise, such as jogging or walking, your weekly routine also needs light resistance exercise.’ Stretching is important too, so even on days when you don’t have a formally scheduled workout, take time to do gentle lunges and other moves to stretch your muscles and body. Take the test You should be able to run 5km in 40–60 minutes. n
I MAG E GETTY/GALLO IMAGES, LIAM NORRIS
It’s not so long since you had compulsory PE, so you may still feel sprightly. But without exercise scheduled into your day, it can be difficult to make time to stay fit. Between managing university, or work, and a social life, finding an hour to get to the gym or go for a run can lose its priority status. But it mustn’t. At this stage, you need to focus on three core areas of fitness, says Durban-based biokineticist Kiruben Naicker. ‘Your aim is to build a solid cardiovascular endurance foundation on to which other components must be added. Your cardio exercise can include jogging, swimming, running and cycling. For strength, you need to do weight training, then incorporate a regular stretching routine for flexibility.’ Take the test You should be able to run 5km in 30–40min.
IN YOUR
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FIRST PERSON
SAVED MY LIFE Last year, at the age of 36, Chantal Sham made the decision to become a single mom. Little did she realise this would save her life
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I M A G E G E T T Y / G A L L O I M A G E S , A D A M H E S T E R ; A S T O L D T O LY N N E G I D I S H
HAVING A BABY
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I M A G E G E T T Y / G A L L O I M A G E S , A D A M H E S T E R ; A S T O L D T O LY N N E G I D I S H
F
OR THE LAST 10 years, motherhood has been increasingly on my mind. Having never met Mr Right, and with my biological clock loudly ticking, I finally decided to go it alone. It wasn’t a decision I took lightly. I’m Catholic and quite religious, so when I went for artificial insemination, I prayed to God to make it happen if it was meant to be as I wasn’t going to do it again. Despite the low odds of conceiving the first time around – a mere 20% – I fell pregnant. My news was met with mixed reactions. I was fully supported by my parents, who knew how much I wanted a baby, but others weren’t so accepting, which really didn’t bother me as single motherhood is becoming far more common these days. I also had to deal with my own emotions – mourning the fact that I wasn’t able to go the natural route and trying to come to terms with it all. Luke was born at Life Wilgeheuwel Hospital on 16 March this year – the happiest day of my life. His delivery via C-section went very smoothly but, soon afterwards, a maternity nurse noticed blood in my wound drainage bag. This necessitated a trip back to theatre to determine the cause of the bleeding, which left doctors baffled. That’s the last I remember. I became increasingly disorientated and later found myself in ICU after having a massive seizure. The following day, an MRI revealed a brain tumour the size of an orange, which completely shocked my doctors and me. I’d never had any symptoms or any real issues of concern in the past to indicate something was wrong. Needless to say, I was suddenly on an emotional roller-coaster ride with the joy of my son’s arrival almost overshadowing this terrifying development. My medical team were absolutely great. Everyone from my gynae and neurologist to my physician and neurosurgeon were wonderfully reassuring. Yes, I had a brain tumour and yes, it was scary, but there was also good news: the scan had revealed that not only was the growth benign but, more important, it could be removed. All the nurses I met, both in the maternity section and later in the surgical unit, were amazing too, clearly demonstrating they genuinely cared about people and what they did on a daily basis was not just a job. I left the hospital one week later with a sadness of a different kind – being unable to breastfeed Luke as I was taking anti-seizure medication, which is contra-indicated during breastfeeding. I also knew I had ‘this thing’ in my brain that needed to come out – sooner rather than later to decrease the emotional stress I was experiencing – and, of course, I worried about having another seizure while holding or caring for my son. However, living with my parents meant we were never alone and they took over his care when I went for my brain surgery on 18 May. It was a complete success and five days later I was given the all clear with the instruction to go out there and live my life. And that’s exactly what I’m doing, despite not being allowed to drive for a year since my doctors want to ensure I remain seizure-free before I hit the road again. Realising how life can change in an instant is an extremely humbling experience, which is why I’m so grateful to all my doctors at Life Wilgeheuwel Hospital for giving me this second chance. Motherhood is amazing and I feel a huge debt to Luke for not only the gift of his life, but also for mine because had all the puzzle pieces not fitted so well together right from the start – with a little Divine intervention too – there’s a very good chance neither of us would be here today! ■
Chantal and Luke (seven weeks at the time), a month before surgery
IN HER DOCTOR’S WORDS Because the pregnancy and baby’s birth brought on Chantal’s seizure, we were able to pick up the tumour and successfully remove it without any consequences. Had she not decided to have a child, the tumour could have remained undetected, growing in size and doing a lot of damage in the process before manifesting any symptoms. This could have resulted in a seizure taking place in a more dangerous situation, or the tumour may have increased to the extent that we’d be unable to operate. She’s a lucky lady. DR SCHALK BURGER, neurosurgeon, Life Wilgeheuwel Hospital
WWW.LIFEHEALTHCARE.CO.ZA 15
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WHAT
(HORMONES)
TO EXPECT WHEN YOU’RE EXPECTING
I M A G E G E T T Y / G A L LO I M A G E S , C U LT U R A R M / C H E V W I L K I N S O N
From conception to delivery, hormones play a wondrous role in helping a woman’s body nurture new life. By Catherine Eden
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GROWING LIFE
A
SK A PREGNANT woman about hormones and she will tell you that they’re responsible for mood swings, morning sickness, tender breasts and heightened sensitivity to taste and smell. What are these substances and what is their purpose during the various stages of pregnancy? Hormones are manufactured all the time. These chemical messengers, carried in the blood stream, regulate body functions and perform a multitude of tasks. During pregnancy, particular hormones come into play. Activated by the body’s mysterious intelligence, they create a supportive environment for the developing foetus and prepare the way for delivery.
Are you pregnant?
Human chorionic gonadotropin (hCG), sometimes called the ‘pregnancy announcer’, is secreted in the uterus by trophoblast cells that will eventually become the placenta, explains Dr Danie van der Walt, obstetrician/gynaecologist at Life Cosmos Hospital. During an average pregnancy, hCG levels double every two days for the first 10 weeks or so. This hormone can be detected in the urine. It increases the blood supply to the pelvis, often resulting in a sensitive bladder, and is thought to be implicated in the nausea that plagues many women in the first trimester.
What is making you tired and queasy?
The corpus luteum of the ovary secretes progesterone at the point where the egg was expelled. ‘It supports the pregnancy in the early weeks, until the developing placenta is able to take over production of the hormone,’ says Dr Van der Walt. ‘It is progesterone that makes women feel so tired at the start of the pregnancy.’ Among its major functions are to dilate blood vessels, soften ligaments and cartilage and to prevent the uterus from contracting while the baby grows. This can also have a relaxing effect on other smooth muscles, such as the lower oesophageal sphincter, resulting in heartburn and acid reflux, and on the bowels’ muscles, causing some distension and bloating. If the mobility of the large colon is slowed, the woman may also become constipated. Like progesterone, oestrogen is secreted by the corpus luteum until the placenta takes over. Rapidly increasing levels of this hormone could also be responsible for nausea, but as the pregnancy moves into the second trimester, this generally passes and the woman feels a surge of energy and well-being. Oestrogen plays a big part at this time, both in development of the foetus and in changes to the mother’s breasts, which become enlarged as milk ducts develop.
I M A G E G E T T Y / G A L LO I M A G E S , C U LT U R A R M / C H E V W I L K I N S O N
Preparing for birth
Hormonal changes can affect mood as the pregnancy advances. In addition, the mother may experience increased heartburn, backache caused by postural changes, and a degree of joint pain as progesterone does its work to relax ligaments and soften cartilage, preparing the body for delivery. ‘The full-term baby triggers the placenta to produce prostaglandins, which signal the uterus to begin contractions,’ explains Dr Van der Walt. ‘Oxytocin is the hormone that allows the cervix to open and prolactin, produced in the pituitary gland, stimulates the breasts to begin the lactation process. Placental hormones suppress lactation until after the placenta has been delivered; that is why there is no milk in the breasts before the baby is born.’ We can blame hormones for some discomfort, or see them as marvels in the creation of life.
Q&A
The role of a midwife in pregnancy The Little Life Birth Basics programme for midwifery-led deliveries is gradually being introduced at Life hospitals. Sister Anita Isaacs of Life Cosmos Hospital explains the role of the midwife in pregnancy and delivery
How often will I see the midwife?
‘We see pregnant women at around 10 weeks and every four weeks thereafter, until the 28th week. Then it’s every two weeks until the 36th week, and weekly until delivery. We see them on day three and one week after discharge, and there is a six-week check-up for mother and baby.’
What can I expect?
‘The midwife will ask health-related questions regarding your pregnancy to assess possible risk. Routine blood tests will be done, such as HIV, syphilis and blood grouping. There are ultrasound scans at 12 and 24 weeks, and between 34 and 36 weeks for smokers. Midwives offer a high level of expertise, health education on every aspect of pregnancy, excellent support and encouragement. During delivery, the hospital’s gynaecologists are on standby, if necessary.’
When is it not advisable to have a midwife?
‘Midwives will be advisable for low-risk, uncomplicated pregnancies. Any complicated or high-risk pregnancies will be referred to a medical practitioner.’
What are the cost implications?
‘For the first visit, expect to pay R380 plus blood tests and vitamins; R130 for subsequent visits; R9 600 for the delivery and hospital stay. If a caesarian is needed, the cost is R19 900. It’s the same level of care that a doctor would provide, at a more affordable price.’ n WWW.LIFEHEALTHCARE.CO.ZA 17
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T H E WA Y W E E A T
10
SMART
FOOD SWAPS
1
You usually have a cooldrink
Rather try: a glass of red wine
Because: ‘Red wine, in fact, white and rosé wines too, have high levels of antioxidants,’ says dietician Amanda van Huysteen, based at Life Wilgeheuwel Hospital in Johannesburg. ‘These antioxidants protect our bodies against disease and ageing. Fizzy drinks, on the other hand, don’t supply anything good to our bodies. But remember, all alcohol must be consumed in moderation.’ 18
LIFE_KNOWS_Nutrition.indd 2
I MAG ES GETTY/GALLO IMAGES, LACAOSA, ANDREW HOUNSLEA; ISTOCK
Simple dietary changes can pack a powerful health punch, says Norma Young
1
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2015/09/03 2:25 PM
I MAG ES GETTY/GALLO IMAGES, LACAOSA, ANDREW HOUNSLEA; ISTOCK
2 3 4 5 6 7 8 9 10 LIFE_KNOWS_Nutrition.indd 3
You usually make a white sauce Rather try: marinara sauce
You usually use mayonnaise Rather try: plain Greek yoghurt
You usually eat milk chocolate Rather try: dark chocolate
You usually make rice Rather try: quinoa
You usually use sugar to sweeten Rather try: cinnamon
Because: With tomatoes as a base, a marina sauce can transform a pasta dish to be both tasty and nutritious. Tomatoes contain lycopene, which helps decrease free radicals in the body, and vitamin C, which protects against illness. By contrast, a butter-, cheese-, flour- and milk-based white sauce has fewer health benefits because of its processed ingredients. It also has a higher fat content from the inclusion of cheese and butter. On average, a half cup marina sauce has 250kJ, while the same portion white sauce has around 1 040kJ. Because: It’s a healthy natural food that works just as well as mayo whether on a sandwich or on top of a baked potato. ‘Greek yoghurt is loaded with beneficial flora, which promotes a healthy gut,’ says van Huysteen. ‘It’s a good source of protein and calcium.’ Because it has oil, eggs and vinegar, mayonnaise has a higher fat content and more kilojoules too. Because: While it’s not licence to devour an entire slab in a sitting, if you are looking for a sweet treat, the nutritional benefits of dark chocolate make it a winner. Not only does it have half the sugar of milk chocolate, cocoa-rich dark chocolate can improve your health. Findings presented at the 2014 American Chemical Society meeting revealed that because cocoa powder is rich in antioxidants, it also has anti-inflammatory benefits. Because: Great nutritional benefits are the reason why NASA proposed quinoa as an ideal food for long-duration space flights. The grain is useful for us on planet earth too, as it’s naturally gluten-free and contains iron, B vitamins, magnesium and calcium. Though it’s classified as a pure protein, it makes a great base for curries, stews or even as a cooked porridge. Because: Sugar makes no significant nutritional contribution while cinnamon adds in flavour and health benefits. ‘Latest research shows that the spike in blood sugar following sugar intake plays an important role in the development of cardiac disease,’ cautions van Huysteen. ‘Do not forget about the negative role sugar plays in dental health, weight gain and blood sugar control.’ On the other hand, a teaspoon of cinnamon has as much antioxidants as half a cup of blueberries.
