Mediclinic Family Summer 2011

ISSUE 9 l SUMMER 2011

YOUR FREEY COP

SOUT

HOEVEEL IS TE VEEL? All fired up

Healthy recipes for the braai

Breast reconstruction step by step SWEAT IT!

It’s good for you

A C H M AT H A S S I E M • P A R A LY M P I C S W I M M E R

S H A R K B OY ‘ T H AT G R E AT W H I T E C H A N G E D M Y L I F E F O R T H E B E T T E R ’

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issue 9

| summer 2011

Contents 14

Check up

Check out

2 Welcome

By Wimpie Aucamp, Chief Operating Officer, Mediclinic Southern Africa.

28 What happened next?

After years of inactivity because of a bad knee, Ben Mathewson opted for health... and then cycled the Cape Epic.

5 Mailbox

Your news, views and letters.

30 Photo essay Heal your body, mind and soul by stepping into the outdoors.

8 The issue Dr Omar Jooma volunteered his services in disaster-stricken Somalia.

10 ask us Your health questions answered.

12 woorde van wysheid Hoeveel is te veel sout, en hoekom het ons sout in ons dieet nodig?

34 NUTRITION Turn summer braais into healthy feasts with Abigail Donnelly’s low-fat dishes for the fire.

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41 BEHIND THE SCENES As a Mediclinic patient, your journey, from check-in to discharge and rehabilitation, has been carefully considered.

18 neem die toets Die papsmeer is een toets wat jy eenvoudig nie kan bekostig om te mis nie.

Check in 14 SPOTLIGHT Paralympic swimmer Achmat Hassiem says losing his leg to a great white shark changed his life for the better.

42 news First cochlear implants performed in Namibia.

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26 How it works Listen up! You need your ears for balance, too. Take a closer look at these remarkable organs.

43 my hospital

Tips for hassle-free admission.

45 HEALING TIME Good ideas to keep you busy and entertained.

20 wellness Postnatal depression affects more women than you think. Here’s how to deal with it.

22 step by step What you need to know about breast reconstructive surgery.

38 Exercise Why working up a sweat is very good for you.

46 Just a minute Stay smart, stimulated and sharp with these mind-benders.

34

48 net voor jy loop Susan Erasmus vertel ons hoe maklik dit eintlik is om geluk te vind.

d i d yo u k n o w ?

You can read MediClinic Family onLINE AT www.mediclinic.co.za

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summer 2011 |

we l c o m e

THE PATIENT JOURNEY

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t Mediclinic, our patients are at the heart of our business. Our relationship starts developing long before you are admitted and lasts beyond your discharge. To ensure that this relationship grows and endures, we’ve identified a number of key patient moments, which we can measure against our five brand drivers – human, deliberate, exacting, practical and orchestrated, encapsulated in our new motto, ‘Expertise you can Trust.’

We call this ‘the patient journey’, and it begins with the consultation with your GP and referral to a specialist at one of our hospitals. It progresses from there through a number of phases from admission to post-discharge rehabilitation.

We pay deliberate attention to each step along the way.

We are aware that a hospital stay can be stressful, so we approach our brand of care as empathically and humanely as possible.

We try to make your experience of our hospital one of quality. For this reason, we are standardising our care process at all 52 of our hospitals to ensure you always receive the level of care and service that you expect from Mediclinic. Find out more about the patient journey on page 41.

Another journey you can read about in this issue is that of Achmat Hassiem, who lost part of his right leg in a shark attack in 2006. This only made him more determined to pursue his dreams. He went on to participate in the 2008 Beijing Paralympic Games and overcame his fear of the sea by completing the Cadiz Freedom Ice Water Swim from

DIE PASIËNT SE REIS

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asiënte is die hart van Mediclinic, en dié verhouding begin lank voor jy opgeneem word en duur voort tot ná jou ontslag. Met ons nuwe motto – ‘Kundigheid wat jy kan Vertrou.’ – wil ons verseker dat ons verhouding blom, en daarom het ons spesifieke oomblikke geïdentifiseer wat vir pasiënte belangrik is en wat ons kan meet aan ons vyf handelsmerk aandrywers – menslik, weloorwoë, noukeurig, prakties en georkestreer. Ons noem dit ‘die pasiënt se reis’, wat begin met ’n konsultasie by jou algemene praktisyn, gevolg deur ’n verwysing na ’n spesialis by een van ons hospitale.

Van daar af kan verskeie stappe volg – van opname tot rehabilitasiebehandeling ná jou ontslag – en aan elkeen word deeglik aandag geskenk. Ons verstaan dat ’n tyd in ’n hospitaal baie stresvol kan wees, en daarom benader ons ons versorging met soveel empatie en menslikheid as moontlik.

Ons wil hê jou besoek aan ons hospitale moet getuig van gehalte. Daarom word die versorgingsproses by al 52 ons hospitale gestandaardiseer om seker te maak jy kry te alle tye die vlak van behandeling en diens wat jy van Mediclinic verwag. Lees op bladsy 41 meer oor die pasiënt se reis.

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Wimpie Aucamp Chief Operating Officer, Mediclinic Southern Africa Bedryfshoof, Mediclinic Suider-Afrika

Robben Island to Big Bay, Blouberg, earlier this year. Find out more about how he beat the odds on page 16.

In July, Dr Omar Jooma, a paediatrician at Mediclinic Pietermaritzburg, was part of a rescue effort to take muchneeded humanitarian relief to Mogadishu in Somalia. Read his eye-opening account of a country in crisis on page 8.

We pride ourselves on being associated with medical firsts, such as the three cochlear implant operations recently performed in Namibia. These procedures were carried out at Mediclinic Windhoek in September (see page 42). This is great news for Namibians – in the past, patients who needed this operation had to travel abroad for surgery.

It is through our commitment to improving the quality of life of all our patients that we will realise our vision of being the benchmark for acute-care hospital services.

ons standaardiseer pasiënte se reis van begin tot einde by al 52 ons hospitale om te verseker dat elkeen die beste gehaltesorg ervaar. ’n Ander reis waaroor ons in hierdie uitgawe skryf, is dié van Achmat Hassiem, wat ’n deel van sy regterbeen verloor het in ’n haai-aanval in 2006. Die ongeluk het hom net nóg meer vasberade gemaak om sy drome te bewaarheid. Hy het in 2008 aan die Paralimpiese Spele in Beijing deelgeneem en sy vrees vir die see te bowe gekom deur vroeër vanjaar deel te neem aan die Cadiz Freedom Ice Water Swim van Robbeneiland na Grootbaai in Blouberg. Lees op bladsy 16 meer oor hoe Achmat ná die aanval opgestaan en aangegaan het.

Dr Omar Jooma, ’n pediater by Mediclinic Pietermaritzburg, was in Julie deel van ’n broodnodige humanitêre noodlenigingbesoek aan Mogadisjoe in Somalië. Lees sy ontnugterende verslag oor dié oorlog- en hongergeteisterde land op bladsy 8.

Ons is trots op ons verbintenis met mediese eerstes, soos die eerste drie kogleêre inplantings wat in Namibië gedoen is. Dié operasies is in September by Mediclinic Windhoek uitgevoer (sien bladsy 42), en is goeie nuus vir Namibiërs, wat voorheen na die buiteland sou moes reis om die operasie te ondergaan.

Deur ons verbintenis om die lewensgehalte van al ons pasiënte te verbeter wil ons ons visie verwesenlik om die maatstaf te stel vir akutesorg-hospitaaldienste.

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LETTERS

| SUMMER 2011

MAILBOX

Send us your news and views about your experience at Mediclinic. Are there people you’d like to thank? Or is there a staff member who has gone beyond the call of duty?

GET IN TOUCH Email your letters to mediclinic@newmediapub.co.za

Ode of thanks

All grown up My son, Harvey Roscoe Cupido, was born prematurely at Mediclinic Paarl. After three weeks he was transferred to Mediclinic Panorama. He was kept in an incubator for almost two months and we took him home as a healthy baby. I just want to thank the hospital staff for doing the best they could to save my boy. He turned 21 on 16 April this year and is a final-year student in Wellington.

Roslyn Cupido

A shoulder to lean on Earlier this year I found myself in Mediclinic Cape Town with a very painful shoulder. I went in for X-rays and saw orthopaedic surgeon Dr Joe de Beer. He took one look at the X-rays and said I needed an operation. Within 20 minutes I was admitted and ready for surgery. The nursing staff were wonderful and very knowledgeable. I was in and out of surgery with no complications. They kept me overnight for observation, and the next morning I was greeted by a friendly nurse practitioner bringing me breakfast in bed. Dr De Beer came to check on me and I was discharged half an hour later... just in time for a semi-final rugby game I really wanted to watch. This was all made possible by the wonderful and efficient Mediclinic Cape Town staff. Thank you so much.

Diaan de Beer

OUR

Thank you for trusting my mom enough to SPECIAL handle me in the early days, for understanding LETTER that I needed her warmth and love more than my special beepy bed. Thank you for lifting me up with careful hands so I could lie on her chest. Thank you for letting her sit in that big comfy chair and for allowing us to sleep there together. Thank you for being a friend in my mommy’s time of need. Surviving is a full-time job, and in the midst of just breathing and trying to grow, I totally forgot how to suck. Mommy was so worried about me. I was trying so hard, but couldn’t tell her myself. Thank you for doing it for me. Thank you for placing your hand on her shoulder when she wept at my bedside. Thank you for telling her that I deserved a fair chance and that, after all I’d been through, I deserved a little extra time too. I am forever grateful. All of you at Mediclinic Potchefstroom have touched my life.

Benjamin van Rooyen (5 May – 21 June 2011) From his parents, Steph and Ian van Rooyen

Exemplary care My mother, Eunice Trewhella, was a patient in your care from 28 August to 9 September this year. I’d like to commend all the staff members at the Mediclinic Worcester CCU who took such good care of her.

Mom was given exemplary care and shown incredible empathy. Sadly, she passed away on 9 September. It has left a big void in my life, but I take comfort in knowing that her last hours were spent in an environment where people cared. Thank you all for that.

Evelyn Maclout

PHOTOGRAPHS Angus Douglas, Thinkstock

PATIENT IMPRESSIONS

Theo Maseki (33) from

Nicole Taljaard (43)

Ligia Nobrega (46) of

Gaborone gave birth to Lorako Caleb at Mediclinic Morningside.

‘My journey as a patient was exceptional.’

was admitted to Mediclinic Morningside.

‘The unit managers are very hands-on.’

Atlasville was a patient at the Wits Donald Gordon Medical Centre. ‘It’s very peaceful and I really like my room.’

Brian Mbele (26) of Katlehong was admitted to Mediclinic Sandton. ‘A positive attitude impacts on your health and wellness.’

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M A I L B OX |

CONTINUED

WE CELEBRATE OUTSTANDING MEDICLINIC STAFF. NOMINATE YOUR STAR AND TELL US WHY. Email mediclinic@newmediapub.co.za

EDITOR Natanya Mulholland COPY EDITOR Vivian Dart ART DIRECTOR Anton Pietersen BRAND ASSISTANT Luyanda Ceketwane ACCOUNT DIRECTOR Jason Curtis Published in association with Health24 and the Faculty of Health Sciences, Stellenbosch University COVER MODEL Achmat Hassiem PHOTOGRAPHER Cameron McDonald

I was admitted for treatment at Mediclinic Sandton in June.

