Bonitas – innovation, life stages and quality care

When it’s not flu’….  

While the ‘official’ flu season may still be a month or two away, reports indicate a rise in respiratory illnesses like the flu, Respiratory Syncytial Virus (RSV), and Human Metapneumovirus (HMPV), suggesting an early start to the respiratory virus season, with these viruses circulating earlier than usual.  Respiratory infections can pose serious health risks, especially for vulnerable groups such as young children, the elderly and those with chronic conditions. That’s why Bonitas Medical Fund has created the Respiratory Hub – a go-to resource for members and non-members -talking about all things related to your respiratory health. From prevention and symptoms to treatment and support, you’ll find all the information you need to take control of your respiratory wellbeing. www.bonitas.co.za/Respiratory-Hub. Respiratory illnesses that are NOT flu and for which there is no vaccine What are the most common? Dr Themba Hadebe, the Clinical and Managed Care Executive at Bonitas Medical Fund says, ‘both RSV and HMPV are being detected at increasing rates, potentially indicating a broader respiratory illness surge and are more common in young children and older adults.’ Are these respiratory diseases restricted to the winter months? Studies show that in temperate regions, HMPV mainly spreads in late winter and spring, at the same time as other common respiratory viruses such as seasonal flu and RSV. RSV is highly contagious and the season in South Africa usually runs from February to May. However, it continues to spread at lower levels and can make some people sick all year around. According to The World Health Organization (WHO), it spreads like other common cold viruses do, through infectious respiratory particles that circulate through the air. This means you can catch the virus when you are in contact with a sick person or sharing a closed space with them. You can also get infected by touching contaminated surfaces like doorknobs or handles and then touching your eyes, nose or mouth.  Why are these viruses a concern? Early increases in respiratory viruses can put added strain on healthcare systems, especially for vulnerable populations like young children and older adults.  Symptoms  Coughing, wheezing, runny nose, sore throat, fever, fatigue, muscle pain, loss of taste or smell and breathing difficulties. Who’s at risk? Children under 5, adults over 65 and people with weakened immune systems. While anyone can catch HMPV and RSV, infants, older adults and those with health conditions like immunosuppression, chronic obstructive pulmonary disease (COPD) and asthma are at higher risk for severe illness. Extra care should be taken to protect at-risk groups and health care workers from any respiratory infections. How to prevent getting them  How are they treated? Is there medical prevention?  At the moment no. Two new RSV prevention strategies are being considered for licensing and use in South Africa, namely nirsevimab and a maternal RSV vaccine. Dr Hadebe says, it is the time of the year to take precautions against all respiratory diseases. ‘Not only do these respiratory diseases make you feel ill and put added strain on the healthcare system but they can compromise your long-term health. Prevention is always best, so we urge you to follow the guidelines to avoid contracting any of these viruses and also to have a flu vaccine. While the vaccine won’t always prevent you or your family from getting the flu, it can prevent severe and secondary illness related to the flu.’   For more health tips and resources on respiratory illnesses, visit the Respiratory Hub on the Bonitas website: www.bonitas.co.za/Respiratory-Hub Remember: Your GP or clinic is your first healthcare port of call.

Bonitas – innovation, life stages and quality care

Premature birth – what to expect

Expecting a baby is an exciting time of your life, and you want to make sure that you do as much as you can to make sure your new child is as healthy as possible. Premature birth is something you want to try to avoid or manage as carefully as possible. In many cases the cause is unknown, and according to The World Health Organisation, one in ten babies are born preterm. A birth is considered premature when a baby is born before the 37th week of pregnancy. The final few weeks in the womb are important to your baby’s full development, so being born prematurely can lead to longer hospital stays, short term, and long term complications. Why does it happen? Some of the more common risk factors which contribute to preterm births are having had a premature birth before, you’re pregnant with twins/multiples or you have issues with your uterus or cervix. However, often the cause of preterm birth often can’t be identified. Your health is also a factor that impacts on your likelihood to have your baby prematurely. Smoking during your pregnancy (which is not recommended), diabetes, high blood pressure (which can develop into preeclampsia) and being over or under weight are all potential premature birth causes. To try and avoid preterm birth you can talk to your doctor about any existing health issues, such as depression, diabetes or high blood pressure) before getting pregnant – this way you can manage any problems with a treatment plan. Waiting 12 months between pregnancies and eating healthy (making sure that you get the correct prenatal vitamins needed) can also help prevent premature birth. What if my baby is born preterm? If your baby is born prematurely they are at risk for long and short term complications. Many preterm babies lead completely healthy lives, however, the more premature and underdeveloped your baby is when they are born, the more likely they are to have issues. If your baby is born prematurely they may be put into a neonatal intensive care unit into an incubator. Some babies will spend longer in the unit than others, this all depends on when they are able to live without medical support.