Because: At between 40–49%, dependent on whether dry- or oil-roasted, almonds have a lower fat content – and these are very healthy fats. ‘Almonds also supply beneficial nutrients, including vitamins, especially vitamin E, minerals and antioxidants,’ says van Rather try: almonds Huysteen. However, she advises almonds are healthiest when eaten raw and unsalted.
You usually eat peanuts
You usually eat cream cheese Rather try: hummus
You usually have a cappuccino Rather try: green tea
You usually eat ice cream Rather try: a frozen banana
Because: Made from chickpeas, lemon juice, garlic and olive oil, this creamy paste works well as either a dip or a spread. Unlike cream cheese, which has no vegetables, hummus is both fibre and protein rich. Published in 2014, a study in the Journal of Nutrition & Food Sciences confirms people who snack on hummus have a 53% reduced chance of being obese. The study also found hummus eaters waists to be five centimetres smaller on average. Because: Green tea can contain as little as 15mg of caffeine to as much as 75mg per cup. So if you’re after an energy boost, you can get it from green tea along with a host of other health benefits. Rich in antioxidants, this beverage is hailed for its positive effects against heart disease, certain types of cancer and Type 2 diabetes. Natural chemicals, called polyphenols are believed to provide an anti-inflammatory boost, making green tea a medicinal and refreshing drink. Because: You’ll get the same refreshing cold texture snacking on a frozen banana, but miss out on the high sugar and fat content of ice cream. Bananas are high in nutrients, such as potassium, folate and vitamin C, but free of cholesterol, fat and sodium. The fibre and vitamin B6 in bananas also support heart health. You can chew on the frozen snack or blend it in a food processor so it’s as creamy as a yummy soft-serve. n
2015/09/03 4:01 PM
OVERCOMING
THE NOONDAY DEMON
‘Y
ou lazy lout, I have no sympathy for you.’ ‘Snap out of it.’ ‘You are such a drama queen.’ ‘Grow up.’ ‘Pull yourself together.’ People living with depression face this kind of abuse daily, as their bodies and minds enter a darkness very hard to explain to those who have not themselves suffered from this illness. In South Africa, with contributing stressors, such as high incidence of violence and unemployment, clinical depression affects a large 20
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I M A G E G E T T Y / G A L LO I M A G E S , C U LT U R A / M O O F
Tried and tested techniques and new, innovative approaches offer hope for those suffering from depression. Vivian Warby seeks them out
SPRING 2015
2015/09/03 2:25 PM
MIND WISE percentage of the population and its social and economic impact on the country is devastating. Major depressive disorder and anxiety costs the country a whopping 2.2% of its annual GDP. And suicide, poor socio-environmental conditions and unemployment are all side effects. Yet, while we know all of this, depression still remains misunderstood, and often an embarrassment for those inflicted with this medical condition. Dr Marius Welgemoed, a psychiatrist at Life Little Company of Mary Hospital in Pretoria, says there are not enough psychiatrists to treat the need in South Africa. But, fortunately, GPs are well qualified to help as far as referring patients for psychotherapy and prescribing drugs. It is important to understand that depression is a medical condition, Dr Welgemoed says. There are many stressors that contribute, from grief to a chronic illness, but ultimately it is an imbalance in the chemistry of the brain. While a psychiatrist remains the most responsible physician, they are becoming more open to integrating other non-Western practices ‘as long as they are not harmful to our clients,’ says Dr Welgemoed. Janine Roos, head of the Mental Health Information Centre of Southern Africa, which forms part of the Stellenbosch University/ University of Cape Town MRC Unit on Anxiety and Stress Disorders, says research challenges, these days, are finding out how and where in the brain antidepressants work so better medication can be developed (especially with regards to a faster response time and less side effects). There have been huge advances in neurobiology and brain imaging in recent years, and in the field of identifying biological markers for depression. Both Roos and Dr Welgemoed say this bodes well for the future treatment of depression and Dr Welgemoed stresses that there’s hope for those suffering (see The depression treatment cycle).
Take a blood test
While you could easily be tested for diabetes and high cholesterol, up to now, the diagnosis of depression has been subjective and based on symptoms, such as poor mood, fatigue and change in appetite. Last year, however, the very first blood test to diagnose depression in adults was developed by American scientists at Northwestern Medicine, a breakthrough approach that will provide the first objective scientific diagnosis for depression, says Roos. The test identified depression by measuring the levels of nine RNA blood markers. RNA molecules are the messengers that interpret the DNA genetic code and carry out its instructions. The blood test also predicted who would benefit from cognitive behavioural therapy based on the behaviour of some of the markers. This could mean more effective, individualised therapy for people with depression, says Roos.
I M A G E G E T T Y / G A L LO I M A G E S , C U LT U R A / M O O F
Stimulate your brain
Brain stimulation therapies hold promise for treating certain mental disorders that do not respond to more conventional treatments, says Dr Welgemoed. One of the newer treatments is repetitive transcranial magnetic stimulation (rTMS), he says. Instead of an electrical current, rTMS uses a magnet to activate the brain. In October 2008, rTMS was approved for use by the FDA as a treatment for major depression for patients who have not responded to at least one antidepressant medication.
LIFE PLUS
How does it work? A typical rTMS session lasts 30 to 60 minutes and does not require anaesthesia. An electromagnetic coil is held against the forehead near an area of the brain that is thought to be involved in mood regulation. Then, short electromagnetic pulses are administered through the coil. More research is underway to determine the safest and most effective use of rTMS, but it does offer hope to those more resistant to other therapies.
Get fit
Exercise has long been known to help lift depression. Studies show that regular exercise helps ease depression in a number of ways such as: • Releasing feel-good brain chemicals that may ease depression (neurotransmitters, endorphins and endocannabinoids) • Reducing immune system chemicals that can worsen depression • Increasing body temperature, which may have calming effects • Regular exercise has many psychological and emotional benefits too
TIP Enlist a personal trainer or a friend to help motivate you to keep appointments to exercise. You do not have to start big or even leave your room. Just lifting some weights next to your bed can be a start, or get a stationary bicycle or stepper you can use at home.
Cultivate an attitude of gratitude
Can being thankful help ease depression? Studies show that consistent positive interactions, particularly ones that involve gratitude, increase happiness and decrease levels of depression. Scientists say that gratitude techniques, such as keeping a gratitude journal or doing an act of kindness, shift our thinking from negative outcomes to positive ones, elicit a surge of feel-good hormones like dopamine, serotonin and oxytocin, and build enduring personal connections.
TIP Before you open your eyes in the morning, count five things for which you are grateful. List the acts of kindness you do daily, and those done to you. Look back at your week and see how some challenging moments turned into good ones. n
The depression treatment cycle Roos says that antidepressants are the cornerstone of treatment for depression. Studies show that 70–80% of patients with depression improve or recover when treated with antidepressants. Majority of people recover when treated with antidepressants alone (together with a good doctor-patient relationship). Psychotherapy can be used alone or in conjunction with medication in mild depression. Where feasible, patients should receive a combination of medication and psychotherapy. Antidepressants are not effective immediately, but patients start feeling better within one to three weeks after starting with medication.
CONTACT ONE OF THESE LIFE HEALTHCARE MENTAL HEALTH FACILITIES FOR HELP: LIFE HUNTERSCRAIG PRIVATE HOSPITAL, CENTRAL PORT ELIZABETH, 041 586 2664; LIFE ST MARK’S CLINIC, SOUTHERNWOOD, EAST LONDON, 043 707 4400; LIFE GLYNNVIEW, BENONI, 011 741 5460; LIFE POORTVIEW, ROODEPOORT, JOHANNESBURG, 010 003 0930; LIFE RIVERFIELD LODGE, FOURWAYS AREA, JOHANNESBURG, 0860 748 373; LIFE ST JOSEPH’S, BEREA, DURBAN, 031 204 1470; OR SOUTH AFRICAN DEPRESSION & ANXIETY GROUP 0800 12 13 14 WWW.LIFEHEALTHCARE.CO.ZA
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2015/09/04 9:02 AM
LIFE QUIZ
HOW RESILIENT ARE YOU? Resilience is the quality that allows you to ‘survive’ and gain strength from hardship. Do you bounce back easily from life’s trials and tribulations or do they throw you for a serious loop? See how you fair when the going gets tough
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.
what happens to me. A/ Completely true B/ Mostly true C/ Somewhat true/false D/ Mostly false E/ Completely false
2 What doesn’t kill us makes us stronger. A/ Strongly agree B/ Agree C/ Somewhat agree/disagree D/ Disagree E/ Strongly disagree
3 We can overcome painful childhood memories and
lessen their influence on our behaviour and emotions. A/ Strongly agree B/ Agree C/ Somewhat agree/disagree D/ Disagree E/ Strongly disagree
4 You hear through the grapevine that one of your
friends is hosting a huge birthday bash on the weekend. You rush out and buy a great gift, but the invitation never comes. You find yourself at home alone on Saturday night watching reruns. The next Monday everyone is talking about the great party. What’s your reaction?
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A/ I feel terribly hurt, but never admit it to anyone. It bothers me for days. B/ I am annoyed and demand to know why my friend didn’t invite me. C/ I am angry and no longer consider him or her a friend. D/ I assume it was just a mix-up and forget about it. E/ I feel a little hurt and approach my friend, nicely asking why I wasn’t invited. F/ I feel hurt but time will heal the wounds. G/ I feel hurt but make a joking comment to my friend about it so that it doesn’t seem like a big deal. H/ I feel depressed and think about it for weeks. I/ I don’t care and don’t think about it.
5 You’ve been working hard and your boss has finally
taken notice. You’re sure a promotion is coming any day. When you arrive at the office on a Monday morning, however, you find out that your colleague got the promotion you wanted … so you’re stuck in the same old grind. How do you react? A/ I get angry and confront my boss aggressively; it’s not fair! B/ I get angry but don’t say anything to my boss. It eats away at me for a few weeks. C/ I feel frustrated and decide not to get my hopes up any more, since things never work out. D/ I’m very disappointed, but feel too uncomfortable to ask my boss about it. E/ I’m disappointed but think there must be a reason. I talk to my boss and ask what I need to accomplish in order to advance. F/ I quit my job and lick my wounds for months. G/ I don’t give it a second thought – all is fair in love and work!
I M A G E G ET TY/GALLO I MAG ES, HALFDAR K; COPYR I G HT 2015 – WWW.QU E E N DOM.COM
1 I often feel like a victim with little or no control over
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6 When you think about the most difficult times you have faced in the past, what is your first thought? A/ ‘I’m so angry!’ B/ ‘I can’t think about it without getting physically ill!’ C/ ‘Thank God that’s behind me!’ D/ ‘I wouldn’t necessarily want to live it again, but I learnt a lot from it.’ E/ ‘It’s some kind of miracle that I survived it; I couldn’t do it again.’ F/ ‘Why do these things happen to me? Life is so unfair!’
7 How would you describe the evolution of your
self-esteem over the years? A/ It has increased with time and is at the highest it has ever been. B/ It’s getting worse and worse. C/ I’ve experienced ups and downs, but I generally like myself. D/ I don’t like myself very much and never have.
8 Overall, how emotionally strong do you feel
you are? A/ Strong as an ox – I can survive anything. B/ I’m usually strong, but I have moments of vulnerability. C/ Strong in some ways, vulnerable in others. D/ I’m somewhat strong, but I lean more towards vulnerable. E/ I’m very vulnerable. F/ To be truthful, I can’t stand on my own two feet.