I’d like to single out two of the attendant nursing staff who cared for me during my stay in the nursing unit. Puleng Mosia on the night shift is the epitome of someone for whom nursing is a calling. Aside from her lovely disposition, she is compassionate, considerate and kind. Alex Sindane on the day shift is a true professional. He is attentive, efficient and highly skilled, and gives me faith in the future of South Africa and especially the health profession.

Eelco Lodewijks

Dedicated

Thank you to the theatre staff at Mediclinic Bloemfontein. Professional nurses Julie van Heerden and Denise Davidson are two outstanding and dedicated health professionals.

Often those in theatre don’t get the recognition they so deserve. Thank you and well done for all your outstanding work.

Jason Huckfield

Alex Sindane

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Head office – Cape Town 021 417 1111 NATIONAL ADVERTISING DIRECTOR Aileen Lamb 021 417 1228 aileen.lamb@newmediapub.co.za BUSINESS MANAGER Nicolette Davids 021 417 1147 nicolette.davids@newmediapub.co.za

EXECUTIVE DIRECTORS GROUP CONTENT DIRECTOR Irna van Zyl BUSINESS DEVELOPMENT DIRECTOR John Psillos MANAGING DIRECTOR Bridget McCarney

Denise Davidson

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Welcoming

Allow me to express my appreciation of the entire personnel of Mediclinic Highveld. The reception staff are warm and welcoming, from admission right to the emergency centre. I met a team of dedicated staff including nurse practitioners, cleaning service personnel and doctors. Every patient is treated with the same respect and care. I’d like to extend particular thanks to the Unit D team, and also to specialist physician Dr Mohammed Bahadur for his professionalism.

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ADVERTISING

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Editorial submissions may be sent to mediclinic@ newmediapub.co.za. A response is not guaranteed.

For all new business enquiries, contact Bridget McCarney on 021 417 1111 Copyright © New Media (Pty) Ltd. All rights reserved.

While all precautions have been taken to ensure accuracy of information, neither the editor, publisher nor New Media can be held liable for inaccuracies or injury or damage that may arise.

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PHOTOGRAPHS Supplied

Quality

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SUMMER 2011 |

THE ISSUE

A gift of life

When the Paediatric Management Group put out a call for doctors to do relief work in drought-stricken Somalia, paediatrician Dr Omar Jooma offered his expertise.

Words Nicci Botha

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Dr Omar Jooma

ABOVE Dr Jooma with patients and fellow Gift of the Givers Foundation volunteers in Mogadishu. The organisation provides medical help and food to more than 100 000 people. ‘The realities of life here are tough,’ said Dr Jooma. ‘There’s man-made deprivation as well as overindulgence.’

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n July 2011, Dr Omar Jooma, who practices at Mediclinic Pietermaritzburg, accompanied a group of medics, dieticians and members of Gift of the Givers Foundation on a week-long volunteer programme to Mogadishu, Somalia.

‘Mogadishu was startling: The city is bombed out, the buildings are riddled with bullet holes, and AK47s are a common sight regardless of whether the carrier is in military uniform or civilian clothes,’ recalls Dr Jooma. ‘Our first task was to find a place for a clinic near the refugee camps. The camp near our set-up was new, and most of the children we saw were suffering from diseases such as marasmus, kwashiorkor and gastroenteritis.

Families had walked for days to get to the city in the hope of finding food, and many of the children had never seen a doctor before.’

The second clinic they set up was close to a more established camp and, while these children were also malnourished, here lung diseases, measles and gastroenteritis were most prevalent.

Describing his experience, Dr Jooma says it was emotionally taxing. ‘Gunshots are a daily occurrence, and so there was a feeling of insecurity, and the condition of the camps was shocking, which caused stress for many.

‘Although you try to stay emotionally detached, it is hard to do so. I don’t think anyone can deal with the situation for more than seven or eight consecutive days. But, having said that, it’s also time for Africa to sort out Africa’s problems,’ he added.

Gift of the Givers was one of the first nongovernment organisations to provide medical aid to Somalia. After this, the SA government donated R4 million and, later, a Hercules aircraft to transport food to Mogadishu.

• If you’d like to get involved with Gift of the Givers Foundation, call 033 345 0163 or visit www.giftofthegivers.org

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CHECK UP |

ASK US

If I wear a hat instead of sunglasses, will my eyes be damaged? And is the glare from water a problem?

‘Wearing a hat gives more protection against ultraviolet (UV) radiation than wearing sunglasses alone. For maximum protection, you should wear a hat and sunglasses,’ says Dr Carl Wilms, supporting ophthalmologist at Mediclinic Nelspruit. He also warns that overexposure to UV radiation is the single-most important factor in causing cataracts, macular degeneration and pterygiums (growths of scar tissue and blood vessels on the surface of the eye as a result of UV damage). ‘Without protective eyewear, the glare from water gives direct reflection into your eyes with the same consequences as sunlight,’ says Dr Wilms.

Summer is the season of sunburn and sniffles.

Here’s how to take care.

Words Robyn von Geusau

‘Due to the glare and reflection of the sun on white beach sand, your baby (and you) can most certainly get burnt to a crisp, even while under an umbrella,’ warns Dr Frieda French, paediatrician at Mediclinic Kloof in Pretoria. ‘You will find quite an assortment of trusted brands of hypoallergenic sunblock that has been specially formulated for the sensitive skins of children and infants at just about every pharmacy, so make sure you keep her well covered in sunblock at all times.’ To avoid dehydration, extra water or juice is always a good idea for the whole family, especially when spending time in the hot sun.

I suffer from hay fever and am always on medication in summer. I’d like to ‘go it alone’ this summer. Any helpful hints?

‘Simple non-pharmacological and avoidance measures do help,’ says allergy expert Dr Adrian Morris of the Cape Town Allergy Clinic (www. allergyclinic.co.za). ‘A simple saline (salt water) nasal douche is effective, and saline and sea-water nose sprays help flush pollen grains from the nasal mucosa.’ A little petroleum jelly applied to the lower nostrils can also help to soothe and protect. Also try to stay indoors during mid-morning and afternoon when pollen counts peak. ‘An immediate shower and change of clothing after extended outdoor exposure will reduce the amount of pollen that gets transferred indoors,’ he suggests.

When travelling by car, close the windows and use the air conditioner to filter out pollen. Medication may be necessary when pollen counts are very high.

PHOTOGRAPHS Thinkstock, Gallo images/Getty images

We’re taking our eightmonth-old daughter to the beach. Can I use any sunblock on her? She will be under an umbrella, but what other precautions should I take?

Email your health-related questions to mediclinic@newmediapub.co.za or write to us at Mediclinic Family, PO Box 440, Greenpoint 8051

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WYSE WOORDE

S UTSAKE

CHECK UP |

Hoekom het jy sout in jou dieet nodig?

Natrium, een van die elemente in sout, help om die liggaam se vloeistofbalans te handhaaf, om spiersametrekking en -verslapping te bewerkstellig, en om senuwee-impulse te gelei. Maar slegs klein hoeveelhede natrium is nodig, sê Lucy Gericke, ’n geregistreerde dieetkundige by die Hart- en Beroertestigting van Suid-Afrika. Die meeste van ons eet oorgenoeg sout om dié funksies seepglad te laat verloop, en baie van ons heeltemal te veel.

Hoekom kry jy soms lus vir sout?

Daar’s min dinge so lekker soos ’n stukkie biltong of ’n pakkie grondboontjies wanneer die lus vir ’n southappie jou pak – iets wat die meeste van ons van tyd tot tyd oorkom. Swanger vroue ervaar ook dikwels ’n sterk drang na souterige kosse.

Navorsers krap egter nog kop oor die kompleksiteit en oorsake van kosdrange.

Wees bewus daarvan dat ’n lus vir sout op ernstige siektetoestande soos Addison se siekte of Bartter se sindroom kan dui. Die Mayo-kliniek in die Verenigde State raai aan dat jy met jou dokter gesels indien jou soutlus buitengewoon erg is en met spierswakheid, moegheid en/of gewigsverlies gepaard gaan.

’n Mens kan jou kwalik ’n lewe sonder sout voorstel, maar te veel van hierdie eeue-oue geurmiddel kan jou gesondheid benadeel. Woorde Carine Visagie

Is jy een van daardie mense wat southappies bó soetgoed verkies? ‘Dis beslis moontlik om ‘n aangeleerde smaak vir souterige kosse te ontwikkel,’ sê Irene Labuschagne, ‘n geregistreerde dieetkundige by die Voedingsinligtingsentrum van die Universiteit van Stellenbosch (NICUS).

‘Sommige mense is geneties meer geneig tot ‘n voorliefde vir sout (teenoor soet) kosse.’

Navorsing toon ook dat mense hulself kan afleer om sout te eet, wat moontlik beteken dat jy wel aan souterige kosse verslaaf kan raak. Maar verdere navorsing is nodig om dit onteenseglik te bewys.

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Hoeveel is te veel sout?

In die Westerse wêreld eet die gemiddelde mens sowat 10–12 g tafelsout per dag, sê Owens en Ackerberg. Dis hopeloos te veel as mens in ag neem dat jou totale sout-inname vir die dag liefs nie een teelepel (5 ml) moet oorskry nie. En dis beslis die moeite werd om daardie pizza met ’n gesonde slaai te vervang: die World Action on Salt and Health-groep beweer dat, indien almal hulle soutinname met een teelepel per dag sny, die aantal sterftes weens beroerte met 24% en die aantal sterftes weens hartvatsiektes met 18% kan daal. Wêreldwyd kan dit sowat 2,6 miljoen sterftes per jaar verhoed.

FOTO’S Thinkstock

Kan jy aan sout verslaaf raak?

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Watter kosse moet jy vermy om jou sout-inname te sny?

Kos wat jy nie tipies as ‘sout’ sal bestempel nie, bevat dikwels versteekte soute wat vinnig jou natriumchloriedinname drasties kan verhoog, sê Gericke. Dis wys om etikette te lees en produkte met ’n baie hoë soutinhoud (soos aftrekselblokkies, kitssop, wegneemetes, souse, piekels, skyfies en gesoute neute) te vermy, en altyd die opsie met die laagste natriumchloried-inhoud (‘sodium chloride’ in Engels) te kies. Probeer ook om nie sout by jou kos te voeg nie – eksperimenteer eerder met ander geurmiddels soos kruie, speserye, uie, knoffel en asyn.

Wat doen oortollige sout aan jou liggaam?

Studies toon dat Suid-Afrikaners hopeloos te veel sout eet. Baie vereenvoudig, veroorsaak ’n oormaat sout dat jou niere meer water in die liggaam terughou.

Hierdie ekstra water verhoog jou bloeddruk en plaas druk op jou niere, are, hart en brein, en kan sodoende jou risiko vir ’n hartaanval, beroerte of nierversaking verhoog.