Bonitas – innovation, life stages and quality care

All about epilepsy

It’s not surprising that Lavender is recognised as the international flower of epilepsy. Said to symbolise isolation and loneliness, often associated with epilepsy. National Epilepsy Week is celebrated from 10-16 February this year, its purpose: To create awareness about epilepsy and support the rights and well-being of individuals with epilepsy.  Dr Themba Hadebe, Clinical Managed Care Executive with Bonitas Medical Aid, discusses the causes, types, treatment and misdirected social stigma around epilepsy.  ‘Epilepsy is the most common chronic brain disease,’ says Dr Hadebe, ‘it affects an estimated 50 million people worldwide – across all ages, cultures and backgrounds.  In South Africa, 1 in every 100 people have epilepsy. As we mark the significance of epilepsy globally, it is vital to explore this brain condition, including addressing the social challenges and stigma around the disease.’  He says, ‘despite its prevalence, many people suffering from epilepsy – especially in low and middle-income countries do not receive the treatment or understanding they need.’ What is epilepsy? It’s characterised by recurring seizures, which occur when there is excessive electrical discharge in a group of brain cells. Dr Hadebe says, ‘While seizures can range from mild lapses in awareness to severe convulsions with loss of consciousness, the frequency and severity of episodes can vary widely. Although one seizure does not constitute epilepsy, people who experience two or more unprovoked seizures are diagnosed with the condition.’ In high-income countries, treatment access is more readily available but the disease remains a challenge, due to misdiagnosis and the persistence of stigma, making life difficult for those affected. It is also worth noting that up to 70% of people living with epilepsy could become seizure-free with proper diagnosis and treatment. Yet, an estimated 90% of people in some low-income countries remain untreated. This gap in access is worsened by a lack of trained healthcare providers in these areas. Causes of epilepsy There are a number of causes, including: Types of seizures There are focal seizures, which start in one part of the brain and generalised seizures, which affect both sides of the brain. Focal seizures Simple focal seizures: The person remains conscious and may experience unusual sensations, such as strange tastes or visual disturbances. Complex focal seizures: These may impair consciousness or awareness and may involve repetitive movements such as hand-wringing or lip-smacking. Generalised seizures Tonic-clonic seizures: Involve stiffening of the muscles followed by rhythmic jerking movements, often accompanied by loss of consciousness. Absence seizures: Brief lapses in awareness, often misinterpreted as daydreaming. Myoclonic seizures: Sudden, jerky movements that can affect the limbs or entire body. Atonic seizures: Sudden loss of muscle tone, which may cause falls or head drops. The impact of seizures The impact on an individual’s life can extend beyond the physical symptoms. People living with epilepsy often experience higher rates of mental health disorders, particularly anxiety and depression. In fact, the risk of premature death for people with epilepsy is up to three times higher than the general population, with the greatest risks found in low-income countries. Treatment and care Although epilepsy is a lifelong condition, seizures can often be controlled with medication. ‘The primary treatment for epilepsy is the use of antiseizure drugs and, for up to 70% of individuals, these drugs can lead to seizure-free living’ says Dr Hadebe. ‘In some cases, when medication fails, additional options like surgery, vagus nerve stimulation, or responsive neurostimulation can help manage seizures.’ Many countries lack affordable antiseizure medications and healthcare workers may not have the training necessary to accurately diagnose and treat epilepsy. The World Health Organization’s (WHO) efforts to bridge this gap include training primary healthcare providers in diagnosing and treating epilepsy, which has already proven effective in pilot projects in countries like Ghana and Myanmar. Prevention An estimated 25% of epilepsy cases are preventable. Preventing traumatic brain injuries, improving perinatal care, reducing the incidence of stroke and infections and addressing health conditions like hypertension and diabetes, can help lower the incidence of epilepsy. In tropical regions, eliminating parasitic infections like neurocysticercosis is also critical for reducing the burden of epilepsy. The impact of diet on epilepsy management Diet can play a supportive role in managing epilepsy. The ketogenic diet, a high-fat, low-carbohydrate eating plan, has been shown to significantly reduce seizure frequency in both children and adults. It works by promoting a metabolic state called ketosis, where the body burns fat for energy instead of carbohydrates, which can help stabilise brain activity.  For individuals who do not respond well to the ketogenic diet, alternatives like the Modified Atkins Diet or the Low Glycaemic Index Treatment (LGIT) can also be effective. In addition, ensuring adequate intake of omega-3 fatty acids, vitamin D and magnesium may help support brain function and reduce the risk of seizures. More research is needed to understand the impact of diet on epilepsy, but these dietary strategies offer an important complementary approach to medical treatment. Social stigma and Human Rights Dr Hadebe says, the stigma surrounding epilepsy is a significant barrier to care. ‘Many people with epilepsy suffer discrimination, whether in the form of myths about epileptics, workplace bias or limitations on their legal rights. The problem is so pronounced that Epilepsy South Africa’s hashtag is  #StampOutStigma. In some countries, people with epilepsy face challenges in obtaining marriage licenses, employment or even the ability to drive. ‘Addressing these issues requires improved public education, along with legislation that protects the rights of people with epilepsy and ensures they receive equal treatment in all aspects of life.’ Epilepsy remains a global health issue that impacts millions of lives, particularly in low- and middle-income countries. The international community, with organisations like WHO leading the charge, continue to work towards reducing the global burden of epilepsy. By recognising the causes, types and treatment options available and addressing the social stigma, we can create a more inclusive world for people living with epilepsy.  It is time to bring epilepsy out of the shadows and into the light of understanding, compassion and care.