S C O R IN G YO U R S E LF
I M A G E G ET TY/GALLO I MAG ES, HALFDAR K; COPYR I G HT 2015 – WWW.QU E E N DOM.COM
QUESTION 1 2 3 4 5 6 7 8 9 10
A B C D E F G H I
0 10 10 5 4 0 10 10 10 10
2 8 8 7 2 0 3 8 9 9
5 5 5 2 1 8 7 6 8 8
8 2 2 9 5 10 0 4 3 5
10 0 0 8 6 8 0 10 9 0 10 5 0 1 6 3
0 0 2
2 0 1 0
9 You overhear two colleagues that you don’t know
very well discussing YOUR character flaws! What do you do? A/ I leave it alone; I don’t really care what they think. B/ I leave it alone; I accept that I cannot possibly please everybody. C/ I confront them and tell them that I don’t appreciate their behaviour. D/ I hide in the bathroom and vent my emotions (by crying/screaming/hitting something) but never say anything to them. E/ I complain to my supervisor that they are spreading rumours about me. F/ I go home and call in sick for the rest of the week. G/ I get my revenge by spreading nasty rumours about them. H/ I quit my job.
10 How long does this event linger in your mind? A/ Maximum five minutes B/ Less than an hour C/ No more than half the day D/ All day E/ A couple days F/ Most of the week G/ All week H/ Over a week
When dealing with hardship, some people feel victimised and blame others. Some feel helpless and shut down, while others get angry and lash out at those around them. Certain individuals, however, face the same hardships in a very different way; they use the experience and inner strength they’ve gained to pick themselves up and move forward, rather than wallowing in feelings of pain and hurt. These are the survivors. History is full of their stories – men, women and children who have lived through experiences that would have crushed most people. These resilient individuals manage to go on to achieve success and happiness. This test cannot measure whether you’ve bounced back from hardship, as we don’t know your personal history. What it can look at, however, is your attitude and the way you approach problems.
0–40
40–70
70–100
Depending on the situation or your mindset at the time, you have a fair amount of difficulty coping with both day-to-day and life-altering problems. The good news, however, is that you can learn and practise the skills that will better prepare you for life’s trials and tribulations. For starters, remember that a tendency to ruminate can trap you in a negative cycle. Over-thinking problems in your life and allowing them to take over your thoughts can make a problem seem even more overwhelming. If you find yourself obsessing over an issue in your life, make an effort to stop those thoughts in their tracks. Pick up an engrossing book, watch a comedy on television, or go for a bike ride. Continue to develop more strategies for coping with stress and build a stronger support network to help you along the way.
You are somewhat resilient, but like most individuals, there are times when situations or people can cause you to stumble. This is understandable; resilience, after all, is a changing, dynamic quality that can really be put to the test during particularly difficult tribulations. On the upside, you have, at certain times, shown that you do possess the overall qualities of resilience. Add to your repertoire of coping strategies in order to further develop this important trait. For example, consider the spiritual and psychological benefits of meditation and exercise. Relaxing activities allow you to detach yourself from the negative clutter that may sometimes fill your mind and helps you to gain perspective of a situation, while exercise releases tension and floods your body with feel-good hormones.
Overall, you are a fairly resilient individual. You are generally able to bounce back easily from a variety of trying situations and get on with your life. Essentially, you possess most of the characteristics of a ‘survivor’, such as flexibility, self-confidence, optimism, and an ‘internal locus of control’ – you believe that you have the power to change your circumstances for the better. You do your best to avoid taking things personally and are able to put troubles in perspective, which helps prevent you from sinking into despair when the going gets rough. Keep it up, and don’t overestimate some of the simpler ways of dealing with life’s troubles. Laughter, talking to a trusted friend, and cosying up with a pet have been shown to have a wonderful impact on our peace of mind. n
WWW.LIFEHEALTHCARE.CO.ZA
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JOURNEY
STOP AND SMELL
THE WILD FLOWERS
IMAGE ISTOCK
From the psychedelic daisies of Namaqualand and the Cape West Coast to the wild pink and white cosmos of Mpumalanga, every year the wild flowers across the country put on a fabulous spectacle. Shake off your winter woes and enjoy the show with Bridget Hilton-Barber’s guide
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DOING THE DAISIES IN DARLING, DARLING
THE GREATEST FLOWER SHOW ON EARTH
THE GARDENS OF SOUL
Pure white, canary yellow, deep purple and wild pink. For a class act combined with food, wine and entertainment, head for the Darling Wildflower Show. The wild daisies bloom in the hillsides as the trendy little town of Darling puts on her party dress and throws the festival for flower heads and lovers of fine food and wine. The Darling Wildflower Show takes place 18–20 September 2015, and entrance is R50 per adult and R30 per child or pensioner. For more information, call 022 492 3361; email: info@darlingtourism.co.za or visit www.darlingtourism.co.za
Wild carpets of intense purple and acid pink. Entire fields of incredible yellow. Great swathes of orange and white speckles. They call the spring wild flowers of the Cape West Coast and Namaqualand the greatest flower show on earth. Every year, the air is filled with the collective gasps of delight as thousands of visitors head out to see the spring wild flowers in bloom. Experts say the best places to view flowers up north are Namaqua National Park near Springbok, and Nieuwoudtville near Van Rhynsdorp. As the floral spectacle moves south with changing habitats and temperatures, you should head for the Biedouw Valley and Ramskop Wildflower Garden in Clanwilliam. Other stops of note are the Skilpad section of Namaqua National Park near Kamieskroon, West Coast National Park at Langebaan and the flower reserves around Darling. For more information, visit www.capewestcoast.org, call West Coast Tourism on 022 433 8505 or call West Coast Flower Hotline on 072 938 8186.
‘The kiss of the sun for pardon, the song of the birds for mirth, one is nearer God’s heart in a garden, than anywhere else on earth.’ So said Dorothy Frances Gurney, and the plaque inscribed with her poem just about says it all when you stand in the gardens of Cheerio in Haenertsburg in spring. The azaleas bloom in an astonishment of pinks – rose, salmon, shell-pink, fuchsia – cherry blossoms are exquisitely white, and it’s all reflected in three ponds that are the feature of this exotic English garden. Enjoy a cup of tea or coffee, or linger over a glass of wine looking on to the water. There are self-catering chalets on the property. For more information, call Cheerio Gardens on 083 355 0835; email: sarah@brandcafe.co.za or visit www.cheeriogardens.co.za n
COSMOS COUNTRY Swathes of wild pink, purple and white cosmos break out in Mpumalanga in late summer. Welcome to Cosmos Country, as the region has been dubbed. It straddles the borders of the Free State and Gauteng in the south-western part of Mpumalanga and is popular with weekenders who come to enjoy the show. For more information about places to stay and things to do, call Cosmos Country Tourism Centre on 017 620 6282 or visit www.mpumalanga.com
LIFE PLUS EXTENDED FLOWER POWER HOUR
IMAGE ISTOCK
To maximise your enjoyment of the greatest flower show on earth, you need to catch flowers when the sun is strongest – from 11am to 3pm – known as the extended ‘Flower Power Hour’. Remember hats, sunglasses and sunblock. If you’re enjoying the flowers with your family, remember that children have a less well-developed defence system, so they need extra protection. The risk caused by sun exposure is 10 times higher for them.
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HEALTH HEART MONTH / NEW CANCER TECHNOLOGY / MEDICATION AND WEIGHT GAIN / YOU AND YOUR PREEMIE
‘MY OWN PRESCRIPTION FOR HEALTH IS LESS PAPERWORK AND MORE RUNNING BAREFOOT THROUGH THE GRASS.’
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LESLIE GRIMUTTER
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COVER FEATURE
WOMEN:
KNOW YOUR HEART Every year, heart disease kills one out of six women in South Africa. Early detection is essential to help reduce the incidence. Charlene Yared-West speaks to Life Healthcare cardiologists and presents the facts
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S
EPTEMBER IS HEART Awareness month in South Africa and World Heart Day is celebrated globally on 29 September. Contrary to popular belief, heart disease isn’t something that only affects men. Despite awareness efforts over the past 10 years, only 54% of women recognise heart disease as their number-one killer.
The facts of the matter
Most people are familiar with the formula for good health: don’t smoke; get daily exercise; choose to eat healthy food along with a balanced diet; reduce your stress levels. Common sense, right? Surely most South Africans are getting this formula correct? Wrong. Cardiovascular disease is the second leading cause of death in South Africa, second only to HIV and Aids – and this is even more staggering when you consider that 80% of cardiovascular disease can be attributed to diet and lifestyle, and is therefore preventable just by living a healthier life. It’s a common misconception that heart disease is typically a man’s disease and breast cancer a woman’s – heart disease is the biggest killer among women, globally, and kills more women than men in South Africa. Research shows that more than 500 000 women die in the US each year of cardiovascular disease, making it their number-one killer – not breast cancer, which accounts for around 60 000 deaths annually.
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Heart attack, Hollywood style
‘Many women do not even realise they are having a heart attack (and are more likely to wait when they experience symptoms), and when they get to hospital say they have indigestion or backache, not chest pain,’ says Life Healthcare cardiologist Dr Jens Hitzeroth. ‘Often, women with heart problems present in an atypical way, which may result in a delayed diagnosis and treatment. We tend to think about the “Hollywood heart attack”, which presents with severe chest pain, but it’s not uncommon for women to have generic symptoms.’ Dr Hitzeroth explains that the longer the heart muscle is without adequate blood supply, the worse it is for the heart tissues, which die without oxygenated blood. According to a report by the American Heart Association, almost two thirds of women who die suddenly of heart attack had no previous symptoms. Women might feel run-down or are more likely to experience shortness of breath, back or neck pain or fatigue. ‘These are not your typical symptoms and because so many women do not recognise the seriousness of their condition, they’re less likely to seek out emergency help,’ says Dr Hitzeroth. ‘Many women are so busy taking care of everyone else that they pay little attention to themselves.’
What does it mean to have heart disease?
‘The disease includes a variety of conditions where the heart is affected adversely by vessel blockages, heart infections, inflammation and birth defects with one of the most common conditions of the heart called
Are you having a heart attack? Not feeling yourself? Look out for the following warning signs that you could be having a heart attack.
– Chest pain – Pain radiating to the jaw or arm – Uncomfortable pressure in the chest area – Nausea and vomiting – Abdominal pain – Back pain – Unexplained fatigue – Dizziness and sweating If you experience symptoms suggestive of a heart attack, don’t delay in getting to a hospital that has a cath lab,’ says Dr Hitzeroth. ‘Otherwise known as a catheterisation laboratory, it is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualise the arteries and chambers of the heart and treat any current or potential problems. These labs can be found all over the country at selected hospitals and if you are having a heart attack, patients are best treated at one of these.’
MEET OUR EXPERT DR JENS HITZEROTH, cardiologist Dr Hitzeroth consults and performs procedures at Life Bay View Private Hospital in Mossel Bay, and is in private practice at Life Vincent Pallotti Hospital in Cape Town. His interests are in interventional cardiology and device implantation. He’s a member of the executive committee of the Heart Failure Society of South Africa. WWW.LIFEHEALTHCARE.CO.ZA
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COVER FEATURE
What treatment is available?
1
MEDICAL THERAPY: ‘Studies have shown that women
are less likely to be on aspirin or beta blockers or statins and the reason for this is unclear,’ says Dr Hitzeroth. ‘These medications have been proven to be effective in women and careful attention should be paid to establishing women on these life-saving drugs. Antiplatelet therapy for acute coronary syndromes should include clopidogrel and aspirin.’ HORMONE REPLACEMENT THERAPY: ‘Studies suggest that early hormone replacement therapy may lower the risk of heart disease,’ says Dr Hitzeroth. REVASCULARISATION: ‘This refers to opening up blood vessels that are blocked or have a bad narrowing. It is usually done percutaneously with balloons and stents,’ says Dr Hitzeroth. ‘It is especially important to do this in patients who have a heart attack.’ Above all, adds Dr Hitzeroth, lifestyle change is still the most important and often effective intervention.
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Am I at risk?
According to Dr Hitzeroth, the primary cardiovascular risk factors for women are similar to those in men. ‘Diabetes and smoking, in particular, seem to increase the risk more in women than in men. The risk of fatal coronary heart disease in women with diabetes is about two-fold higher when compared to men,’ says Dr Hitzeroth. ‘Cigarette smoking, from as little as one to two cigarettes per day, elevates the cardiovascular risk of women significantly. About 50% of all coronary events in women are associated with smoking. Should a female patient be able to stop smoking, her cardiovascular risk would return to that of a woman who hadn’t smoked within two to three years – and that is significant.’