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CHECK IN |

SPOTLIGHT

chmat Hassiem strides into the coffee shop. Behind him glitters the deep blue sea beyond Muizenberg beach on Cape Town’s South Peninsula – the same place where he was attacked by a 4,7 m great white shark five years ago. But the only clue to all that trauma is a slight limp due to the prosthesis on his right leg, which proudly sports the South African flag.

Achmat (28) is tall and broad-shouldered, with the healthy tautness particular to the very fit, and he has a big, beaming smile. He’s squeezing this interview into his very busy life. He has just returned from an Olympic training camp in Durban and the All Africa Games in Mozambique, where his times pushed him into the top eight para-swimmers in the world. He’s making a brief stop in SA before he jets off to Brazil to compete there. On top of all of this, he’s also studying marketing, and spends much of his time giving motivational talks and training hard for the London Olympics.

‘My mom calls me a jetsetter,’ he laughs, before settling into the story of his loss, horror, triumph and zest for life.

JAWS OF LIFE Losing part of his leg to a great white shark irrevocably changed the life of Paralympic swimmer Achmat Hassiem. He tells us why he wouldn’t have it any other way.

Words Lisa Templeton Photographs Cameron McDonald

SHARK ATTACK Sunday 13 August 2006 started like many others for Achmat – with him trying to rouse his younger brother Taariq from bed. Achmat was 23 years old and mad about sport. He dreamt of representing Western Province in life-saving, and he planned to spend the day practising his drills. He needed someone to act as a patient, and Taariq was it.

A few hours later the two of them were in the sea, 10 m apart, waiting for the rubber duck to buzz by and pick them up. ‘I remember the day vividly. There were clouds over the sea with patches of light and the water was flat and clear.

Treading water, we were joking about sharks and Taariq was singing the Jaws theme music.’ As they heard the rubber duck approaching, Taariq floated face down in the water to act like an unconscious patient. That’s when Achmat noticed a large, grey fin heading straight for his brother.

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CHECK IN |

SPOTLIGHT

‘I started to drum frantically on the water to draw its attention away from him, and I was screaming at the guys in the rubber duck to get my brother out of the water.’ Achmat’s diversion tactic worked, and the shark swung round and sliced through the water away from his brother – 4,7 m of apex predator was now heading straight for Achmat.

Knowing that sharks breach when attacking, Achmat sunk and felt it brush by him and thrash as it prepared to turn back towards him. ‘Then it charged at me.

I tried to paddle back and I saw its teeth as it lunged at me. I tried to dodge it and parried it away with my hand. I tried to scramble onto the safest place I could think of – the shark’s back – but I couldn’t.

I was stuck. When I looked down to see why I couldn’t move, I saw my leg in its mouth.’

Back on the surface, Taariq looked up from the safety of the rubber duck at a sea that was eerily still – there was no sign of his brother. Under the water, the shark was pulling Achmat out to sea.

‘It was pulling so fast that I was flapping at its side and I could see its tail some distance from me. I’m two metres tall, so I knew it was big.’ And all this time, Achmat was fighting it. He describes this as ‘punching a tank covered in

LOSING A LIMB ‘Taariq kept telling me I was alright; it was just a scratch. It was better that I didn’t know just yet that I had lost part of my leg.’ It was only when Achmat had recovered from surgery that Taariq, tears running down his face, told him to look under his covers. ‘I lifted my bed covers and saw that my lower right leg was gone.

I stared in horror. My goal was to be a great sportsman and now it was over.

I was devastated.’

For two days Achmat languished in despair. ‘I’m so grateful to the nurse practitioners at Mediclinic Constantiaberg.

I went through hard times and they were a great help and support.’

Then Taariq said to him, ‘You don’t have to give up on your dreams. Let’s get you swimming-ready for the Paralympics in Beijing.’ A small nugget of hope and determination began to build in him.

It took three attempts to achieve the times he needed to qualify for the 2008 Olympics but, just two years after his attack, Achmat walked into Beijing’s Bird’s Nest Stadium alongside his Olympic team members.

GETTING BACK ON HIS FEET When Achmat was first shown his prosthetic limb by prosthetist Jayson Chin

‘That shark changed my life for the best.

I could shake it by the fin. I have been honoured by the opportunities I’ve been given and the people I have met.’ sandpaper’. He would later discover that his knuckles were raw and bleeding.

‘I couldn’t get up for air, and I thought I was going to drown. Then I heard a huge crack, and I was free. I shot up to the surface, waved one hand in the air, and that was all I could manage. I started to sink back down.’

But that was all Taariq needed to spot his brother. Achmat could see the vivid red of his brother’s vest and the belly of the rubber duck as it rushed towards him.

And then the brothers’ hands clasped each other and Achmat was hauled into the rubber duck – not a moment too soon, as the shark swung around and catapulted into the rubber duck.

As the rubber duck whizzed back to shore Taariq lay on top of Achmat to hide his leg and held the wound in one hand.

Back on dry land, a helicopter arrived and whisked him to Mediclinic Constantiaberg.

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hand, and I was the happiest person in the world.’

And? Do chicks dig it? Achmat flashes his bright smile. ‘Ja, it goes down really well in nightclubs!’

GOING FOR GOLD Since the attack, Achmat has captained the Western Province able-bodied swimming team, broken disabledswimming records and completed the Cadiz Freedom Swim from Robben Island to Big Bay. He’s currently training at least three hours a day for the London Paralympics. ‘That shark changed my life for the best. I could shake it by the fin. I have been honoured by the opportunities I’ve been given and the people I have met.’

Achmat advises people never to give up and to live life to the fullest. With the right attitude you can do so much. ‘Don’t wait for a 4,7 m shark to bite you on the bum. Go out and achieve the impossible.

As they say in the Adidas ad, “impossible is nothing”.’

RIGHT While most of us start our week in an office, marketing student Achmat begins his with intense training, starting with a one-hour session in the gym and two hours in the pool at the Sports Science Institute in Newlands, Cape Town.

BELOW Ranked among the world’s top five para-swimmers in the 100 m butterfly and 400 m freestyle, Achmat has smashed South African and African records, and has returned from London with medals clinking around his neck. His advice: Never give up.

of The Cape Amputation Clinic, Taariq joked, ‘Chicks are going to dig this.’ But it was a lengthy process as Achmat started rehabilitation. ‘Initially it was weird to do gym with one leg. Simple things like riding the exercise bike were suddenly so hard.’

There were challenges along the way, but his ‘pit crew’ – the team at the amputation clinic – kept giving Achmat new goals and, as his stump shaped and he got fitter, he became excited.

‘Achmat really was exceptional,’ says Jayson. ‘He took his disability by the horns and turned it around. As an ablebodied guy he was good, but he is an exceptional disabled guy and a really good motivator of other amputees.’

About two months into rehabilitation, Achmat went to a vending machine for a packet of chips and took his first unaided steps on his prosthetic leg. ‘I was edging forwards with a packet of chips in my

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USEFUL ADVICE from the prosthetist: what you need to know Jayson Chin of the Cape Amputation Clinic says most amputees can be up and walking within three months by adhering to the following guidelines: • Start rehabilitation as soon as you are able. Select prosthetic components that suit your needs. Not everyone needs the most expensive prosthesis.

• Make sure you have a supportive medical team. ‘Our team includes a prosthetist, a physiotherapist, an occupational therapist, an orthopaedic surgeon, a biokineticist and a psychologist.’ Your relationship with your prosthetist will be a long one, as your needs will change over time. Choose someone with a good reputation and to whom you can relate.

• Meet other amputees so that you can support each other. Gear up with as much information as you can.

Contact the Cape Amputee Clinic on 021 531 7232 or visit www.amputee.co.za.

The clinic also runs a free consultation clinic every two weeks.

Learning to re-embrace life Dealing with the loss of a limb is a threefold process, says clinical psychologist Ronèl de Villiers.

1. You need to deal with the trauma that caused it. Was it an accident? Were you fighting for your life? Was it cancer?

Debriefing with a counsellor may help you deal with the shock.

2. You will need to grieve the loss of the limb, just as you would grieve a loved one. Initially one might feel numbness and denial, then anger, regret, bargaining (with feelings of ‘if only’) and depression.

Acceptance is the final phase.

3. And then there is the pain, as well as the ‘phantom’ aches and sensations in the missing limb. You may feel a desperate itch in a toe that is no longer there. This is quite normal. Your old body map needs to update itself gradually as the nerve endings heal. It takes a while for the body to adjust to its new form. ‘Don’t be alarmed by this,’ says Ronèl. ‘The amputation does not define who you are. Re-embrace life and become curious about the good that may come from a very tough situation. You are a survivor with a full life ahead of you.’

Visit www.achmat.com or follow Achmat on Twitter @achmathassiem.

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dames

neem die toets

wanneer laas is julle getoets?

Sommige vroue voel effe verleë daaroor of is selfs bang om vir ’n papsmeer te gaan, maar dié blitsvinnige toets is nie pynlik of ingewikkeld nie – en kan jou lewe red.

Woorde RUTH REHBOCK Foto THYS DULLART

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’n eenvoudige toets Indien jy 18 of ouer is, of reeds seksueel aktief is, moet jy elke jaar vir ’n papsmeer gaan om vir abnormale selle (displasie) te toets. Kwaadaardige veranderinge in die serviks se selle kan kanker veroorsaak. ’n Abnormale papsmeeruitslae dui egter gewoonlik net op klein veranderinge in die serviks, wat maklik behandel kan word.

‘Die papsmeer het my lewe gered’

wat is jou risiko?

Die papsmeer kan ook vir menslike papillomavirus (MPV), ’n risikofaktor vir servikale kanker, toets. Jou risiko vir dié vorm van kanker is ook hoër indien jy ’n familiegeskiedenis van die siekte het, jy vóór die ouderdom van 17 geboorte geskenk het, verskeie kere voltermynswanger was, of ongesond eet of rook.

Hoewel meer as 40 verskillende variasies van die MP-virus seksueel-oordraagbaar is, veroorsaak HPV 16 en HPV 18, wat geen simptome toon nie, sowat 70% van gevalle. ’n Papsmeer is die enigste eenvoudige manier om servikale kanker in die prekwaadaardige fase te diagnoseer, sê Dr Hylton Sevitz, ’n ginekoloog en verloskundige by Mediclinic Morningside. Hoe vroeër servikale abnormaliteite bespeur word, hoe groter die kans op genesing.

Hoe werk ’n papsmeer?

Jy sal eers gevra word om al jou klere van jou middellyf af ondertoe uit te trek en op die ondersoektafel te lê. Hierna sal jou ginekoloog vir jou ’n laken gee om oor jou maag en bobene te plaas, sodat jy nie té blootgestel voel nie.

Jy sal gevra word om jou voete stil te hou, terwyl jou dokter ’n spekulum (’n instrument wat met ’n klein bietjie KY-jellie gesmeer is) in jou vagina plaas om dit effe oop te rek sodat ’n klompie selle saggies met ’n maskara-agtige borseltjie van jou serviks afgeskraap kan word. Baie vroue voel niks tydens dié kort prosedure nie, terwyl ander net effense ongemak ervaar.