Bonitas – innovation, life stages and quality care

Talking about HPV, cervical and the HPV vaccine

As the Department of Health gears up for the first round of Human Papilloma Virus (HPV) vaccinations for girls between 9 and 14 from February 3 to March 28, we put the spotlight on HPV and cervical cancer. The focus is on: Empowering, Preventing and Early Detection of cervical cancer. It’s important because cervical cancer kills more South African adolescents and women aged 15 to 44 than any other cancer.  It can be successfully treated, if caught early enough but it’s far better to prevent it in the first place.  Dr Themba Hadebe, Clinical and Managed Care Executive at Bonitas, provides some insights and important information about cervical cancer – caused by persistent infection with HPV – whyit is essential to screen for the virus and the vaccination that can help prevent it. Why a vaccine against HPV? HPV infects the cells of the cervix and, in some cases, the virus can persist – leading to abnormal changes in the cells that may eventually become cancerous. Over 99% of all cervical cancers are caused by persistent infection of high-risk types of HPV, including HPV-16 and HPV-18. ‘To help prevent cervical cancer, we have expanded our preventative care benefits to include the HPV vaccine across all plans,’ says Dr Hadebe.  ‘As recommended by The World Health Organization (WHO), this is 2 doses for females aged 9 to 14 years and 3 doses for females aged 15 to 26 years, per lifetime’. Screening for HPV and cervical cancer: Screening is essential to mitigate the risk of developing cervical cancer and aims to identify cervical cell changes and detect early cervical cancers before they cause symptoms. Two screening tests help with detection: It is recommended that between the ages of 21 and 65, women should have a pap smear every two years and, from the age of 30 onwards, a pap smear and HPV test should be done every 5 years. Signs and symptoms: The symptoms of the HPV virus can include: Lesions on the genital area as well as darker lesions on other parts of the body, to painful bumps on your upper limbs and skin growths on the balls of the feet and heels. The power of prevention: ‘Talk to your daughter about important lifestyle choices she must make’, says Dr Hadebe. ‘These may be uncomfortable conversations to have but they’re vitally important to protect her from HPV and subsequent diseases.’ Discussion points include the fact that the HPV vaccination is her best opportunity for protection from the virus.  In addition, she needs to consider the following: If you develop cervical cancer: Just like other cancers, cervical cancer is graded according to severity. From in situ, which means it hasn’t spread to nearby tissue, through stage one (it’s still in the original organ and small). If it progresses, it spreads to the surrounding lymph nodes and, in the most severe form, the cancer has metastasised to surrounding tissues and other lymph nodes.  As cervical cancer develops, the following may occur: ‘Cervical cancer is the most prevalent cancer among women after breast cancer,’ says Dr Hadebe. ‘Yet it has a good chance of being cured, if diagnosed at an early stage and treated promptly. Which is why, it’s important to have regular pap smears to detect any changes in the cervix and to vaccinate young girls to protect them against possible HPV infection.’  Additional information on cervical cancer and HPV can be found on the Bonitas website: www.bonitas.co.za or the Department of Health https://www.health.gov.za