These are the most common risk factors: – Smoking – Diabetes – Hypertension – High cholesterol – History of peripheral vascular disease – Family history of premature coronary artery disease – Previous history of coronary artery disease – Elevated triglycerides – Obesity – Sedentary lifestyle – Age greater than 55 years
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Heart to heart: THE TRANSPLANT CONNECTION
According to Life Healthcare cardiac surgeon Dr Otto Thaning, 3 500 heart transplants are undertaken per year worldwide. In South Africa, there are only four centres capable of performing heart transplants and the total amount is relatively low – about 20 to 30 per year. ‘A team of cardiac specialists normally determines eligibility for cardiac transplantation for a patient. This team usually includes cardiologists, cardiac surgeons, physicians, social workers and counsellors, who assess every possible aspect of the patient’s physical and mental suitability to undergo the procedure,’ says Dr Thaning. ‘Ideally, the recipient shouldn’t have other significant diseases or disorders and should be in a family or support environment where adequate care is possible at all times and at all levels. A heart transplant is considered for a patient with end stage cardiac disease where no further medical or surgical options exist for improving the patient’s quantity or quality of life.’ Dr Thaning adds that more men than women undergo heart transplants and about 60% of transplants undertaken worldwide are in males. The reason for this is more related to the greater prevalence of acquired vascular and cardiac disease in men compared to women worldwide. In general, men do marginally better than women in terms of survival statistics.
Become an organ donor It’s very easy to sign up. Simply visit www.odf.org.za/become-an-organ-donor to register. It’s completely free and one donor can save seven people.
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ischaemic heart disease,’ explains Dr Hitzeroth. ‘This occurs when the arteries that supply blood to the heart muscle become hardened and narrowed, causing reduced blood flow to the heart muscle.’ Angina, he explains, is chest pain or discomfort that occurs when the heart muscle doesn’t get sufficient blood and oxygen, and this is usually aggravated by exertion, such as exercise. A heart attack occurs when the diseased and hardened arteries of the heart become too narrow or a clot forms, and the heart muscle may be suddenly starved of oxygen resulting in death of a heart muscle segment. Other forms of heart disease include heart failure, rheumatic heart disease and other inflammatory conditions as a result of infection of the heart muscle.
SPRING 2015
2015/09/03 2:28 PM
DOCTOR’S ORDERS
How can women lower their risk factors?
Dr Hitzeroth shares six ways:
AVOID
cigarette smoking – this includes passive side-stream smoking.
FOLLOW
a balanced diet and try to maintain/achieve an ideal body weight (BMI 20–25).
GET
treatment for hypertension and diabetes.
DO
at least 30 minutes of moderate aerobic physical exercise on most days of the week.
CHOLESTEROL
should be lowered to target levels (less than 2.5mmol/L).
SECONDARY PREVENTION
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with aspirin, statin, beta blockers and ACE inhibitors should be offered to women (as it should to men) together with lifestyle modification after coronary events.
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UNDER PRESSURE
Mrs Renee Lucas, 48, received treatment at Life Vincent Pallotti Hospital from Dr Hitzeroth.‘I wasn’t aware I had heart problems at all. I had symptoms relating to high blood pressure and high cholesterol along with other aches and pains. I was on blood pressure medication, but for the longest time I didn’t feel well. I was always tired, often dizzy and just felt exhausted most of the day. One day, when I was spring cleaning, I felt an uncomfortable squeezing with an electric-like sensation in my chest. It worried me, so I made an appointment with a physician and saw him five days after that episode. All my vital signs seemed fine, but a blood test confirmed I had suffered a heart attack. It was as if everything went into slow motion at that point, because the next day I was in theatre, where the cardiologist discovered a blocked artery in my heart, which required inserting stents. They said how lucky I was to be alive, as I was heading for another heart attack had I not received treatment. My experience has changed my life. I am more aware of my health now and I also value my life more and realise how quickly things can change. It was a very sobering experience for me – and my family.’
Know your numbers BLOOD PRESSURE
CHOLESTEROL
BLOOD GLUCOSE
WEIGHT STATUS
According to the Heart and Stroke Foundation, South Africa has one of the highest incidences of high blood pressure worldwide. A recent international survey found that eight in 10 adults over the age of 50 in South Africa have high blood pressure.
With a family history of high cholesterol, levels can be two to four times higher than normal. If these individuals don’t make dietary changes and start medication, they will suffer heart disease at a very early age. In contrast, slightly elevated cholesterol in a person who is otherwise fit and healthy will have a marginal and often insignificant impact.
Abnormally raised blood glucose can be a sign of insulin resistance/ glucose intolerance or diabetes. Sometimes central obesity, raised blood glucose, high blood pressure, and abnormal cholesterol levels are present in the same person. This is a condition known as metabolic syndrome and it’s an important risk factor for cardiovascular disease.
Forty percent of women in South Africa are obese, the highest prevalence in sub-Saharan Africa. In South Africa, cultural and social perceptions also affect body image. In a recent national survey, two thirds of adults were happy with their weight, and the overwhelming majority agreed their ideal body image was being ‘fat’. Being overweight is often associated with health and prosperity, and weight loss with illness.
Ideal blood pressure is
120/80mmHg.
Blood pressure higher than 140/90mmHg is classified as high blood pressure or hypertension. Blood pressure over 130/85mmHg is called pre-hypertension.
THE IDEAL NUMBERS:
If tests measure elevated total cholesterol
(greater than 5mmol/L), further tests are needed.
IMPROVE YOUR CHOLESTEROL LEVELS
IMPROVE YOUR BLOOD PRESSURE
Lifestyle changes to control blood pressure include reducing salt intake, eating more fruit, vegetables and dairy, increasing physical activity, weight loss and stopping smoking.
Lifestyle changes to improve cholesterol levels include changing the amount and types of fats in the diet, reducing sugary and refined starches, increasing activity, weight loss and smoking cessation.
THE IDEAL NUMBERS:
An ideal value is less than 8mmol/L. Caution should
be taken to interpret this if done within an hour after a very starchy or sugary meal. A level above 11mmol/L is indicative of diabetes. A fasting blood glucose test is typically done in the morning after an overnight fast. This provides a clearer picture and an ideal value should be less than 6mmol/L. A value between 6 and 7mmol/L can point to glucose intolerance.
IMPROVE YOUR BLOOD GLUCOSE LEVELS
Treatment for insulin resistance may require medication in addition to lifestyle and dietary changes.
THE IDEAL NUMBERS:
Central weight distribution is a greater risk factor for cardiovascular disease and metabolic syndrome than general obesity, therefore waist circumference is a useful diagnostic tool. The ideal BMI range is between
18.5–25kg/m2.
Between 25 and 30kg/m2 is overweight, and a BMI of over 30kg/m2 is obese. Waist circumference measurements of greater than 80cm and 94cm identify overweight females and males respectively. REDUCE YOUR WEIGHT
Regular exercise and a balanced diet are key. ■ 34
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SPRING 2015
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MRS General Advert 2015_Life_Mag.indd 1
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H E A L T H I N N O VA T I O N
NEW TECHNOLOGY
Life Vincent Pallotti Hospital, in Cape Town, has upgraded its successful ‘first for Africa’ multimillion-rand Novalis Tx radiotherapy equipment, better known as Novalis Radiosurgery. Charlene Yared-West finds out more about its faster, more accurate targeting and treatment of previously untreatable tumours 36
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WAGES WAR AGAINST CANCER SPRING 2015
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AN CANCER REALLY be beaten? The disease has become so common as more and more people are diagnosed with some form of it. Sadly, we are all programmed to think it could never happen to us or to someone we love – a family member, friend or colleague – but then it does. The question we want answered then is: can cancer be beaten? Research from the University College London School of Pharmacy projects that worldwide, cancer is expected to reach 26 million new diagnoses and 17 million deaths by 2030. However, with new therapies, pharmaceuticals and technologies, such as the Novalis Tx equipment, constantly being developed, many forms of cancer could be eradicated for most age groups by the year 2050. Last year, it was reported that more than one million patient treatments worldwide had been performed with the Novalis Tx machine since its launch in 2007, and an estimated 200 000 treatments are now performed annually. Studies have shown one out of every two cancer patients can benefit from Novalis Radiosurgery, which is good news for those diagnosed. ‘I believe that this machine offers top-end technology, which allows us to treat our patients with a high degree of accuracy and, due to its significant output, can also minimise treatment times,’ says Dr Rainer Fröhling, radiation and clinical oncologist at Life Vincent Pallotti Hospital in Cape Town. ‘It allows us to target cancers in sensitive areas and minimise side effects, and in conjunction with other treatment modalities, offers the chance of better outcomes to our patients.’
Saving lives without scalpels
IMAGE SHAUN ROY
The Novalis Tx has been in operation since 2007 in selected countries around the world. It was launched in South Africa at Life Vincent Pallotti Hospital in December 2013, six years after its inception. It is a non-invasive radiotherapy using state-of-the-art high-tech systems to destroy cancer anywhere in the body in short 20-minute sessions – without the need for surgical incisions or serious operations. With its sleek design, the machine rotates around the patient from every angle, delivering radiation beams on to the body, where needed. The team of attending medical professionals, including oncologists, a medical physicist and radiotherapists, skilfully manage and guide the Novalis Tx, obtaining necessary information about the tumour during treatment. ‘The Novalis Tx is used to treat both malignant and benign conditions. In simple terms, it produces radiation in the form of photons and electrons used in radiotherapy, which causes damage to the structure of a tumour cell, resulting in the cells dying and the tumour shrinking – this can be seen in follow-up scans,’ explains Dr Fröhling. ‘The Novalis Tx produces radiation, which enters the patient from the outside and targets the tumour on the inside. It has the technology to make its treatment as accurate as possible, and has an array of imaging tools to ensure precision.’ The machine is so smart, says Dr Fröhling, it can take into account the patient’s breathing so as to focus the radiation beam on to the tumour only, while minimising the dosage to normal tissues around the tumour. ‘These highly focused treatments are particularly useful for brain tumours, as well as those found in the lung, pancreas, spine and liver, where you have to be very careful not to damage surrounding tissues – and where surgery would be very difficult.’ Dr Fröhling adds the machine is linked to sophisticated software to plan the treatment, assess the dose and positioning of radiation in the patient, and deliver the radiation with a high degree of accuracy.
How does it compare to other cancer therapies?
Besides its acute precision to the millimetre, normal tissues are increasingly spared of radiation damage. This can therefore also lower the side effects of the treatments as the Novalis Tx shapes the radiation beam precisely to match the tumour or lesion. Conventional radiotherapy also usually takes place over an extended time frame of between two and six weeks, whereas Novalis Radiosurgery is much shorter and can be done in as little as one treatment in certain cases. ‘I do believe the technology available to us with the Novalis Tx allows for highly accurate radiotherapy and, in the correct indication, this accuracy is clinically relevant,’ says Quinton Africa, lead therapist at the Novalis Tx unit at Life Vincent Pallotti Hospital. ‘Chemotherapy and surgery maintain a vital role in the successful treatment of many cancers, and all available treatment options should be accessible to our patients to maximise their results. Radiotherapy on certain brain tumours may lower the extent or eliminate the need for surgery and so decrease surgery-related death.’ The cost of treatment with the Novalis Tx is more than conventional radiotherapy, but with the correct motivation for the correct indication, it is considered by most medical aids. Eligibility for radiosurgery depends on the type and location of the tumour and the extent of the patient’s disease, and is determined on a case-by-case basis.
Minimal side effects
Novalis Radiosurgery does not require anaesthesia and usually, there is no scarring and very little risk of infection when compared to conventional surgery, explains Africa. ‘You might, however, experience a headache, dizziness and fatigue immediately after, so it would be advisable to arrange for transport home after the treatment,’ he says.