Die ginekoloog sal hierna die klompie selle wat uit jou serviks gehaal is na ’n gesteriliseerde glasskyfie oorplaas, wat dan na ’n laboratorium gestuur word vir analise. Die spekulum sal uitgehaal word, waarna jy weer regop kan sit en jou klere kan aantrek. Dis so eenvoudig soos dit.

Jou dokter sal die toetsresultate tussen twee en 10 dae ná die toets ontvang.

Indien die papsmeer op abnormale selle dui, is dit belangrik om hierna gereeld getoets te word, aangesien dié selle met verloop van tyd kankeragtig kan word.

Jou mediese fonds behoort die papsmeer uit jou dag-tot-dag voordeel óf ’n spesifiek-geallokeerde voordeel te dek.

Fiona Zerbst, 42, leef vandag danksy ’n papsmeer.

In 2008 is Fiona Zerbst tydens haar jaarlikse papsmeer onkant betrap. Haar serviks het tekens van relatief-aggressiewe kankeraktiwiteit getoon.

Maar aangesien dié verandering vroeg bespeur is, kon sy onmiddellik suksesvol behandel word.

‘Ek was geskok. Ek het immers geen simptome getoon nie en het heeltemal goed gevoel – één van die redes waarom servikale kanker as ’n sluimerende siekte beskou word. As dit nie vir dié klein toetsie was nie, kon ek nou dood gewees het,’ verduidelik dié vryskutskrywer van Pretoria wat gereeld hardloop, Oosterse gevegskuns beoefen en nou fikser as ooit is.

‘Ek het pas 38 geword en ek was geensins bekommerd nie, aangesien ek elke jaar vir my papsmeer gegaan het. Toe my ginekoloog ’n paar dae later bel en vra dat ek weer inkom omdat sy met my wou gesels, het ek geweet dat daar’s fout.’

Fiona se toetsresultate het gewys dat sy fase-drie pre-kankeragtige letsels op haar serviks het. Nadat sy haar opsies oorweeg het – onder andere om ’n endoskopiese ondersoek te kry om die area van naderby te ondersoek of om dadelik te opereer – het Fiona besluit om onmiddellik vir die operasie te gaan.

‘My dokter het onder narkose die kankeragtige selle uitgesny, ondersoek ingestel om te sien of daar ander abnormaliteite was, en nóg kwaadaardige selle in my baarmoeder ontdek. Sy het die kwaadaardige selle in my serviks, asook

’n klein area van my baarmoeder, verwyder.

Ek het net een aand in die hospital deurgebring, waarna ek huis toe is.’

Fiona weet dit was ’n gelukskoot: indien die kanker na haar ander organe of opwaarts in die rigting van haar rugstring versprei het, sou dokters moontlik nie kon opereer nie. ‘Dis hoekom hierdie eenvoudige toets so belangrik is. Dit verhoog jou kans om kanker vroeg te bespeur en chemoterapie vry te spring,’ sê Fiona, wat nou ’n punt daarvan maak om haar vriendinne en kollegas aan te moedig om vir ’n papsmeer te gaan.

‘Gelukkig het ek en my man nie beplan om kinders te hê nie, so ek het gevra om sommer gesteriliseer te word,’ voeg sy by.

Haar ginekoloog verduidelik dat Fiona steeds kinders sou kon hê, maar dat swangerskap en geboorte heel moontlik moeiliker sou wees.

‘Dit het my laat besef indien ’n mens kinders wil hê, moet jy vir ’n gereelde papsmeer gaan. Mense is geneig om te dink dit kan nie met hulle gebeur nie of hulle is te jonk, maar ek glo dis een van daardie toetse wat jy net móét doen,’ sê Fiona. Sommige vroue meen dat die toets ongemaklik is, maar die alternatief is erger.

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Bundle of blu

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WELLNESS

At least one in 10 mothers suffers from postnatal depression.

What can be done when your bundle of joy is fine, but you’re not?

Words Lisa Templeton Photographs Jan Ras

A

baby is a blessing, right? It’s supposed to be a time of blissful reverie and gurgling giggles between serene sessions of breastfeeding.

Actually, it’s not always like that; that image is just the result of good marketing.

‘Having a baby can be a crisis in a woman’s life,’ says Debbie Levin of the Post Natal Depression Support Association (PNDSA), ‘and yet it is something that’s totally underestimated by society.’

It is a little-known fact that at least 10 to 15% of all women develop postnatal depression (PND) at some stage during the first year of having a baby (often within the first four weeks) and that many women suffer this misery in silence and guilt because it is a time during which society expects them to be happy.

‘PND was the worst hell I have ever experienced.’

‘I revelled in my pregnancies and had fantasies about a beautiful, fulfilling mothering experience,’ says mom of two Linda Lewis, who suffered from PND after the births of both her children.

‘I had no idea of the agony I would face.

I became beset with anxiety and obsessed with sleep – it became my total focus.

I began to withdraw from my world of activity and socialising. I couldn’t even watch TV or read a book because I just couldn’t concentrate. The smallest task, like brushing my teeth, became totally insurmountable.’ Linda, a psychologist who now counsels women with PND and author of When Your Blessings Don’t Count: A Guide To Recognising And Overcoming Postnatal Distress (Metz Press), says that she felt as though her bright, energetic self had died. ‘I was terrified that I’d never be “me” again,’ she recalls. But, as she says, nobody suffers from PND forever. She recovered with the help of her family, a psychologist and medication. ‘You can bring back the joy and happiness you thought you had lost forever.’

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Linda with her younger daughter Raphaella (16)

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blues Don’t suffer in silence ‘Seek help quickly,’ says Linda. ‘Having PND is nothing to be ashamed of and it is a sign of strength to look for help.’ Don’t keep this to yourself. Explain it to your loved ones so that they can support you.

Linda also suggests a combination of therapy – to help you work out the issues that may have played a role in the onset of PND – and antidepressant medication, which will help get you back to functioning mode (although it may take a while to get your medication and dosage just right).

Group therapy can also be very helpful, if only to see that there are other women from all walks of life and with vastly different circumstances who are also grappling with the same issues.

Whichever route you choose, get help as soon you realise that you have a problem. It could make all the difference.

How do I know if I have postnatal depression?

‘I couldn’t hold the baby, I couldn’t do anything for the baby, I couldn’t look at the baby. I just cried all day long.’

BROOKE SHIELDS

• Do you feel that you are not the mother you thought you’d be?

• Are you weepy and tearful a lot of the time?

• Do you feel antisocial, as though you want to crawl under a rock and not see anyone?

• Are you anxious and nervous?

• Are you obsessed with sleep and your lack thereof?

• Do you have feelings of inadequacy?

• Do you feel guilty because of your negative feelings?

• Are you lethargic and unenthusiastic?

• Are you not enjoying things any more?

• Are you uninterested in yourself and your baby?

• Are you forgetful?

• Do you keep losing things?

• Do you feel unable to cope with life?

• Do you sometimes have thoughts of harming your baby or yourself?

If you suffer from any of these symptoms on most days for a period of longer than two weeks, you may have PND. To do an online test for PND, log onto www.pndsa.org.za and click the ‘Help For Moms’ tab.

Get help Speak to your health professional or contact the Post Natal Depression Support Association for more info.

Call 083 309 3960/082 882 0072. www.pndsa.org.za

photographs on this page Thinkstock, supplied

What are the ‘baby blues’?

Linda’s book, When Your Blessings Don’t Count, is written with profound empathy and is filled with positive suggestions. As devastating and debilitating as it is, postnatal depression can be overcome. If you’re feeling unsupported, anxious and are not enjoying being a new mom, you will find this book to be a useful tool in your recovery process.

GIVEAWAY To stand a chance to win one of four copies of When Your Blessings Don’t Count (Metz Press, R145), email mediclinic@newmediapub.co.za

Psychologist Linda Lewis suffered from PND and now counsels other new moms.

Having a baby is a very emotional experience, and the ‘baby blues’ or ‘three-day blues’ are common and not to be confused with PND. Often kicking in on the third day and gone by the tenth, the baby blues can make you feel sentimental and weepy, irritable, anxious and overwhelmed.

While researchers aren’t 100% sure what causes it, the sudden postpregnancy drop in hormones, tiredness and anxiety can all play a role. If you are still feeling down and have been unable to lead a normal life for longer than two weeks after the birth of your baby, chances are you have PND and should seek help as soon as possible.

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STEP BY STEP

breast reconstruction

know your options When you’re facing breast cancer, knowing your options for breast reconstructive surgery gives you a meaningful boost for both physical and emotional healing.

F

Words Robyn von Geusau, Helen Wills Photographs Diaan de Beer, Roger de la Harpe

or many women, their breasts are the symbols of their femininity. Most women would find it difficult – if not impossible – to imagine life without them. The good news: mastectomy need not be the final word when it comes to breast cancer.

Thanks to ongoing advances in breast reconstructive surgery, there are now several options available, all of which can help patients to regain their former shape and self-image.

‘After a patient has been referred to me by a breast surgeon, I chat to her about her choices,’ says Dr Shane Barker, a plastic and reconstructive surgeon at Mediclinic Constantiaberg.

Depending on the circumstances, she could opt for an immediate reconstruction (done at the same time as the mastectomy) or a delayed one. ‘All patients are different,’ advises Dr Barker, ‘and you have to tailor the reconstruction to

the nature of the disease, the general health and lifestyle of the patient, her history, body type and, of course, personal choice,’ advises Dr Barker. Apart from choosing when to have the reconstruction, you can also go either the prosthetic (using manufactured implants) or autologous (using tissue from other areas of your body like your back, below the breast, thigh, buttock or lower abdominal area) route.

Although the length of recovery depends on each individual patient, physical recovery usually takes between 10 days to two weeks. ‘Emotional recovery takes a lifetime,’ says Dr Chetan Patel, a plastic and reconstructive surgeon at Mediclinic Sandton. ‘Every breast-cancer survivor should attend a support group. You need empathy from those who are going through it themselves, or who’ve been there.’

surgery using implants First surgery

Second surgery

Step 1

Step 2

Step 3

Step 1

Step 2

The tissue expander is placed in position.

The injection dome is located. Expansion begins by injecting saline through the dome.

The tissue expander is removed after a few weeks.

The implant is then placed in the expanded pocket.

Complete procedure.

A nipple can be added once the breast has ‘settled’.

During reconstructive surgery, the patient is taken into the operating theatre in which a breast surgeon, oncologist and reconstructive surgeon are present. Working in unison, they complete the mastectomy and perform the reconstruction.

Dr Barker explains how a two-stage immediate breast reconstruction with prostheses works: ‘Because skin and breast tissue is removed during a mastectomy, there is often not enough to work with for a new breast, so we implant a temporary tissue expander. This slowly expands the skin envelope.’ The breast ‘grows’ thanks to a nifty injection dome

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through which saline solution is injected once a week for a few weeks. The skin gradually stretches and, once the breast has reached the desired size, the expander is removed and replaced with a permanent implant. ‘We may have to make a minor adjustment to the other breast,’ explains Dr Barker, ‘so that both look equal.’ Once the breast has ‘settled’, a nipple is created using skin from either a toe or an ear. The patient can also choose to have an aereola tattooed onto her skin to finish off the procedure and give her newly reconstructed breasts an even more natural look. ‘It just completes it,’ adds Dr Barker.