Bonitas – innovation, life stages and quality care

Physical Touch & Newborns- Why is this so Important

The birth of your baby is a beautiful and special moment in both of your lives. You may be wondering about your newborn’s senses, while they are born with all necessary senses, some are less precise than others and develop as your baby grows. Physical touch is an important aspect of your child’s growth, coming from your womb, where they are tightly cocooned in your womb. Skin to skin contact offers benefits to both you and your baby, and touch is one of the senses that can help comfort your baby, making them feel more secure and helping strengthen the bond between the two of you. Why is touch important? Touch enables your baby to learn more about the world, bond with their mother and learn communication skills, as touch and body language will be the first way that you can ‘speak’ to one another. Breastfeeding is an important part of this, as your baby then spends time in her mother’s arms. The benefits of touch goes beyond the physical. Contact between mom and baby has been shown to lower cortisol levels, which in turn benefits the functioning of the immune system.  Children that are deprived of touch can be more aggressive with other conduct disorder problems. What is swaddling? Coming from a tightly packed womb, you’ll find that your baby is comforted by touch and close cuddles. Swaddling your baby in a blanket is also another technique that you can use on young babies to help them feel more secure, as it stops them from upsetting themselves from their own startle reflex. It’s important that your newborn finds their new world a comfortable and soothing place. Swaddling is an old technique, and beyond helping your little one feel safe and secure, your baby is likely to sleep better and will be kept nice and cosy in their blanket. If you decide to swaddle your baby it’s best to do so from birth, as opposed to introducing it when they are older as this can increase the risk of Sudden Infant Death Syndrome. Using the proper techniques when swaddling is also important, as incorrect wrapping can lead to issues.

Bonitas – innovation, life stages and quality care

Why should I breastfeed my baby, and what if this is not an option?

Breastfeeding is important to your baby’s health and is the safest and healthiest thing that you can feed your little one. It is recommended by the American Academy of Pediatrics (AAP) you should feed your baby exclusively with breastmilk for the first six months. Unfortunately, some moms can’t breastfeed due to medical or health reasons. Read on if you want to know the benefits of breastfeeding, or if you can’t breastfeed your baby, here are some healthy alternatives. What are the benefits of breastfeeding?  Breastfeeding is the perfect way to get all the nutrients needed to your baby, as well as being a special bonding experience between mom and child. Breast milk is optimally suited to babies providing all the right nutrients, vitamins and minerals, being easily digestible and helping protect your baby by providing important antibodies. Baby’s who are breastfed have less ear infections, issues with diarrhea and respiratory issues. Benefits of breastfeeding include lowering your baby’s chance of getting infections and breastmilk can also help lower instances of asthma and eczema, and is thought to lower the risk of diabetes as well. Not only is breastfeeding good for your baby, but it’s also good for you. It helps your bond with your baby as your body releases the hormone oxytocin, which helps your uterus reduce to its pre-pregnancy size as well as lowers stress levels. And it’s an added bonus is that breast milk is cost effective and easily available. The only thing lacking from breast milk is vitamin D, and you can supplement this to your little one from birth. What are alternatives if I can’t breastfeed? Sadly some moms aren’t able to breastfeed their babies due to not having enough breastmilk supply, being on medication that could damage their baby’s health and, infectious diseases such as HIV. Although it’s hard not to be able to breastfeed, remember this won’t stop you bonding with or providing nutrients for your baby. The best alternative to your own breast milk is donated breast milk. However, if you are struggling to find adequate supply you can make use of baby formulas. In South Africa, the South African Breastmilk Reserve and Milk Matters supports breastfeeding moms through the provision of donated milk.  SABR focuses on helping premature babies under the age of 14 days, and Milk Matters supports babies in neonatal intensive care units (NICUs) in the Western Cape.