Meet the team
The specialised Oncology Centre at Life Vincent Pallotti Hospital embodies a multidisciplinary team approach to cancer care – a distinction the unit is very proud of. Patients are treated by a team of oncologists, radiotherapists, medical physicists, nurses, surgeons, psychologists and other specialists that work together for a truly multidisciplinary approach to cancer treatment in a modern, convenient and comfortable setting. One team member, radiotherapist Lesle Campbell, says it’s her responsibility to deliver accurate treatment and ensure patients are cared for, informed and happy. ‘I respect the fact that I’m helping patients at a very difficult time in their lives. I am able to listen, encourage and support as well as actively participate in helping them overcome cancer,’ she says. ‘I also love that my job is technically challenging. It is not an easy career path, but it is a rewarding one.’ Radiotherapist Jamie-Lee van Niekerk ensures that treatment on the Novalis Tx is administered with minimal discomfort for patients. ‘It is amazing to see how technology has changed the landscape of cancer care,’ she says. ‘It is a very fast-paced job that advances and changes all the time. This is part of why I love what I do.’ Another radiotherapist, Lucinda Oosthuizen, explains that a large part of her role is to listen to the stories of the families she sees. ‘We have to inform families about treatment and the side effects – we really do build strong relationships with our patients,’ she says. ‘The gratitude most patients display for the role we have played in their lives and their treatment journey, and seeing their condition improve, is rewarding and fruitful.’ n
Opposite page: The Novalis Tx Treatment Team, from left to right, Lesle Campbell (radiation therapist), Lucinda Oosthuizen (radiation therapist), Quinton Africa (lead therapist), Ali Gurmani (physicist), Dr Rainer Fröhling (radiation oncologist), Dr Jacqueline Hall (radiation oncologist) and Jamie-Lee van Niekerk (radiation therapist) WWW.LIFEHEALTHCARE.CO.ZA 37
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H E A L T H I N N O VA T I O N
Other treatable conditions with Novalis Radiosurgery ‘We are finding new ways of using the technology to treat various conditions all the time; the sky is the limit,’ says Dr Fröhling. ‘The patients who entrust us with their care are our daily motivation. Working with a team of dedicated radiotherapists, planners, a physicist and oncologists allows us to get the best out of our equipment for our patients.’ According to Dr Fröhling, the machine can be used to treat malignancies, benign tumours and some non-cancerous conditions included in the list below: – Malignant brain tumours (metastasis from other cancers, primary brain tumours, tumours of the skull) – Benign tumours of the brain and in the head and neck area (meningiomas, acoustic schwannomas, pituitary adenomas) – Functional pain conditions (trigeminal neuralgia) – Blood vessel malformations (arterio-venous malformations) – Tumours involving the ocular structures – Tumours close to the spine where radiation dose to the nerves/spinal cord needs to be minimised – Malignant tumours of the pancreas – Liver tumours, such as metastasis – Lung tumours (primary lung cancers and metastasis)
MEET OUR EXPERTS
DR RAINER FRÖHLING, clinical and radiation oncologist Dr Fröhling opened his practice, Above the Waves Oncology, at Life Vincent Pallotti Hospital in January 2015. He recently trained in Germany under the leadership of Professor Reinhard Wurm, one of the world’s leading radiosurgery oncologists.
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QUINTON AFRICA, lead therapist He is a radiation therapist who is very passionate about the quality of care patients receive at their facility. ‘With the upgrade, radiotherapists can accurately place the patients in the treatment beam in order to treat tumours anywhere in the body.’
SPRING 2015
2015/09/03 3:17 PM
HOT TOPIC
EVERYBODY’S TALKING ABOUT...
VACCINATIONS
A generation ago, people routinely took their children to the clinic to be inoculated. These days, there is growing resistance, and the results may put us all in danger. Jamie Parker investigates
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T THE TURN of the millennium, polio was close to being eradicated thanks to good global inoculation programmes – the same thing that wiped out smallpox. Measles was fairly under control too, but then, very recently, it reared its ugly – and life-threatening – head and we began to hear reports of outbreaks. The disease that had killed 2.6 million people a year before a vaccine was developed had resperrfaced. Three months into 2014, the US was reporting a record number of outbreaks for that year. The resurgence is accredited to a growing movement of ‘anti-vaxxers’, who believe vaccines are unsafe and therefore refuse to inoculate their kids. ‘Vaccines are simply there to prevent disease,’ says Dr Dharmandra Daya, a paediatrician at Life Cosmos Hospital. ‘There are no long-term bad outcomes as so many believe.’ Much of the anti-vaxxer movement revolves around the idea that the MMR (measles, mumps, rubella) vaccine causes autism. But there is no legitimate scientific controversy about whether or not they are safe. The original study that began all the doubt has been retracted outright, and the evidence against administering the MMR vaccine to healthy individuals is completely without merit. ‘Confusion arises because the time at which kids get their shots is also when we start to see signs that a child has autism,’ says Dr Daya. ‘A lot of effort has been put into trying to find a link between vaccines and autism, and there is absolutely no evidence to suggest it as a cause. It is a pure coincidence.’ The problem with the anti-vaccine stance is that those parents believe they are making a decision for their own family. But there are two important considerations here: first, if their children don’t contract any serious infectious diseases, it’s because they are relying on what
immunologists call ‘herd immunity’ – their kids don’t get sick because everyone else’s children have been vaccinated. Second, they place the public in greater danger of what is increasingly being seen as a public health crisis; a ticking time bomb of sorts because vaccination works best when everybody does it. That’s how diseases, such as measles, will be completely stamped out. To minimise outbreaks, for example, 90% of people need to get their shots. So if the anti-vaxxer movement moves beyond the 10% tipping point, we could be in trouble. ‘Side effects can also put people off,’ says Dr Daya. ‘They’re not bad, just a bit of fever, discomfort and irritability, and usually paracetamol will sort the symptoms out. But parents aren’t warned about the side effects. I find once parents know what to expect, they’re a lot calmer.’ Vaccines can’t overwhelm your child’s immune system. They contain fewer antigens than kids pick up just crawling around the living-room floor. And they won’t get the disease the injection is supposed to prevent, a common myth around the flu vaccine. They may still get a bout of flu, yes, but it won’t be the strains in that year’s injections; the strains considered to be dangerous. Finally, vaccines don’t provide 100% protection against all diseases. For example, Dr Daya points out that the BCG vaccine is only about 40–50% effective against TB. Rotavirus vaccines are also only up to 70% effective, but given how delicate a young child’s immune system is, it will substantially reduce their risk of some serious, potentially life-threatening diseases as well as give them a better shot at good health. n WWW.LIFEHEALTHCARE.CO.ZA 39
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GOOD MEDICINE
YOUR OPTIONS
Maintaining a healthy weight can be challenging when your medication leads to additional kilos. Lisa Witepski investigates 40
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WEIGHING UP SPRING 2015
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EING TOLD YOU need to take chronic medication can require a real mental adjustment, but more upsetting still is the acknowledgement that certain long-term treatments may contribute to weight gain. According to Dr Latisha Raghubir, a psychiatrist practising at Life Springs Parkland Clinic and Life Glynnview, weight gain is a common reason patients discontinue their medication. Her observation is borne out by an article on WebMD.com, which explains that as many as 25% of people taking antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), will gain about five kilograms during the course of their treatment. It’s a bitter pill to swallow, especially when you’re already trying to process the fact that your health needs some extra attention.
Not all medications are created equal
Dr Lizl Smith, an endocrinologist at the Life Little Company of Mary Hospital, pinpoints antipsychotic drugs as major contributors to weight gain. However, she cites a study by the Boston University of Medicine, ‘Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline,’ which notes several other culprits, among them contraceptives, glucose-lowering medication, insulin therapy, hypertension medication, anti-epileptic drugs, antiretroviral therapies, corticosteroids (commonly used to treat chronic inflammatory diseases, such as rheumatoid arthritis) and antihistamines. Dr Raghubir points out that it’s important to note not all these medications (especially antipsychotic drugs) cause weight gain, just as not all patients who are prescribed such treatments will find themselves having to loosen their belts. ‘However, there are certain “culprit” medications in each medicine class that psychiatrists know are more prone to cause weight gain than others,’ she says.
discuss options. ‘It’s vital to have an open relationship with your prescribing doctor. Don’t be afraid to ask questions,’ she advises. By keeping channels open in this manner, you’re laying a foundation, which makes it possible to jointly plan a course of treatment that’s optimally beneficial, and with the fewest side effects. ‘This means choosing the medicine least likely to cause weight gain from the outset, especially in a patient who may already be concerned about the problem,’ says Dr Raghubir. Maintaining an open relationship with your doctor also means creating the space to report unwanted weight gain (or other negative side effects) as your treatment progresses. The sooner you make mention of such conditions, the better, so that corrective action can be taken timeously. If you’re still experiencing negative side effects, it’s worth discussing alternative options with your doctor. All medications work differently, which means that a specific drug may be less effective in treating your particular condition. However, Dr Raghubir points out that it’s better to switch drugs than to give up taking your medication altogether, or to face a new set of risks and concerns caused by weight gain, such as diabetes. New medication may also prevent the no-less-worrying situation of abusing other medications or trying alternate solutions, such as extreme diets, to stop weight gain. There is, however, the danger that your condition may relapse.
It’s vital to have an open relationship with your prescribing doctor. Don’t be afraid to ask questions
The why and how
Just what is it about these meds that causes such an unwanted side effect? In the case of antidepressants, the reason may be as simple as patients rediscovering life’s pleasures, including food. There’s also a theory that medication may affect metabolism, while some researchers suggest that antidepressants may stimulate appetite – especially a craving for carbohydrates.
Taking action
For patients who suddenly have to come to terms with a new body image, the reasons behind weight gain aren’t as important as what to do about it. Dr Raghubir says the first and most important step is empowering yourself as a patient. Yes, it’s critical you listen to your doctor’s advice, but that doesn’t mean you can’t
This is something that must be carefully considered by your doctor, and the two of you should discuss the pros and cons until you reach a solution you’re both comfortable with. You may also consider ‘non-pharmacological’ solutions, Dr Raghubir suggests. In fact, she says that scientific research has found these to be among the most important and effective ways of handling the problem, so it’s a good idea to talk about possible techniques at the outset. These include cognitive behaviour therapy (CBT), nutritional counselling with a dietitian and following an exercise programme. An important point to keep in mind, and one your doctor will most definitely warn you about, is that while it may be tempting to find quick-fix ‘band-aid’ solutions, such as appetite suppressants, laxatives, diet pills, detox products and stimulants, which promise miraculous and speedy weight loss, Dr Raghubir says these should be strictly avoided, especially if you are receiving treatment of psychiatric illness. ‘These preparations are contra-indicated when using psychotropic drugs,’ she notes. ■
IMAGE ISTOCK
Four out of 10 people treated with antidepressants improve with the first one they try. If the first antidepressant medication
help, the second or third often will. Most people eventually find one that works for them. Yet many people who could LIFE PLUS doesn’t benefit from an antidepressant never try one, often because of fears about [their side effects]. www.webmd.com WWW.LIFEHEALTHCARE.CO.ZA 41
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THE BABY FILES
BORN
TOO SOON One of the risks of pregnancy is that your baby may be born prematurely. Jamie Parker finds out what you should know if this happens
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T
HE TEXTBOOKS WILL tell you pregnancy lasts 40 weeks, but your doctor will tell you babies don’t read textbooks – some are born early and some are born slightly late. A premature birth, however, is one that takes place more than three weeks before the baby is due, before your 37th week of pregnancy. Because these babies have less time to develop in the womb, the earlier they are born, the more complicated their medical problems. ‘Most premature births are under 32 weeks,’ says Dr Dharmandra Daya, a paediatrician at Life Cosmos Hospital, ‘and in South Africa, we’re not allowed to resuscitate a baby who is born before 26 weeks of
Premature babies face a wide variety of short- and long-term health challenges, and your paediatrician will guide you through dealing with each one as it arises. There may be other medical staff in the neonatal intensive care unit (NICU) taking care of your infant, but you are also an important part of the team, and you will work with them, eventually learning how to hold, feed and care for your child. Premature babies usually stay in an overhead warmer at first, and are moved to an incubator once they reach a certain weight and age. This helps them to maintain a normal body temperature. From there, they’ll generally move to a crib, and finally they’ll be discharged. ‘When possible, the NICU staff will show you
Many women who have a premature birth have no known risk factors, so it pays to be mentally prepared gestation or weighing less than 600g. In the public sector, the weight criterion is a bit higher because of a lack of facilities.’ Premature babies can quickly develop serious complications, such as infection in the bloodstream (sepsis) and respiratory distress syndrome, but this depends on how early they are born. Some of the signs of a premature baby include: – Small size, with a disproportionately large head – sometimes the brain is growing at the correct rate, but the body isn’t because of factors affecting blood flow to the body – Sharper-looking, less rounded features than a full-term baby’s features, due to a lack of fat stores – Fine hair (lanugo) covering much of the body, as well as under-developed bones, large muscles and sensitive skin – Low body temperature, especially immediately after birth due to a lack of stored body fat – Laboured breathing or respiratory distress – Lack of reflexes for sucking and swallowing, leading to feeding difficulties
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– Low blood sugar – Jaundice
It’s not always clear why a baby is born prematurely, says Dr Daya, but there are a number of factors that may increase your risk of premature birth: ‘A previous premature birth, multiple birth, an interval of less than six months between pregnancies, in vitro fertilisation, smoking, drug abuse, poor nutrition, infection, high blood pressure, diabetes or even a stressful life event can result in a premature birth. But it can really happen to anyone – many women who have a premature birth have no known risk factors, so it pays to be mentally prepared.’