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Nadine Foster, breast cancer survivor, takes time out with Ben and Sophie, her devoted walking, playing and relaxation companions.

ASK YOUR doctor

‘I didn’t want to look unbalanced.’ nadine foster, 54 When Nadine Foster learned she had breast cancer, she knew she wanted a full rather than a partial mastectomy.

She had lost her beloved sister to the disease, and Nadine was very clear about the way forward.

‘I was angry with that breast: I wanted it off my body,’ she says. ‘I discussed my reconstruction in depth with Dr Barker, who pointed out all the options to me.’

Nadine says her decision to have a breast reconstructed was based on practical rather than emotional reasons.

‘I didn’t feel that I’d lose my femininity

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when I lost my breast. Rather, because I’m an active person – I swim and am always on the move – I didn’t want to feel or look unbalanced.’

Not only is Nadine able to wear fitted clothing, she is once again full of zest and energy. ‘The surgery helped me move forwards and onwards,’ she concludes.

‘I can do everything I used to do.’

Nadine has these words of advice for other women who may be considering reconstructive surgery: ‘Do what feels right for you, and make sure you have all the information available to you before making a decision.’

• W hat are my options?

• What are the risks and complications of each surgery?

• Will this interfere with my cancer treatment?

• Can I see before-and-after photographs of other patients?

• When can I resume normal activities?

• How long will the procedure take?

• What are the costs involved?

NOW OR LATER? • H aving immediate reconstruction means you only have one operation and recovery period, it helps you preserve a positive body image and you avoid the experience of having one or no breasts.

• The benefits of delayed reconstruction are that you have more time to consider different surgery options, to focus on your recovery from cancer and to rebuild your strength.

find out more Dr Shane Barker on 021 762 6350 Dr Chetan Patel on 011 463 1210 www.mediclinic.co.za

2011/11/29 12:17 PM

CHECK IN |

STEP BY STEP

‘I just didn’t feel like a real woman.’

MONA MCDONALD, 68

Mona McDonald runs a support group for female cancer survivors, and volunteers at a local oncology unit.

Soon before she was about to embark on a whole new phase of her life, a malignant lump was detected in her breast. So Mona said goodbye to her right breast before having a mastectomy. After her left breast also had to be removed, Mona became very self-conscious.

‘I just didn’t feel like a real woman, with a flat chest,’ she says. ‘I wore baggy clothes, but where my breasts were supposed to be there were just pockets. It didn’t bother my husband at all, but it really bugged me that I didn’t have boobs anymore,’ she adds.

Her unhappiness led her to visit plastic surgeon Dr Bronwen Schoenfeld at Mediclinic Howick. ‘I took off my wig, took off my top, and looked down at my chest as the tears flowed down to the floor,’ she remembers.

‘I later regained my sense of humour and decided I wanted big boobs!’ she laughs. After reconstruction, Mona ended up with a lovely rounded cleavage that is not over the top but ‘firm and upright’. She feels great and says she usually forgets that her breasts are artificial as she experiences no discomfort or disability.

SURGERY USING YOUR OWN TISSUE STEP 1 The mastectomy is performed and the donor site is marked.

This image shows Step 1 in the TRAM flap procedure.

STEP 2 The tissue is tunnelled to the mastectomy site and used to create a mound. This image shows Step 2 in the latissimus dorsi flap procedure.

STEP 3 An implant can also be used to create the breast mound.

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Incredible as it may sound, your own tissue – taken from your back, under your arm, tummy, buttock or thigh – can also be used to reconstruct your breasts. This type of procedure, referred to as flap surgery, is the option most commonly opted for.

In latissimus dorsi flap surgery, for example, tissue (skin and muscle) is taken from your back and then tunneled to the breast area to create a breast mound. A breast implant can be used along with the tissue for a fuller, more natural look. ‘The latissimus dorsi flap is a good option for mastectomy patients from whom the pectoral muscle was removed and for those patients who require additional tissue for reconstruction,’ says Dr Chetan Patel, a plastic and reconstructive surgeon at Mediclinic Sandton.

Another type of flap surgery is known as the TRAM flap, where excess skin and fat of the lower abdomen are transferred using the blood supply from the rectus abdominus muscle.

‘It’s a great form of reconstruction, using excess tissue in one region to reconstruct a defect in another,’ says Dr Patel. ‘Skin colour and texture is superior in the TRAM as opposed to the latissimus dorsi flap.’

THINGS WORTH KNOWING

No breast reconstruction should happen until both the surgeon and the oncologist are happy the cancer margins are as clear as can be reasonably ascertained.

The reconstructive surgeon may choose to delay the operation if he or she is unhappy with certain criteria, such as insufficient blood supply to the area.

Patients with significant medical problems, such as cardiac, diabetic or lung disorders, may be better served if initial surgery is restricted to cancer surgery. Reconstruction should only be done if and when any other prevailing conditions have been optimally treated.

YOU’RE NOT ALONE The Cancer Association of South Africa reports that one in 29 South African women will be diagnosed with breast cancer.

Support from other women who know what you’re going through is essential.

Here are some places to start: www.reach4recovery.org.za www.pinkdrive.co.za www.cansa.org.za

SUMMER 2011

2011/11/25 10:45 AM

CHECK IN |

HOW IT WORKS

LISTEN U

THE SCIENTIFIC STUDY OF SOUND IS CALLED ACOUSTICS.

THE PHYSIOLOGY OF THE EAR Auditory nerve connected to the brain

Three semicircular canals

Anvil Stirrup Hammer

Cochlea

Eustachian tube connects to the pharynx Eardrum Outer-ear canal

What causes hearing loss?

Birth or pregnancy complications, or genetics German measles, toxoplasmosis or herpes during pregnancy may cause hearing loss in an unborn child.

Premature birth or a lack of oxygen during birth can also play a role, as can infections such as measles, mumps and meningitis. Some ototoxic drugs can also cause damage to a child’s hearing. Although deafness can be genetic, children can be born deaf even if both parents have perfect hearing.

Damage to the inner ear As people age, or if they’ve been exposed to very loud noises over a prolonged period of time, the nerve cells or hairs in the cochlea that send sound signals to the brain could be damaged.

A gradual build-up of earwax in the ear canal can prevent sound waves from being conducted. This is sorted out by the removal of the earwax.

Ear infections, abnormal bone growths and tumours in the outer or middle ear: any of these could cause hearing loss in people of all ages. A severe inner-ear infection could also affect hearing, spatial perception and balance.

Ruptured eardrum Eardrums could be ruptured by infections, sharp objects, changes in pressure or sudden blasts of loud noise.

PHOTOGRAPH Gallo Images/Getty images

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n up

Our ears are remarkable organs that help us in more ways than we think.

Here’s how they work. Words Susan Erasmus

Hear Here When something vibrates it moves air and water particles around, causing a sound wave. The bigger the vibration, the louder the sound, the higher the frequency of the sound wave, the higher the pitch we hear. Sound travels at about 1 230 km/h.

When a whip cracks, what you’re actually hearing is its tip breaking the sound barrier.

easy on thE volume

Pinna

Loudness is measured in decibels (dB) on a scale system: 20 dB is 100 times louder than 10 dB. Normal conversation takes place at around 60 dB, while a gunshot registers at about 140 dB. Loud music at 120 dB or higher can cause permanent damage to your hearing.

3

There are three sections to the ear,

REVERSING deafness • Permanent hearing loss can’t be reversed, but specialists use certain devices to amplify the sounds you are able to hear.

• Ear infections are usually treated with antibiotics, after which hearing mostly returns to normal. Surgery can sometimes repair damage caused by injury.

• Hearing aids are classified in terms of where on the ear they are worn (in the ear canal or behind the ear).

• A cochlear implant is a small electronic device that is surgically implanted into your ear. It helps to ‘make’ sound if you have total or severe hearing loss by doing the job of your damaged or absent nerve cells.

the outer, the middle and inner ear. The outer ear directs sound waves to the eardrum, which cause it to vibrate. The three bones of the middle ear (the smallest in the human body) work together in a type of lever system to amplify the vibrations. They pass these vibrations along to a smaller vibrating membrane on the surface of the cochlea in the inner ear. The vibrations then travel through the fluid-filled spiral tube of the cochlea to tiny hair cells along the inside.

The hairs move, and nerve cells at their bases change this movement into electrical signals that are relayed to the brain, which interprets those signals as sounds. All of this takes place during a complex process that we don’t fully understand yet, and that scientists are still busy investigating.

(See page 42 for more on cochlear implants.)

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w h at h a p p e n e d n e x t ?

physical inactivity kills more people than smoking, obesity and diabetes combined.

Ben Mathewson, a Cape Town-based criminal lawyer, competes in his second Cape Epic Mountain Bike Challenge. His troubled knee gave him a reason to keep fit, healthy and positive.

knee DEEP

When Ben Mathewson damaged his knee as a teen, doctors feared he wouldn’t be able to walk by the time he was 35. Thanks to corrective surgery, therapy and a lifestyle overhaul, at 39 he cycled the Cape Epic – injury free.

Words Natanya Mulholland

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gruelling six hours in the saddle for eight consecutive days covering 780 km is hard,’ says 40-year-old Ben Mathewson. ‘But each time I’ve stood in the chute at the start of the Cape Epic, I’ve realised how privileged I am to have a second chance. It’s very special because cycling gave me a new lease on life. Completing it is an emotional experience for me, because not long before this, I was heading for a heart attack,’ he explains.

Six years ago, Ben couldn’t have imagined riding the Epic, known by athletes around the world as the ‘Tour de France of mountain biking’. His current fitness levels, let alone his positive outlook, are a far cry from what he used to be, which is what he calls ‘the going-nowhere, stressed-out, 105 kg couch potato with a bad knee’.

‘Looking back to my pre-cycling years, I had a very different physical and mental disposition. As a teenager I injured my knee in a motorbike accident.

I tore the anterior cruciate ligament (ACL), one of the four major ligaments that connect the bones of the knee joint. I had reconstructive surgery to fix it. A few years later, at a Craven Week rugby trial, I snapped that same ligament. I had surgery again to reconstruct it, but battled. I was unable to run or do any of the sport that has been such an integral part of my life.

I immersed myself in my university studies, and later in my work. But I was very angry and often used to ask myself: Why did this happen to me?’

Over the years, he gained weight. ‘I was really fat, and the weight put huge pressure on my already compromised joint. It was only when I turned 35 that I took note of the red alerts and realised I’d better make a few serious changes to my lifestyle. I didn’t want to die the same way my dad did when he was 35... and I knew I was also heading for a heart attack.’

The orthopaedic surgeon Ben saw was upfront about his condition. ‘He basically said to me: “You don’t need an orthopaedic surgeon, you need to lose weight, get fit and see a psychologist.”’

Ben bought a bike and started to get fit and shed his extra weight. He also had surgery to clean up his knee as the materials that had been used in his initial reconstruction had wasted away and were causing irritation to the joints and ligaments. Then he saw a podiatrist who helped him build up his foot strength to take strain off his damaged knee. He began eating healthily and taking additional supplements that help preserve and rebuild cartilage.