how to hold your baby with skin-to-skin contact, known as “kangaroo care”,’ says Dr Daya. ‘It’s important for temperature control and for bonding between baby and parents.’ Your little one’s vital signs will also be continually monitored – blood pressure, heart rate, breathing and temperature are all watched very carefully, and a ventilator may be used to help with breathing. At first, they may need a feeding tube, but when he or she is strong enough to suck, you will be helped with breast- or bottle-feeding. Premature babies may also spend time under phototherapy lights to treat infant jaundice, and they may even need a blood transfusion as they aren’t always able to make their own red blood cells. And finally, there are medications they may be given to help their lungs mature, or strengthen their breathing and heart rate, for example. They may need oxygen therapy, which comes with a risk of retinal damage, but Dr Daya says paediatricians have to balance the eye damage against the potential brain damage the child would have without the therapy. Premature babies need to be regularly checked for one to two years after they’re born. ‘They need to be carefully monitored for developmental delays and disabilities that may be identified over time,’ says Dr Daya. ‘Your baby will also need vaccinations but these may be delayed, so keep talking to your paediatrician for advice based on your baby’s progress.’ It’s also important to remember that your baby’s immune system is likely to be very weak, so ensure that people they regularly come into contact with have their own immunisations up to date. In fact, the less contact they have with people the better, as they are less likely to pick up infections. WWW.LIFEHEALTHCARE.CO.ZA 45
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THE BABY FILES
Caring for your premature baby can be physically and emotionally exhausting. There’s a great deal of anxiety around their health – or even survival – and you may feel angry, guilty or overwhelmed. It’s going to be difficult and, most days, you will be tired and emotional. But there are things you can do to help stay calm and cope with the challenges.
MEET OUR EXPERT
DR DHARMANDRA DAYA, paediatrician, Life Cosmos Hospital MB CHB NATAL(1989), FC PAED (SA) (1998) Dr Daya has a passion for children and child health. This month he also lent his expertise to ‘Everybody’s Talking About…Vaccinations’ on page 39.
THESE SIX TIPS MAY HELP: Learn everything you can about your baby’s condition. Read as much as you can: good books, information brochures and even reliable websites can be sources, as well as talking to your baby’s doctor and other caregivers. Look after yourself. Get as much rest as possible and ensure you’re eating healthily. You are no good to your baby if you pass out from exhaustion. Maintain your milk supply. Get a breast pump and keep using it until your little one is able to breast feed. The hospital staff will be able to show you how to use it and how to store the milk. Ask for help. You’re going to be spending a lot of time in the hospital, so accept help from others: allow them to look after your other children, bring meals, clean your house or run errands for you. Most people will be happy to help you in practical ways. Keep a journal. Record the details of your baby’s progress as well as your own thoughts and feelings. You may want to include pictures of your baby so that you can see how much he or she changes from week to week. This may also help you to remember questions you want to ask your baby’s paediatrician. Use your support system. Talk to your partner or spouse, friends, family or baby’s caregivers. Find out if there’s a social worker you can talk to, or if there’s a support group in your area. (Your baby’s caregivers may be able to suggest a support group too.) Knowing that others have experienced something similar can be very helpful. Caring for your premature baby is going to be a challenge, but babies are extraordinarily resilient and often beat incredible odds. Just take it one day at a time and celebrate every small victory along the way. n
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Questions To Ask One of the scariest parts of having a premature baby is the uncertainty. In addition, your tiny baby will be hooked up to many different tubes and machines, which can be bewildering for new parents. The key is to ask questions – write them down if you need help remembering. Here are some important ones: How is my baby’s condition? Has anything changed? How does this equipment help my baby? Why are you giving my baby medication? What types of tests does my baby need? When can I hold my baby? Will you show me how? How long will my baby have to continue tube feedings? When can I try to breast- or bottle-feed my baby? When will my baby be able to focus his or her eyes? Who should I contact if I have questions about my baby’s care? Can I bring in a blanket or family photos to personalise my baby’s incubator? What can I do to help care for my baby while he or she is in the NICU? When will my baby be able to come home? What do I need to know about caring for my baby once we’re home? How often do we need to come back for follow-up visits after discharge?
Associate professor of paediatrics at the University of North Carolina and co-author of Preemies: The Essential Guide for Babies Dr Mia Doron says the majority of preemies will catch up in size within the first year, with only a few who will never catch up. In some cases there’s a medical cause for the discrepancy, in others it’s impossible to determine. Genetics is one possible cause. www.mamiverse.com
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1
SPRING 2015
2015/09/03 2:31 PM
POWER OF FIVE
TAKE ACTION
CLEAN HANDS SAVE LIVES
Here’s how to implement this important hygiene habit
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ASHING YOUR HANDS is one of the easiest and most effective ways to prevent infection. From the telephone to the toilet, your computer keyboard to the escalator rail, germs are everywhere and chances are they’ll end up on your hands. While you can’t wear protective gloves all the time, you can wash your hands regularly and properly. The Centers for Disease Control and Prevention says hand washing is like a DIY vaccine that involves just five simple steps – wet, lather, scrub, rinse, dry – to reduce the spread of diarrhoeal and respiratory illnesses so you can stay healthy.
WET
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your hands with clean running water (warm or cold), turn off the tap and apply soap.
LATHER
with the soap. Be sure to include the backs of your hands, between your fingers and under your nails.
SCRUB
for about 20 seconds. Need a timer? Hum the ‘Happy Birthday’ song twice.
RINSE
well under clean, running water.
DRY
your hands using a clean towel, or air-dry them.
Soap and water is the most effective method of cleaning your hands, however, you can use an alcohol-based hand sanitiser with at least 60% alcohol if soap and clean water are not available. Remember, hand sanitisers are not effective when hands are very dirty or greasy.
WWW.LIFEHEALTHCARE.CO.ZA 47
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She s' soaking up new
sounds and scents. Because your baby is the biggest sponge of all.
® Trademark © Johnson & Johnson (Pty) Ltd 2015
Giggles, tickles and your touch during a JOHNSON’S® bath have been shown to promote happy, healthy development. While the soothing scent, the soft lather and the silky smooth lotion after bath help enhance the experience.
Safe. Mild. Effective. To learn more about JOHNSON’S®, go to: www.johnsonsbaby.co.za Johnson’s Baby SA 0860 410032 (SA only)
jnjza@its.jnj.com
SMS jnj & your comment to +27 83 293 3273
so much more
CARE EYE CARE AWARENESS / RECIPES / HEALTHCARE HERO / THE POWER OF TOUCH / SHORT STORY
‘AT THE END OF THE DAY IT’S NOT ABOUT WHAT YOU HAVE OR EVEN WHAT YOU’VE ACCOMPLISHED… IT’S ABOUT WHO YOU’VE LIFTED UP, WHO YOU’VE MADE BETTER. IT’S ABOUT WHAT YOU’VE GIVEN BACK.’
I M A G E G ET TY/GALLO I MAG ES, OJO I MAG ES/PAU L B R ADB U RY
DENZEL WASHINGTON
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MY HEALTH
ABOUT YOUR VISION To celebrate Eye Care Awareness Month, and the importance of good eye health, Lisa Witepski shares 20 facts about your eyes
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20/20 FACTS SPRING 2015
2015/09/03 2:33 PM
F
ROM THE EXACT shape of the dimple in your child’s cheek to the fresh tones of spring leaves, our sense of sight is responsible for giving us so much pleasure. Of course, that’s not all. While your eyes allow you to delight in an athlete’s superlative performance or a magnificent artwork, they also protect you from danger, helping you discern the colours of a changing robot or identify a particularly gruesome-looking creepy-crawly. All of which adds impetus to the need to care for these complex, fascinating organs. That’s why October is designated Eye Care Awareness Month; a great opportunity not only to ensure your vision is in order, but also to screen for common eye disorders.
Did you know…? …the hue of your iris (coloured part of your eye) doesn’t stay the same throughout your life. It usually changes and takes on its permanent colour at around six months. …according to Dr Dylan Joseph, an ophthalmic surgeon at the Southern Cape Eye and Laser Centre, newborn babies can’t focus and do not have appreciable depth perception. This usually starts to develop from about six months. …the images you take in through your eyes are upside down. It’s up to your brain to invert them so you perceive them the right way around. …the eye is essentially an extension of your brain. The optic nerve, which implants at the back of your eye, is made up of millions of light-sensitive cells converging to form the nerve, which then tracks through your brain to the visual cortex located at the back of the brain. …often described as the ‘window to the soul’, the eye is in fact the window to your general health: an ophthalmologist can identify a number of medical conditions and systemic disorders simply by examining the eye.
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Common conditions
If a child is born with a squint, surgical intervention is usually required. However, if the squint develops after two years, it can more than likely be corrected with the use of spectacles. Contrary to popular belief, a cataract is not a membrane which grows over the outside of the eye. It’s a clouding of the natural crystalline lens inside the eye, which most commonly occurs with ageing. Today, cataract surgery is not merely about removing a lens and implanting a new one. Dr Joseph explains that many lens options are available, restoring your ability to read, for
example, or helping to eliminate or reduce refractive errors, such as astigmatism. ‘Presbyopia’ is the word used to describe loss of reading vision over the age of 45. Dry eye is usually associated with poor-functioning oil glands in the eyelid. Treatment requires more than lubricants: you should also use hot compresses and eyelid massage to mobilise these oils. Age-related macular degeneration is a genetic disorder. Smoking is the only behaviour that can modify the condition. Dr Joseph likens the effect of smoking on macular degeneration to ‘petrol on a fire’. Glaucoma too, is a genetic disorder, most commonly affecting white females over the age of 60. Flashing lights and floaters in the eye are usually a consequence of the gel in the eye pulling loose. This generally occurs in individuals older than 55. It’s imperative to have this condition checked by an ophthalmologist, says Dr Joseph. A pterygium is a small, red, fleshy lesion that grows on the surface of the eye in response to ultraviolet exposure, which is
An ophthalmologist can identify a number of medical conditions and systemic disorders simply by examining the eye another reason to remember your sunglasses! Amblyopia is the term used to describe the ‘switching off’ of an eye. The brain does this if one eye is much weaker than the other. This change usually takes place before the age of seven, and if the problem is not identified and treated, this eye will remain permanently ‘switched off’ for life, cautions Dr Joseph. Diabetes can affect the eyes in a number of ways; for example, it can cause your vision to become intermittently blurry or cause the fluid in the back of your eye to leak, thereby impacting your vision. It is therefore vital for individuals with newly diagnosed cases of diabetes (as well as established diabetics) to check in with their ophthalmologists regularly.