‘Today there are seven bikes in our garage,’ he says proudly. ‘My wife and two boys cycle, we have a whole new circle of friends, and I can say that it’s only

because of exercise that I’m able to cope with stress.’

Ben works as a criminal lawyer in private practice and says he wouldn’t be able to do the work he does without exercise to relieve the stress. He believes the setback of his bad knee was a bridge he had to cross.

‘I made a decision to stop blaming my knee. I had to embrace it and work through it, rather than let it destroy my life. Psychologically, I had to work hard, too. If I hadn’t had a knee injury, perhaps I wouldn’t be where I am today.’

no place for mediocrity Mediclinic has supported the Cape Epic since its inception 10 years ago. Every year they pull out all the stops to get 1 200 riders and 800 crew from 52 different countries through this arduous event – more or less intact.

‘Each day we see about 180 patients with saddle sores, lacerations, contusions and abrasions, trauma, sunburn and metabolic problems stemming from poor nutrition and dehydration,’ says Dr Basil Bonner, specialised medical projects manager for Mediclinic’s corporate events division.

‘Broken collar bones and wrists from falls on rocky ground, multiple abrasions and inhalation problems due to sandy and dusty conditions are also common.’

A Mediclinic field hospital provides medical care and deploys teams of health practitioners to three refreshment stations along the rigorous route to treat injuries and other conditions. ER24 ambulances are based at strategic points to transfer patients to hospitals for X-rays or admission. ‘We capture all riders’ details on an electronic patient record to help us manage critical evaluation and decision making,’ explains Dr Bonner.

Thanks to thorough planning, the Cape Epic remains one of the most prestigeous and wellorganised extreme adventure races in the world.

‘I might have been a rugby player, but thanks to my bad knee, I’m now a mountain biker and grateful for it.’

2011/11/29 12:19 PM

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p h o t o e s s ay

One step at a time The healing power of walking is probably best captured in the ancient Chinese proverb: ‘A journey of a thousand miles begins with a single step.’ Photographer SAMANTHA REINDERS zooms in on the therapeutic benefits of putting one foot in front of the other.

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DESERT DUNE (top)

‘I only went out for a walk and finally concluded to stay out till sundown, for going out, I found, was really going in.’

– John Muir

‘Photography is often a waiting game, requiring oodles of patience. In Sossusvlei in Namibia, I saw this guy going for a walk. I knew where I wanted him in my frame, so I waited until I had him perfectly composed.’

Sossusvlei, a salt and clay pan in the southern Namib desert, is one of the best walking destinations in the world – if you don’t mind the heat. Endless horizons and absolute silence make it even more meditative.

COUnTRY ROAD (above) ‘His solitude within this dramatic landscape in the Drakensberg area caught my eye. It’s so green, and the splash of the red umbrella made me pull over and capture the moment.’

Walk your way to a healthy heart. Wear a pedometer, count your steps at the end of each day and gradually increase your steps until you’re taking 10 000 a day.

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Seaside strides (opposite, top) ‘This is Cape Town’s Noordhoek beach before sunrise.

I’m not usually up this early, but after this particular day I wondered why I don’t do this more often. The gentle light, soft sand and fine mists of water combine in a way that’s great for both walking and photography.’

Numerous studies have shown that walking in nature reduces anxiety, promotes the secretion of endorphins (natural feel-good chemicals), boosts your immune system and, of course, helps to keep you fit.

BUNDU BASH (Opposite, bottom) ‘Hluhluwe National Park in KwaZulu-Natal offers a variety of day hikes that allow you to get really close to nature to experience the smells, sounds and textures that you often miss when travelling in a vehicle.’

A study published in the British Journal of Sports Medicine found that 30 minutes of walking per day lifted the mood of depressed patients faster than antidepressants did.

FOOTLOOSE (above) ‘Experiment with unusual angles. Put your camera on the ground and get the viewpoint of an ant, or find the highest point you can and imagine you’re seeing through the eyes of an eagle. Variety almost always makes for a more interesting shot.’

Research conducted on men between the ages of 71 and 93 showed that those who walked more than 400 m a day had half the incidence of dementia and Alzheimer’s disease than those who walked less.

SAMANTHA REINDERS Photographer An award-winning photographer and multimedia producer, Samantha’s not sure when her career actually began. ‘It was either somewhere in the curious hills of Appalachia while riding shotgun in my father’s beloved Landrover, or sandwiched between two other photographers in the press pool in the Oval Office. I love my job – it’s allowed me to chase penguins, fly on Air Force One, swim with sharks and meet interesting people – from businessmen, homeless people and grannies at cake sales, to presidents and rock stars. The profession of photojournalism is a privilege.’

www.samreinders.com

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H E A lt h y b r aa i s

food for

Healthy outdoor cooking with a stylish twist

grilled rye crostini with roasted peppers, broad beans and ricotta

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the fire Recipes and styling Abigail Donnelly Photographs Jan Ras Nutritional information Irene Labuschagne

salad in a jar

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2011/11/25 11:32 AM

BRAAIED PORK FILLET WITH BRAISED TOMATO AND CHICKPEA SALAD

N u t r i t i o n ta b l e

Serves 4

WHAT YOU NEED

2 pork fillets (± 800 g) 4 ripe tomatoes 1 punnet (250 g) cherry tomatoes 1 tin (410 g) chickpeas 1 clove of garlic, crushed 3 T pomegranate molasses 2 T olive oil ½ t smoked paprika salt and pepper

Serves 4

15 g parsley

N u t r i t i o n ta b l e

Serves 4

WHAT YOU NEED 1 medium pawpaw, peeled and chopped 1 punnet (250 g) strawberries, hulled and chopped 200 g asparagus 1 garlic bulb 50 ml olive oil 20 ml fresh lime juice salt and pepper

TO SERVE A handful of small leaves (micro-greens)

WHAT TO DO Blanch the asparagus in boiling, salted water for four minutes or until bright green and just tender. Strain and refresh immediately in ice-cold water. Braai or roast the garlic bulb for 40 minutes at 200 °C till soft. Combine the olive oil, lime juice and roasted garlic, and season to taste. Add dressing to the salad, toss together, pour into a jar and sprinkle with micro-greens.

N u t r i t i o n ta b l e

Per serving

Energy Protein Total fat Carbohydrates Total dietary fibre Sodium Saturated fatty acids Mono-unsaturated fatty acids Polyunsaturated fatty acids Cholesterol

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Season the pork fillet well and rub with the pomegranate molasses and 15 ml of the olive oil. Braai, along with the tomatoes over medium coals for 15 minutes. Squeeze the ripe tomatoes over the chickpeas and fry with the paprika and garlic in the remaining olive oil. Season. Slice fillet and serve with the braaied tomatoes, sautéed chickpeas and chopped parsley.

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1 058 kJ 2,7 g 13 g 24,7 g 6,5 g 19 mg 1,8 g 9,27 g 1,25 g 0 mg

Energy Protein Total fat Carbohydrates Total dietary fibre Sodium Saturated fatty acids Mono-unsaturated fatty acids Polyunsaturated fatty acids Cholesterol

Per serving

2 686 kJ 67,7 g 26,3 g 26,3 g 6,6 g 145 mg 7,4 g 13,43 g 2,9 g 170 mg

BRAAIED SPICY aubergine WITH POPPADOMS Serves 4

WHAT YOU NEED 2 medium aubergines 2 garlic cloves, crushed 1 small chilli, chopped 15 g fresh coriander, chopped 2 T spring onion, chopped 2 T olive oil 2 T lemon juice

TO SERVE 4 poppadoms 80 ml natural yoghurt pink peppercorns Slice the aubergines into 1 cm thick slices and braai for five minutes on each side or until soft. Chop into rough squares and toss with chilli, garlic, olive oil, lemon juice, spring onion and coriander. Season.

Cook poppadoms in the microwave until puffed. Serve with natural yogurt, ground peppercorns and poppadoms.

2 red peppers 4 large slices of rye bread 1 punnet of shelled broad beans 100 g ricotta 2 T soft sundried tomatoes, drained and chopped 2 T olive oil salt and pepper

WHAT TO DO Braai peppers over hot coals till blistered all over. Place in a bowl, cover with clingwrap and let them steam for 15 minutes. Peel over the bowl to retain the juices. Brush the bread with olive oil and toast over medium coals till toasted. Blanch broad beans in boiling salted water for two minutes. Strain and toss with 15 ml olive oil. To serve, stack the toasted rye with peppers, beans and ricotta, and drizzle with pepper juices and sundried tomatoes.

N u t r i t i o n ta b l e

Per serving

Energy Protein Total fat Carbohydrates Total dietary fibre Sodium Saturated fatty acids Mono-unsaturated fatty acids Polyunsaturated fatty acids Cholesterol

1 317 kJ 10,9 g 12,2 g 33,2 g 7g 559,5 mg 6,56 g 13,07 g 2,83 g 25 mg

T = tablespoon • t = teaspoon

nutritional information Irene Labuschagne, Nutrition Information Centre, University of Stellenbosch (NICUS)

WHAT YOU NEED

WHAT TO DO

SALAD IN A JAR

591,5 kJ 2,4 g 9,7 g 8,4 g 3g 27,5 mg 6g 9,85 g 1,7 g 10,3 mg

GRILLED RYE CROSTINI WITH ROASTED PEPPERS, BROAD BEANS AND RICOTTA

TO SERVE

braaied spicy aubergine with poppadoms

Per serving

Energy Protein Total fat Carbohydrates Total dietary fibre Sodium Saturated fatty acids Mono-unsaturated fatty acids Polyunsaturated fatty acids Cholesterol

F O O D FAC TS Braaiing is a low-fat cooking option because most of the fat is lost while being prepared.

Take care to steer clear of store-bought sauces and marinades that are loaded with salt, sugar and preservatives. Your heart and arteries – let alone your waistline – will thank you for it.

GREEN ALERT! We all agree that when it comes to braaiing, local is lekker. Take the next step and make sure that you burn alien wood such as rooikrantz or black wattle and avoid using our precious indigenous species.

summer 2011

2011/11/25 11:35 AM

H E A LT H Y B R A A I S

| CHECK OUT

NUTRITIONAL INFORMATION Irene Labuschagne, Nutrition Information Centre, University of Stellenbosch (NICUS)

BRAAIED PORK FILLET WITH BRAISED TOMATO AND CHICKPEA SALAD

Is braaied food unhealthy?

Recent cancer scares have placed a small shadow of doubt over the traditional carefree braai. But is braaied food really bad for you? The fact is, there are cancer-causing compounds present in meat called heterocyclic amines (HCAs). These compounds are released when heat reacts with the amino acids and creatinine in animal muscle. For worry-free enjoyment of your beloved braai fare, remember to marinate your meat (in a freshly prepared and healthy sauce) for a few hours – or even overnight – before you cook it. Once the meat is on the grid, flip it often and don't cook it till it's well done. The rarer, the better!

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exercise

•T he humidity created by sweating has a relaxing effect on your muscles, easing stress and fatigue caused by muscle tension.

So, instead of reaching for the antiperspirant, rather grab hold of any chance you can to get hot and sweaty and, along with it, the opportunity to keep your body and mind healthy and happy.

WORK UP A SWEAT...