Getting treatment
Dr Joseph explains most eye surgery is conducted under topical (drop) anaesthesia, making it extremely safe. LASIK has become the first choice for correcting a number of refractive disorders, including short-sightedness, far-sightedness and astigmatism. The procedure makes use of cutting-edge technology and is considered safer than wearing contact lenses. ■
Treat them right Early detection of eye conditions makes for more effective treatment, so visit your ophthalmologist regularly. Protect your eyes by wearing sunglasses or, if necessary, protective eyewear, and taking regular breaks from your computer screen. WWW.LIFEHEALTHCARE.CO.ZA 51
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CHEF’S
SPECIAL
Inspired by traditional flavours and ingredients, Chef Reuben Riffel shares his picks of the healthiest and freshest recipes for spring from his cookbook, Reuben Cooks
Lamb Koftas in Tikka Marinade with Spiced Aubergine, Tomato Raita and Cucumber Salad Serves 2 52
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Poached Peach and Plum With Passion Fruit and Tequila Syrup Serves 2
REUBEN SAYS ‘Being a good cook means being open to the opportunities presented by fresh, unexpected produce, and knowing what to do with it. Broadly, my advice is to buy what’s in season, and don’t decide what you’re making until you know what good stuff is available.’ WWW.LIFEHEALTHCARE.CO.ZA 53
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COOK’S CORNER
Pawpaw, Melon and Mango Salad with Mixed Sprouts, Pine Nuts and Poppy Seed and Lime Dressing Serves 4
REUBEN SAYS ‘This is a perfect summer salad when fruit is in season and sweet. It must have the ripest fruit in order to work properly. It’s healthy without being spartan, and is one of my favourites.’ 54
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GIVEAWAY We are giving away two copies of Reuben Cooks: Food is Time Travel (Quivertree). Email lifehealthcaremag@ johnbrownmedia.com by 30 October 2015 to stand a chance of winning.
SPRING 2015
2015/09/03 2:35 PM
Preheat the grill to medium heat (or barbecue over a medium fire). Thread 2 pieces of lamb on to each of 4 wood or metal skewers, reserving marinade. Grill, turning and basting with marinade, for 6–7 minutes on each side or until cooked through. Serve with spiced aubergine, raita, cucumber salad and flour chapattis.
For spiced aubergine
Lamb Koftas in Tikka Marinade with Spiced Aubergine, Tomato Raita and Cucumber Salad (Serves 4) INGREDIENTS
600g boneless leg of lamb For tikka marinade ½ cup thick plain yoghurt ½ cup passata (tomato purée) ¼ cup olive oil 3 garlic cloves, peeled and crushed 1 Tbsp. finely grated ginger 2 tsp. cayenne pepper 2 tsp. paprika 1 tsp. chilli powder 1 tsp. garam masala 1 tsp. salt For spiced aubergine ¾ cup extra virgin olive oil 1 large aubergine, diced into small cubes 1 large onion, peeled and thickly sliced 2 garlic cloves, peeled and thinly sliced 4 small tomatoes, blanched, peeled, seeds removed and coarsely chopped 2 red bird’s eye chillies, seeded and dry-roasted ½ tsp. coriander seeds, dry-roasted ½ tsp. aniseed, dry-roasted Juice of 1 lime Salt For tomato raita 1 cup thick plain yoghurt 2 small tomatoes, blanched, peeled, seeds removed and finely chopped 2 Tbsp. mint leaves, finely chopped 1 Tbsp. extra virgin olive oil ½ tsp. ground cumin Salt and black pepper For cucumber salad 2 Lebanese cucumbers, peeled, seeds removed and cut into 6cm strips Juice of 1 lime 1 /8 tsp. ground cumin METHOD
For lamb koftas in tikka marinade Combine all tikka marinade ingredients in a bowl and mix well. Cut lamb into 8 pieces (each about 2 x 4 x 8cm) and place in a bowl. Add marinade, combine, cover with plastic wrap and refrigerate for 4 hours.
Heat ½ cup olive oil in a large frying pan over medium heat and sauté aubergine in batches for 5 minutes or until soft and just golden. Transfer cooked aubergine to a large saucepan. Add remaining oil. Sauté onion and garlic for 5 minutes or until soft and just golden. Add onion and garlic to aubergine with tomatoes, chillies, coriander seeds, aniseed and lime juice. Season with salt and simmer over a low heat for 30–40 minutes or until reduced to a sauce consistency. Set aside to cool.
METHOD
For poppy seed and lime dressing Mix all ingredients together.
For pawpaw, melon and mango salad Mix pawpaw and mango cubes together. Divide shredded lettuce between 4 serving plates and place pawpaw and mango mix on top. Arrange slices of melon around the sides and top with watercress and coriander leaves. Scatter with sprouts and pine nuts and spoon over some dressing.
For tomato raita Combine yoghurt, tomato, mint, oil and cumin in a bowl. Season to taste with sea salt and freshly ground black pepper. Cover with plastic wrap and refrigerate until required.
For cucumber salad Combine all ingredients in a bowl.
Poached Peach and Plum With Passion Fruit and Tequila Syrup (Serves 2) INGREDIENTS
2 cups water 2 cups sugar Seeds of ½ moist, fresh vanilla pod 1 lime, sliced 2 firm peaches 2 plums Raspberries, to garnish Fresh mint leaves, to garnish For passion fruit and tequila syrup Pulp of 4 passion fruit 1 Tbsp. tequila ¼ cup caster sugar Pawpaw, Melon and Mango Salad with Mixed Sprouts, Pine Nuts and Poppy Seed and Lime Dressing (Serves 4) INGREDIENTS
For poppy seed and lime dressing 2 Tbsp. black poppy seeds ½ cup freshly squeezed lime juice 4 Tbsp. Thai fish sauce 2 Tbsp. (heaped) caster sugar For pawpaw, melon and mango salad 1 small pawpaw, peeled and cut into small cubes 2 ripe (not overripe) mangoes, peeled and cut into small cubes 1 small head iceberg lettuce, shredded 1 small sweet summer melon, peeled and finely sliced Fresh watercress leaves, to garnish Fresh coriander leaves, to garnish Mixed sprouts, to garnish Alfalfa sprouts, to garnish 2 Tbsp. pine nuts
METHOD Put water, sugar, vanilla seeds and lime slices in a saucepan and bring to the boil. Cut a slit across the bottom of the peaches and plums. Place fruit in poaching liquid, reduce heat and poach slowly for 10 minutes. Remove fruit from syrup and leave to cool. When peaches and plums are cool enough too handle, peel skin off, starting at the bottom where you scored the fruit. Serve peaches and plums with passion fruit and tequila syrup and lime slices from poaching liquid. Scatter a few raspberries and fresh mint leaves.
For passion fruit and tequila syrup Combine all ingredients in a saucepan, bring slowly to the boil and simmer slowly for 3 minutes or until sugar dissolves completely. Set aside to cool.
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Grilled Yellowtail with Crispy Potato Wedges, Preserved Lemon, Garlic, Parsley and Chilli Serves 2
2 x 180g portions yellowtail Salt and black pepper Canola oil, for frying 1 garlic clove, peeled and roughly chopped 1 cup flat-leaf parsley 1 red chilli, seeded and chopped ½ cup olive oil ¼ preserved lemon, sliced For crispy potato wedges 2 medium potatoes, peeled and cut into wedges
METHOD Heat a griddle pan until extremely hot and preheat the oven to 180˚C. Season fish portions with salt and pepper and coat with a little oil. Grill fish in the hot pan until well marked with strong brown lines. Remove fish from griddle pan, place on a cold baking tray and transfer to the preheated oven. Bake for about 2½ minutes or until fish is cooked to your liking.
While fish is baking, blend together garlic, parsley, chilli and olive oil. Add sliced preserved lemon and toss through. Remove fish from the oven, coat with garlic, parsley and chilli dressing and season. Serve with crispy potato wedges.
For crispy potato wedges Cook potato wedges gently in salted boiling water until cooked but still firm. Allow to cool. Preheat canola oil in a deep fryer to 190˚C. Fry wedges for 5–8 minutes or until golden brown and crisp. n
REUBEN SAYS ‘When I was a child, all the kids had to take turns helping Oupa work his land. It always seemed to be my turn; when I was hungry, I would eat the rough-skinned lemons from his old trees, skin and all. The skin was thick, white and chewy and the juice was hot from the sun. The taste of preserved lemons and lemon curd takes me right back there.’ 56
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I M A G E S CR AI G FR ASE R AN D QU IVE RTR E E PU B LICATIONS
INGREDIENTS
SPRING 2015
2015/09/03 2:35 PM
SHORT STORY
HOW TO
STAY SANE IN A CRAZY WORLD
STOP AND EXHALE
What does it take to turn your life around? For digital strategist Sophia Stuart, it was an attitude adjustment
I
USED TO MAKE my living from writing. And then the newspaper I worked for in England laid off many of its staff and publications everywhere were downsizing. So I went and tried something else, which required a whole new look from Brooks Brothers and a fancy job in New York City. The suit wasn’t really me, but it was necessary. A decade later (still working as a suit), I started to write again – during nights and weekends and frustrated lunchtimes and long-haul business travel. But then something terrible happened. My doctor found a tumour in my throat. After a year of regular ultrasounds and biopsies, there were three tumours forming a mass that took a five-and-a-half hour surgery to remove. While laying on the stretcher waiting to go into the operating theatre, I decided to do something good with what I knew was going to be a painful, difficult and, quite frankly, hideous experience. I wrote How to Stay Sane In A Crazy World and Hay House published it last year. Here are a few bits from the book that I hope you find helpful as you go through your own journey into the realm of the unwell.