IT’S GOOD FOR YOU But, as with everything in life, maintaining a healthy balance will ensure it stays that way.

Always

Words Vivian Dart

We each have about 2,6 million sweat glands in our skin. Apart from being simply a response to vigorous physical activity, sweating itself is good for you.

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ade up mostly of water, sodium chloride (salt), potassium and, in lesser quantities, urea, lactic acid and glucose, sweat is produced by the body to help regain its normal body temperature when you get hot. But while the thought of sweat doesn’t usually conjure up the most attractive of images, the facts about this remarkable – if somewhat unpopular – substance make it downright desirable.

• When your body temperature rises sharply, your sweat glands respond rapidly by ‘fetching’ water, salt and potassium from tiny blood vessels called capillaries, to form sweat. The heat from your skin causes the sweat to evaporate, which draws the heat away from your body, and this is what cools you down.

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•A recent study conducted at EberhardKarls University in Tübingen, Germany, suggests that sweat contains a natural antibiotic called dermicidin that sits on the surface of your skin and may kill harmful microorganisms such as E.coli, Staphylococcus and Candida albicans.

•W hen you sweat your pores open wide to allow liquid to rise to the surface of your skin. Toxins and impurities in your tissues and in the lower layers of your skin can then also be expelled from your body along with the sweat.

•S weat sitting on the surface of your skin for a short period of time has a slightly diluting effect on the environmental impurities with which it comes into contact.

•W hen your body temperature is high enough to cause you to sweat, your body generates more white blood cells, which strengthens your immune system.

Never • Wear non-breathable fabrics to cause excessive sweating deliberately. This will only cause you to become dehydrated, which can result in heat stroke, circulation problems or even kidney failure.

• Purposefully suppress perspiration for extended periods of time. Not being able to sweat will prevent your body from expelling toxins, which will then be forced deeper into your tissues and can cause disease.

• Use deodorants or antiperspirants that contain aluminium if you’re allergic to aluminium, as this can cause disease and damage over time.

the average person sweats up to 1,4 litres per hour while exercising. to avoid dehydration, replace this fluid with water and a balanced electrolyte solution.

PHOTOGRAPH Thinkstock

my Sweat Surrender

• Drink plenty of water while exercising – a good few mouthfuls every 15 to 20 minutes should do it.

• Rinse your skin with clean, fresh water as soon as possible after exercising.

Sweat that is left on your skin for too long can cause miliaria, also known as heat rash, which can be irritating (and unsightly).

• Use the sauna occasionally. While it won’t make you lose weight, it’s fantastic for keeping your skin soft and clear.

summer 2011

2011/11/25 11:54 AM

The framing line in our new logo mimics a hand-drawn brush stroke, symbolising the human nature of our brand. It denotes our support around the patient who is represented by the centred dot. The dot is a perfect circle, signifying how we deliberately tailor our approach to the patient, who is at the heart of everything we do.

Your hospital experience is core to Mediclinic’s business.

That’s why we’re taking a closer look at how we can further improve your patient journey. Words Lisa Templeton Photographs Jan Ras A warm welcome eases a patient into hospital, as does simplified paperwork and willing assistance.

behind the scenes

focuSed on you

We’re looking at how your patient journey can be made easier, right down to clear signage to help you find your way around.

V

isitors to Mediclinic hospitals may have noticed that a major rebranding exercise is taking place.

Gone are the traditional logo and signage that hark back to the mid-’80s, when the private hospital group was established. Today we welcome you to Mediclinic Southern Africa, part of Mediclinic International, a group of hospitals that stretches from southern Africa to the United Arab Emirates and Switzerland.

‘It’s a proud moment for us, but it means little if our patient is not experiencing a different brand,’ says Wimpie Aucamp, Mediclinic Southern Africa’s chief operating officer. ‘Patients are at the heart of our brand, so our focus is on what we call “the patient journey”.

We’re looking at each and every point at which patients interact with us to see how we can improve our service.’

Mediclinic staff members have brainstormed 350 ideas about improving a patient’s experience from before you even enter a hospital, perhaps with your first consultation with your GP, to after you’ve been discharged, had your follow-ups and rehabilitation. They’ve considered questions such as: How can we make your consultation with the specialists in private practice that much easier?

Can we improve our signage or interior design? Can we send you a welcoming SMS? These are small but important details that may help to ensure a seamless experience from start to finish.

‘For many, a hospital visit can be an anxious time.

We’re aiming to alleviate this as best we can. Patient confidence rests in the high quality of our nursing staff and technology, but if we remove stress out of every possible step and see the experience through the eyes of our patients, we can really provide excellent service,’ said Aucamp.

Roll-out is planned for 2012, so watch this space…

We’ve brainstormed 350 ideas on how to improve our service.

Our new slogan is ‘Expertise you can Trust.’ Confidence is important, as is easy interaction with our experts.

We don’t consider our job done when you’re discharged.

For us, your journey continues through follow-up check-ups and rehabilitation.

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Sounds great!

Namibians needing cochlear implants have always had to travel abroad to have this surgery. But that’s all in the past now. Words Nicci Botha

NEWS

Hendrina Shikongo (2), with her parents Lahja and Lasarus, and Dr Stephan van der Westhuizen at Mediclinic Windhoek shortly after her cochlear implant surgery.

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he lives of three young children changed dramatically in mid-September this year when their silent worlds become permeated with the sense of sound – thanks to cochlear implants. In what was a medical first for Namibia, Tjiri Tjiri Kuveza (3), Fabian Metz (5) and Hendrina Shikongo (2) underwent the procedure at Mediclinic Windhoek.

‘For a successful local programme we needed an interested and trained cochlear implant team comprising of, at least, an ear, nose and throat (ENT) specialist, an audiologist and a speech language pathologist. In addition, there had to be a permanent infrastructure in place to ensure that implant recipients are able to receive life-long care as well as reliable implant suppliers.

‘All these factors are now in place and so we’re finally able to provide a comprehensive care programme for people with cochlear implants,’ says Dr Stephan van der Westhuizen, the ENT surgeon who performed the operations.

The implant, often referred to as a bionic ear, provides a sense of sound to a person who is profoundly deaf or severely hard of hearing. It’s very different from a hearing aid, which amplifies sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognises the signals as sound.

Hearing through a cochlear implant

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is different from normal hearing and takes time to learn or relearn. It does, however, allow many people to recognise warning signals, understand other sounds in the environment and enjoy a conversation in person or on the phone.

According to Dr Van der Westhuizen, research shows that congenitally deaf children who receive cochlear implants before the age of two have better success with them than congenitally deaf children who first receive the implants at a later age. Interestingly, the critical period for using auditory information doesn’t close completely until adolescence.

There is a window of time during which congenitally deaf children can successfully receive an implant and learn to speak. Between the ages of two to four, that ability diminishes.

‘It’s important that potential recipients are recognised and evaluated as early as possible as, by the age of nine years, there is very little chance they will be able to learn to speak properly,’ says Dr Van der Westhuizen.

The devices were switched on three weeks after the operations were performed. ‘Two of the patients responded well to the testing, although the third is taking a little longer,’ he explains. ‘But it’s a lengthy process and a young child normally takes up to a year to interpret the meaning of sounds and learn to speak.’

Dr Van der Westhuizen says the criteria for candidates are rigorous and take into consideration the social circumstances and age of the patient.

‘Post-operative support is essential.

If a proper framework is not in place, there’s even less benefit to the patient than if the implant did not take place.’

The children have been working with specialists as well as the Ear Institute of Namibia. As the main supplier of the units needed for the implant, the Institute is also involved in the aftercare of the patients and will support the programme financially.

• Our next issue features more on the advancement of cochlear implants. We spoke to Western Cape Premier Helen Zille who champions the cause.

COCHLEAR IMPLANTS BYPASS DAMAGED PORTIONS OF THE EAR AND DIRECTLY STIMULATE THE AUDITORY NERVE.

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2011/11/29 12:47 PM

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IT’S BEST TO COMPLETE THE PRE-ADMISSION PROCESS. + Visit our website at www.mediclinic.co.za.

Click on ‘Patients’ to access and complete the pre-admission form online. + Or you can download the pre-admission form from the website. Click on ‘Patients’ to download the form.

Complete the form and fax it to the relevant hospital.

The fax numbers are listed on the website.

2

WHEN YOU ARRIVE AT THE HOSPITAL… + Make sure you have your ID and medical-aid card. + Go straight to the admissions desk. If you completed a pre-admission form online, you will have to confirm your details and sign to confirm that you accept the conditions of admission. + If you have not completed a pre-admission form, our staff will assist you.

3

YOU CAN NOW SETTLE IN. + After the paperwork has been completed, a porter will take you to the nursing unit. + A nurse practitioner will take down your medical history and brief you on the procedure and what you can expect at each step of the process. + It is advisable to send any valuables, such as cellphones or wallets, home with the person who brought you to the hospital.

IT’S A GOOD IDEA TO...

M Y H O S P I TA L

YOUR HOSPITAL STAY MADE EASY

Visit the hospital pre-admission centre.

Staff can advise you on: + the procedure and/or the treatment related to your admission. + the financial aspects of your hospitalisation, including how to obtain pre-authorisation from your medical aid. + the amount of cover authorised by your medical aid and any exclusion of benefits that apply to you.

MEDICLINIC HOSPITAL CARE – ON YOUR DOORSTEP GAUTENG Mediclinic Emfuleni 016 950 8000 Mediclinic Gynaecological Hospital 012 400 8700 Mediclinic Heart Hospital 012 440 0200 Mediclinic Kloof 012 367 4000 Mediclinic Legae 012 797 8000 Mediclinic Medforum 012 317 6700 Mediclinic Morningside 011 282 5000 Mediclinic Muelmed 012 440 0600 Mediclinic Sandton 011 709 2000 Mediclinic Vereeniging 016 440 5000 Wits Donald Gordon Medical Centre 011 356 6000

KWAZULU-NATAL Mediclinic Howick 033 330 2456 Mediclinic Pietermaritzburg 033 845 3700 Mediclinic Newcastle 034 317 0000 Mediclinic Victoria 032 944 5061/2/3/4 LIMPOPO Marapong Private Hospital 014 768 2380 Mediclinic Limpopo 015 290 3600 Mediclinic Thabazimbi 014 777 2097 Mediclinic Tzaneen 015 306 8500 MPUMALANGA Mediclinic Barberton 013 712 4279 Mediclinic Ermelo 017 801 2600

Mediclinic Highveld 017 638 8000 Mediclinic Nelspruit 013 759 0500 Mediclinic Secunda 017 631 1772 NAMIBIA Mediclinic Cottage 00264 64 412200 Mediclinic Otjiwarongo 00264 67 303734 Mediclinic Windhoek 00264 61 4331000 NORTHERN CAPE Mediclinic Kathu 053 723 3231 Mediclinic Kimberley 053 838 1111 Mediclinic Upington 054 338 8900

NORTH WEST Mediclinic Brits 012 252 8000 Mediclinic Potchefstroom 018 293 7000 FREE STATE Mediclinic Bloemfontein 051 404 6666 Mediclinic Hoogland 058 307 2000 Mediclinic Welkom 057 916 5555 WESTERN CAPE Mediclinic Cape Gate 021 983 5600 Mediclinic Cape Town 021 464 5500 Mediclinic Constantiaberg 021 799 2911 Mediclinic Durbanville 021 980 2100 Mediclinic Geneva 044 873 6200

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Mediclinic George 044 803 2000 Mediclinic Hermanus 028 313 0168 Mediclinic Klein Karoo 044 272 0111 Mediclinic Louis Leipoldt 021 957 6000 Mediclinic Milnerton 021 529 9000 Mediclinic Paarl 021 807 8000 Mediclinic Panorama 021 938 2111 Mediclinic Plettenberg Bay 044 501 5100 Mediclinic Stellenbosch 021 861 2000 Mediclinic Strand 021 854 7663 Mediclinic Vergelegen 021 850 9000 Mediclinic Worcester 023 348 1500

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HEALING TIME

WORD FOR THOUGHT triskaidekaphobia

(tris-ky-dek-uh-FO-bee-uh) n Fear of the number 13.

ETYMOLOGY: From Greek treiskaideka (thirteen), from treis (three) + kai (and) + deka (ten) + phobia (fear).

Relax, restore and revive Birkenhead Blooms: The Floral Art of Alyson Kessel

AY GIVEAW

| CHECK OUT

WIN ONE OF FOUR COPIES of Birkenhead Blooms by telling us about a bunch of flowers that lifted your spirits while you were staying at a Mediclinic hospital. Email us at mediclinic@newmediapub. co.za for a chance to win.

A delicious feast of flower arrangements is the focus of Alyson’s first book, Birkenhead Blooms (Struik Lifestyle, R180). This book is ideal for those seeking inspiration to create modern and stylish flower arrangements that are simple, cost effective and sumptuous. Alyson has no formal floristry training and isn’t bound by old-fashioned rules and regulations. ‘My style is minimalistic yet luxurious, quirky but pretty,’ says Alyson, who has been the florist for the Birkenhead House and Villa in Hermanus for the past six years. Page after beautiful page, she shares ideas that allow you to achieve maximum impact with minimal effort.

Although the techniques and containers stay the same, the kaleidoscope of colour combinations and the unique flower choices are always a thing of wonder.

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AND I QUOTE...

‘Love is the answer, and you know that for sure; Love is a flower, you’ve got to let it grow.’

JOHN LENNON

BLOOMING MARVELLOUS is the way we like our flowers.

To keep them fresh and giving joy, make sure you change the water every day. If you’re unable to do this yourself, ask any member of staff at your Mediclinic hospital to help you. Keeping them out of direct sunlight and trimming the ends of the stems also helps to keep cut flowers looking fresh.

C O N V E R S AT I O N S TA R T E R S • What title would you give a novel about your life?

• Can love make you unhappy just as much as it makes you happy?

• Are you truly able to do nothing when you’re doing nothing?

G R E AT W E B S I T E S TO VISIT • www.wordsmith.com for exploring and delighting in the joy of words.

• www.thefancy.com for pure inspiration. Just take a look – it’s a daily dose of great design in all its forms.

• www.gizmag.com for the latest on what’s new and happening in the world of technology.

• www.ted.com for jawdropping insights from the world’s greatest thinkers.

• www.gumtree.co.za to buy or sell anything you want.

Yes, anything!

PHOTOGRAPHS Angus Douglas, Thinkstock

OUR PATIENTS KEEP GOOD COMPANY

Vuledzani Takalani (31)

Bashiwe Kutumela (48)

Gerhard Wessels (52)

Tessa Pretorius (7)

from Cosmos City gave birth to a baby boy, Arehone, at Mediclinic Morningside. ‘My husband is, of course, my very best visitor.’

from Pretoria used to work at Mediclinic Morningside, where she was recently admitted.

‘My favourite visitors are my former colleagues.’

of Alberton enjoyed the friendly care he received from a nurse practitioner at Mediclinic Morningside. ‘It’s always nice to see her.’

from North Riding appreciated the care she received from staff at Mediclinic Sandton.

‘I like being spoiled by the doctors and staff.’

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JUST A MINUTE

game time Compiled by Ellen Cameron

Eight of the best

Thirty-four squared

An eight-letter word can be written clockwise or anticlockwise around each of the eight rings as shown.

The starting point of the first letter of each word is unknown, but some letters are provided as clues.

Each row and each column must add up to 34. Use the given clues, as well as the fact that even numbers can only be placed in yellow squares, and odd numbers only in pink squares. Complete the grid so that each number from 1 to 16 is used only once.

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3 Use the clues below to find the correct words, and then fit them into the puzzle grid correctly.

1. Lying near or next to 2. Emphasised in voice 3. An item of cutlery used with Sri Lanka’s main export crop 4. A place to buy pumps, boots and mules 5. Exhaust the marine stocks 6. The extent of the clouds, news or insurance 7. American fuel 8. Fluctuating according to the time of year

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get better soon

three-by-nine Find the nine-letter word in the middle row by solving the threeletter words in the nine columns. The three-letter words are all regular English words – no names (place names or brand names) and no abbreviations or contractions are allowed. a

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Nine-letter word hint: Only the supplest of people know their

By changing only one letter at a time – creating regular English words in each step – change the word SICK to WELL in only four steps.

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way around this place.

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what does fred do?

The official currency of Kenya is the shilling. b

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The accountant lives between Xola and the doctor.

Fred does not live next to Xola.

Jomo lives between the doctor and the teacher.

Nina is not a doctor and she lives next to the lawyer.

Neither Milly nor Xola is a teacher.

Xola lives in the fifth house.

The lawyer lives next door to the doctor.

The doctor lives in the third house.

MONEY MAKES THE WORLD GO ROUND Fred is a doctor. dentist

Xola

5

accountant

Milly

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doctor

Fred

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lawyer

Jomo

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teacher

Nina

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Job

Name

No.

MONEY MAKES THE WORLD GO ROUND

what does fred do? s s s

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get better soon 13 4 12 5 3 14 6 11 10 7 15 2 8

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Thirty-four squared e g a

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three-by-nine i n s h a 1

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Eight of the best

SOLUTIONS

1. You can use your rubles here to buy a hot rassolnik soup.

2. Lending your lempira will put you in good stead in this small Caribbean country.

3. Getting real means gaining wealth in this part of the Americas.

4. A few lev might buy a tub of yogurt in this country.

5. A loti won’t get you far in this tiny kingdom – certainly not to the top of the mountains.

6. You could buy your dinner with a number of dinars in this hot and dry country.

7. A chronic shortage of krone will make life difficult in this northern kingdom.

8. If you’re in need of a meal in this country, you can buy a goulash with some forints.

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Norway Brazil Bulgaria Lesotho Iraq Denmark Hungary Russia Botswana Honduras Mali Libya Mauritius Israel Mexico

w

Match the eight names of the countries to the currency that is used in that country, from the list of 20 possible answers.

The correct answers will spell the name of the official currency of Kenya in the highlighted column.

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Xola, Fred, Milly, Jomo and Nina each live in one of the five houses.

Each of them has one of the following professions: doctor, lawyer, teacher, accountant and dentist.

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Use the clues below to establish what Fred’s occupation is.

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net voor jy loop

geluk lê net om die draai

’n

Onlangse artikel in die joernaal Perspectives On Psychological Studies het bevind dat die intensiewe najaag van geluk, en die spanning wat onvervulde gevoelens in die verband kan meebring, jou erg ongelukkig kan maak.

Om gelukkig te wees, het deel van die lysie geword van dinge wat gedoen moet word, en daar kan mens ook tekort skiet – met nare gevolge. Soos teleurstelling, ’n algemene gevoel van ontoereikendheid en moontlike depressie. Ai tog. En mens hoef net die meeste reekse op Kyknet onder oë te kry om te besef dat ons baie gemaklik omgaan met wroeging en smart.

Toe ek ’n kind was, was daar ’n plaat wat ek goed onthou: Die 40 Vrolike Vinkies. En vrolik wás hulle. Op die soort manier wat my besonder depressief laat voel het.

So wat stel ek voor? Dat ons almal die hele tyd moet wroeg, of dat ons glimlaggend onbewus van die ellendes om ons deur die lewe moet gaan? Ek dink albei is ewe gevaarlik. Die lewe bevat iets van albei en as ons in die een of die ander vasval, bestaan ons bloot, ons lewe nie.

Maar ’n realis is ’n bedreigde spesie in ons tye. Die advertensiebedryf hou nie van realiste nie, want hulle kan nie maklik gemanipuleer word deur middel van hulle minderwaardigheidsgevoelens nie. Ons is nie dom nie, en tog absorbeer ons hierdie boodskappe oor die perfekte wêreld daarbuite deur osmose. En dit krap my om.

Dis moeilik om oor die konsep van geluk te praat sonder om aan die wêreld van advertensies te dink. Daardie blink, wonderlike plek, waar die besit of gebruik van een of ander item populariteit en sukses weerspieël of selfs veroorsaak. Die implikasie is eenvoudig: besluit om dit nie te koop nie en jy is ’n klaaglike mislukking.

In hierdie wêreld is almal mooi, behalwe die mense wat veronderstel is om snaaks te wees, families is mal oor mekaar, huise is kraaknetjies, en as kinders stout is, is hulle terselfdertyd ook oulik. Mense het nooit ernstige finansiële probleme nie en is nooit werkloos nie.

Miskien is dit tyd om vrede te maak met die feit dat perfekte huwelike nie bestaan nie, dat kinders onmoontlik kan wees, dat baie mense Saterdagaand geen sosiale program het nie en dat huise smerig word. ’n Gevoel van permanente ontoereikendheid veroorsaak dat ons nie in

die hede lewe nie, maar permanent fantaseer oor wat om die draai lê. Die waarheid is dat die hede al is wat ons het.

Dit is tyd om tog stil te staan en te kyk na wat regtig vir ons belangrik is.

Ons hoef nie ambisieloos deur die lewe te flenter nie of geen toekomsdrome te hê nie, maar dis ook onnodig om ure en ure oortyd te werk sodat ons die heel duurste motor kan koop. Tyd met vriende en familie en die doen van dinge wat vir ons nóú lekker is het ook groot waarde.

‘Gekoopte weelde is vir die armes van gees,’ volgens die skrywer Chris Barnard.

Ek beaam dit met groot entoesiasme.

En geluk lê nie om die draai nie. Dis nou en dis hier, en oor die hede is ons baie sekerder as oor die toekoms.

Die finale seggenskap hieroor behoort aan Agnes Repplier, ’n essayis van die VSA: ‘It is not easy to find happiness in ourselves, and it is not possible to find it elsewhere.’

PHOTOGRAPHS Thinkstock, supplied

Om deur die lewe te gaan met die idee dat alles net om die volgende draai sal regkom is om soos ’n kat te wees wat heeldag sy eie stert jaag.

En as jy die stert vang, begin die moeilikheid eers, sê Susan Erasmus.

Susan Erasmus is reeds 11 jaar lank ’n gesondheidsjoernalis by die webblad Health24. Sy skryf ook rubrieke vir News24, en neem in haar vrye tyd aan vasvra-kompetisies deel.

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