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From 2009 to 2012, I had the best view from my office in midtown Manhattan. Yes, it was an impressive sight. But it also deceived me into thinking, and feeling, that I was invincible. (I sort of get the idea that it’s meant to.) But the tumours reminded me that I’m not. The first feeling (as we’re going to talk about feelings now – bear with me if you come from a part of the world where those are just not done) was UTTER RAGE. But I didn’t know that’s what it was. It felt like a cavernous, black, seething hot pit in my stomach. To be honest, it took at least a year for me to calm down after the moment in my surgeon’s office when he said, ‘We found a mass’. He said it with sadness, because he’s a surgeon and has said that line over and over again to type-A female executives in New York. And I said, ‘I’ve seen this movie and didn’t like it’. I had become a statistic, and that made me furious. Do you feel angry that you’re sick – or stressed – or just beyond tired? Good. Feelings are a useful barometer. At least I found them to be so – despite the fact that, for me, they are often a delayed reaction. What do you do with your rage? I wrote. A lot. Most of it on my then blog, teamgloria (teamgloria.com), some of it in my blank notebooks, and a great deal of it in email or on old-fashioned pen and paper and pretty cards sent by post. The funny thing about writing is I can’t lie to myself when the pen hits the page. You probably haven’t written on a regular basis since those heartfelt teen diary entries, right? I also went to the local cinema that has a mini games arcade and played the hell out of Time Crisis. It’s one of those old-school video
arcade games and it really helped to blow up a few things. As did all the movies I watched. And taking long hot baths. For me, there’s nothing like a bath by candlelight, listening to Mozart or Bach or The Archers (a long-running BBC radio programme about a rural farming village – terribly soothing) as the bubbles sink into your soul, and the Epsom salts remove whatever they remove, and tiny beads of perspiration form on your warmed skin. In the weeks leading up to the surgery, I started to collect all the items I would need in my house. Because, once I was on medical leave, I would be too sick to go out for a while. I took a box and painted it and started to pop nice things into it, like tea lights and a yo-yo (nope, I’ve still not mastered it) and lovely rose-scented soap, lavender oil, and a notepad and pencils from the posh hotels I’d stayed in on business trips. About halfway through, I realised what I’d done – I’d made a kindness kit. And for the first time since the diagnosis, I sat down on the sofa and wept. Being kind to myself was a foreign concept. If you can relate to that sentence, let’s make a kindness kit for you. Here’s how I made mine. Because I wouldn’t be able to go out to the shops, I collected sweet objects to have around that would allow me to get through sleepless nights, long days, and the bits in-between. I also wanted everything to be beautiful, so I threw out boring soaps and bought little guest soaps with gorgeous scents. I bought a hand fan from a Chinese store that made me feel like a princess. Lavender sachets made tearful nights easier when slipped under the pillow. I knew I would write, so I collected pencils from glorious hotels and little notepads to have by the bed. Going to the post office would not be an option, so to stay in touch and say thank you for the flowers I received, I pre-stamped pretty postcards that friends could drop in the mailbox for me. The yo-yo might be frustrating. Try bubbles instead to make you smile. Do whatever it takes to get through this scary time. Because if you don’t stop and exhale and look after yourself, you, too, might one day find yourself wearing one of those hideous paper gowns with the ties at the back and lying on a hospital stretcher wondering how the hell it got this bad. Just saying. ;-) ■ Sophia Stuart is a technology columnist and award-winning digital strategist, with over 17 years experience in new product development, based in Los Angeles. How To Stay Sane In A Crazy World is published by Hay House Publishing WWW.LIFEHEALTHCARE.CO.ZA 57
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REACH OUT
THE HEALING
POWER OF TOUCH
Loving touch can heal relationships, comfort the sick and self soothe when you’re feeling stressed. Vivian Warby explores the power of this primary sense
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Y BROTHER’S GIRLFRIEND had been left to care for me one night when I was running a high temperature and feeling awful. I recall her putting her left hand ever so gently on my forehead and stroking me. In that moment, I felt so much physical love, all directed at me. I closed my eyes, feeling calm and peaceful, assured I would get better – and I did. That exchange of compassion, of the reassurance that I was loved and cared for, more than 40 years ago, made such an impact on my young five-year-old spirit. Throughout my life, I have always been aware of the effect a gentle stroke could have. Even as a child, I knew what scientists have since discovered: touch is healing on all aspects of our lives. And it doesn’t have to be elaborate. Small tactile gestures can have great impact. According to researchers at UC Berkeley School of Public Health in the US, getting something as small as eye contact and a pat on the back from a doctor may boost survival rates of patients with complex diseases. In patients with Alzheimer’s disease, studies have shown that touch can have huge effects on getting them to relax, make emotional connections with others and reduce their symptoms of depression. Researchers have confirmed it is a primary language of compassion, and a primary means for spreading it. The late Princess Diana knew this when she reached out to HIV patients all those years ago, touching and holding them when others would not because they wrongly feared that they would get sick themselves. This misunderstanding of the disease and stigma around it left thousands of people without the compassionate loving and healing assurance of touch. It is not only the stigmatised who miss out. People in marriages can get so caught up in living a fast life that the little touches start disappearing. A study from the University of North Carolina found that women who hugged their spouse or partner frequently (even for just 20 seconds) had lower blood pressure, possibly because a warm embrace increases oxytocin (the feel-good love hormone) levels in the brain. While a full-body massage or having sex with your partner is recommended, Dr Paul Zak, author of The Moral Molecule, agrees
that a hug, a pat on the back, playing with your pet, a slow dance, and a friendly handshake can have a similar effect, because all these touches are processed by the reward centre in the central nervous system that says something good has happened. Even the incidental gestures we usually take for granted, a brush on the shoulder, for instance, can have a significant impact, say researchers. Recent studies have found that seemingly insignificant touches – that people don’t remember receiving – yield bigger tips for waitresses, that people shop and buy more if they’re touched by a store greeter, and that strangers are more likely to help someone if a touch accompanies the request. Often these people don’t even remember the contact, just that there had been a connection. And it
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Skin-to-skin contact with babies helps them sleep better, increases brain development and calms them. Mothers win too, with lower levels of depression is not only adults who can benefit from touch. Research conducted on children adopted from Romania, who had spent the first few years of their lives in orphanages with minimal skin-to-skin contact, showed long-term deficits in brain development. Skin-to-skin contact with babies helps them sleep better, increases brain development and calms them. Mothers win too, with lower levels of depression. The release of oxytocin could also help explain many self-caressing gestures you do for yourself as a calming mechanism, for instance, holding your own hands, playing with your hair, stroking your shoulders, rubbing your forehead, patting your legs – things we do subconsciously. All round, it’s human touch that wakens us to being in a body on this earth, a reminder that we aren’t alone, that we matter, that we’re seen. It is no wonder we react so positively to this tactile reminder. ■
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OUR HERO
HERO OF THE MONTH:
PATRICIA MASHELE
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HERE WAS NOTHING unusual about the evening of 1 March. It was a balmy night in Rustenburg and Patricia Mashele, a staff nurse at Life Peglerae Hospital, was on her way to start her shift. Her husband Elphus and son Gladwell, 11, were on their way to drop her at work, but first they would stop and have a bite to eat. ‘It’s amazing how life can change in an instant,’ says Patricia, recalling the dramatic turn the night took. ‘You’re just doing what you usually do, and then something happens that completely changes how you look at life.’ Patricia and Gladwell entered the store, leaving her husband in the car in the parking area. Mother and son quickly got caught up in a conversation about what to eat when, suddenly, they were interrupted by three armed robbers pointing a gun at them. ‘We were told to lie on the floor, but I could only think about saving my son and getting him out of danger, so we crawled into a nearby storeroom to get as far away from the robbers as possible and back to safety. They got away with some cash, but we escaped with our lives, which I am so thankful for every day. I know that the situation could have turned out differently,’ says Patricia. Although she was shaken up, Patricia knew she needed
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You’re just doing what you usually do, and then something happens that completely changes how you look at life
to be somewhere else. She called her unit to inform them of her harrowing experience, but she assured them she would report for duty as soon as she had given her statement to the police and made sure her family, particularly her son, was feeling calmer. No one was more surprised to see Patricia than her unit manager, RN Alet Niemann. ‘Patricia deserves a medal for still coming to work after being involved in an armed robbery. She’s living proof of someone who goes above and beyond the call of duty,’ added Niemann. ‘Patricia works so hard and she is incredibly loyal.’ But for Patricia, the choice was an easy one. ‘So many people depend on the doctors and nurses to take care of them and comfort them, and it’s very important to me that I fulfil my duty towards the patients in my care, so I’m not sure I’m a hero. Like so many people, every day, I am just doing my job and getting on with life in the best way I can. Being a nurse is a special calling and I want my son to see that part of being called to something is to honour your responsibility to others. ‘When I think about that night, it’s not deciding to go to work that stands out, it’s the fact that my son and I survived and I’ll be able to save other lives doing the work I do. That’s the real happy ending.’ ■
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What does it really mean to be called to do a job? For this Life Healthcare nurse, it meant showing up for work, no matter what
NOTES TO SELF
INSPIRED THINKING Whether you slip them into a picture frame, your handbag or pass them to a friend, let these pocket-sized cards empower and uplift
‘IT MAKES A BIG DIFFERENCE IN YOUR LIFE WHEN YOU STAY POSITIVE. THAT’S A SMALL BUT SIGNIFICANT CHANGE YOU CAN MAKE.’
‘A SPIRIT JUNKIE IS SOMEONE WHO CHOOSES TO PERCEIVE THE WORLD WITH LOVING LENSES.’
✂
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ELLEN DEGENERES, entertainer
‘IF YOU DON’T LIKE SOMETHING, CHANGE IT. IF YOU CAN’T CHANGE IT, CHANGE YOUR ATTITUDE.’ MAYA ANGELOU, poet
‘YOU CHANGE YOUR LIFE BY CHANGING YOUR HEART.’ MAX LUCADO, author
GABRIELLE BERNSTEIN, author
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MIND GAMES
PUZZLE THIS... Test your mental agility with our brain-teasers
1 CROSSWORD PUZZLE 2 SUDOKU
ACROSS 1 Annie Lennox’s ‘No More “I Love__”’ 5 Shade provider 8 Grate 12 Ordinate counterpart 14 ‘Do ____others…’ 15 Labyrinth beast 16 Eminem song 17 Little, in Paris 18 Unisex top 20 PC peripheral 23 Folder contents 24 Angered 25 Stately dances 62
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28 ‘___ Misérables’ 29 Pugilist 30 Discoverer’s cry 32 Mosque tower 34 Culture medium 35 ____ and crafts 36 SALT subject 37 Elk 40 Crucial 41 Mideast airline 42 Member of the clergy 47 Skin opening 48 Eternally 49 Prepared to drive 50 Reuben bread
51 Impale DOWN 1 Sweet potato 2 Kyoto cummerbund 3 Sailors’ org. 4 Evaluated by eyeing 5 Jacob’s brother 6 Baton Rouge sch. 7 Strict disciplinarian 8 Potential frat member 9 Con 10 Celeb 11 Bridge, in Brest 13 Particular 19 Speak sloppily
20 Wire measure 21 Utah city 22 Lucy’s partner 23 Repairs 25 Bergen’s dummy Snerd 26 Takeout request 27 Phony 29 Homer’s imp son 31 Sphere 33 Caught red-handed 34 Bottomless pits 36 Estate recipient 37 Sobbed 38 Lotion additive
39 Rid of rind 40 Patella site 43 Wall climber 44 Youngster 45 Historic time 46 CSA soldier
I L L U S T R AT I O N T O B Y N E W S O M E ; P R E S S / M A G A Z I N E F E AT U R E S ( P T Y ) LT D
Difficulty level ***
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3 WORD SLEUTH
Find the hidden words in the diagram. They run in all directions
Baseball Blooms Buds Daffodils
Daisy Equinox Grass Green
Hatch Rebirth Robins Showers
4 BANANAGRAMS!
Each of the three-letter groups below may be extended both on the right and the left to form a seven-letter word. Use the tiles above each group to fill in the blanks
Sprouts Thaw Tulips
4 Answer: POOREST, TYPESET, CAPITAL, ENLARGE, SHAMPOO 2
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SOLUTIONS:
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SOUL FOOD
BEGIN AGAIN
Change expert and author Ariane de Bonvoisin coaches people through the first make-or-break month of any new enterprise. In this excerpt from her book The First 30 Days, she shares how to make a fresh start
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VERYONE IS IN the midst of change. 1) They are either going through a change: a divorce, starting a new job, cancer, having a baby, moving, etc; 2) They are thinking about making a change: starting a business, losing weight, quitting smoking, how to make more money, etc; or 3) They are helping someone else through a change: a parent with a health diagnosis, a friend going through a tough time, etc. (And then there is a fourth category: some people are just waiting for someone else to change!) Most people have been conditioned to believe certain things about change: Change is hard and is something to be avoided. I hate change. I am bad at change. I feel overwhelmed. Change makes me feel alone; I’m the only one going through this. Change takes time, energy and work. Change is stressful and usually involves pain. The excuses people come up with when you ask them why they aren’t making changes they know are important, are quite predictable: I’m too old or I’m too young. I’m not qualified; I don’t have the skills or education. I don’t have the money. I don’t have the time. It’s not my nature. Someone is going to disapprove or get hurt by my actions. I don’t know where or how to start. If this is how you’re feeling right now, you’re not alone. We live in a world where change has become the one constant. Think about it: Millions of people are in the process of getting married or divorced or caring for a parent or child. Millions of others have recently lost
a job, are trying to make financial changes, or want to start a new relationship or get healthy. And there are constant changes in politics, the environment, our jobs, technology, the law, our healthcare system and treatment options, education, the institution of marriage, and the shape of the family today. There are changes in how we eat, live, buy things and even communicate with each other. Given all these changes, it’s no wonder we cling to anything that appears stable and permanent, and then go through a tough time when that, too, inevitably changes. For some, however, change triggers a different response, one of optimism and strength. For these people, the emotional roller coaster of change can be managed; fear and anxiety are replaced with a new way of thinking and there’s a true sense of the resilience of the spirit. These people still find change hard – they are very human and also realistic – but they understand how to make it a little easier. Change always asks you to get comfortable with the unknown. Even if you’re facing an extremely challenging change like the death of a loved one or a devastating health diagnosis, having a new mindset about change will radically affect the way you live your life. You deserve to feel differently about change. The First 30 Days gives you the tools necessary whether you want to initiate a change or to embrace a change that has happened to you. You will come out on the other side feeling hopeful, strong and calm, with renewed optimism about life. This book is based on the knowledge that something good can come from any change. ■
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Ariane de Bonvoisin is the author of The First 30 Days: Your Guide to Making Any Change Easier (Jonathan Ball). To read more about the author, visit www.arianedebonvoisin.com
IMAGE SUPPLIED
We live in a world where change has become the one constant
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