Bonitas – innovation, life stages and quality care

Cwebeni gets a lifeline of water

In many rural villages across South Africa, access to clean, running water is not a convenience – it’s a lifeline.  For the villagers of Cwebeni in rural Port St Johns in the Eastern Cape, fetching water for drinking, cooking and bathing is a daily struggle.  It requires long, exhausting and treacherous walks along a narrow path to a spring, while balancing buckets. Today (November 21) there is cause for celebration as the lives of this local community are being transformed, thanks to the provision and activation of a borehole and access to running water. The need The village of Cwebeni of around 400 households and 3 000 residents, face many challenges. There are few employment opportunities and little access to basic services – such as clean water, sanitation and road infrastructure. They have not had water in the communal taps for the last eight years. This means locals, including the elderly, walk up to 5km every day to access water from a water hole they share with the livestock.  ‘The entire community has suffered because we don’t have easy access to water,’ says Zuzukeli Duna, Principal of Cwebeni Junior Secondary School.  ‘Without water, daily tasks like cooking, bathing and growing food in our gardens are very difficult. A borehole would make a significant difference to us. It will greatly improve life for thousands of people in our community as well as the 361 learners at our school.’ ‘For many of us, water is readily available, so we don’t stop to think what life would be without it,’ says Dr Imtiaz Sooliman of Gift of the Givers.  ‘But access to water is a human right and, without it, communities face huge challenges including the threat of diseases, poor hygiene and malnutrition. Clean water and sanitation go hand in hand with dignity.’ Which is why when Gift of the Givers visited Cwebeni on a hunger alleviation intervention and were alerted to this crisis, they stepped in and approached Mr Duna for permission to drill on the school grounds to look for a good source of water. ‘We always attempt to place boreholes at institutions, such as schools, to secure the infrastructure,’ explains Dr Sooliman.  ‘This provides a solution for both the school and community as we extend the water outlets to outside of the school property, so that the community can benefit too.’ The intervention Gift of the Givers began exploring the possibility of a borehole and approached Bonitas Medical Scheme for funding, as part of the Scheme’s ongoing commitment to community upliftment. Feasibility studies were conducted in March, drilling began in April when water was found, yielding 960 litres per hour. The borehole, at a depth of 200 metres, was completed in July and is solar powered. The pump and control box are run off 4 x 430-watt solar panels and the system has a 1.1 kw solar motor and a Dab 24-1/37 pump. The borehole has been lined with a PVC casing to lessen the risk of collapse and 2 x 5 000 litre storage tanks are on site, as well as two taps – one inside the school grounds and the other outside for community access. Due to the water testing results showing elevated levels of coliform bacteria and to provide  safer and better-quality water, 4 x UV lights have been installed to kill the bacteria. However, it is recommended that water be boiled for drinking. The perfect partnership The partnership between Gift of the Givers and Bonitas began in 2018, the key objective: To provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions.   Lee Callakoppen, Principal Officer of Bonitas says, ‘It’s wonderful to be able to make a difference in the lives of the villagers of Cwebeni. This precious resource is essential to every aspect of life. Water provides the chance for a brighter, healthier future and no one should be denied this fundamental right. ‘This project – and others – rolled out with Gift of the Givers, reinforces our commitment to being the medical aid for South Africa.   It’s the perfect partnership, as we have the same passion and drive to assist where it is needed most. We have over 65 000 members based in the Eastern Cape and so are pleased to support this Province, in a small but meaningful way and help change lives.’ Impacting lives ‘We are so grateful to Gift of the Givers and Bonitas for undertaking this project,’ says Duna.  ‘Life has been tough, especially during the winter but we’re so happy that we now have a borehole and access to running water within the village. It is going to make the lives of our community so much easier’.   Dr Sooliman says, ‘The simple act of turning on a tap and seeing water flowing, inspires hope and possibility for a more prosperous life.’ Future investment Bonitas has committed to continuing to work with Gift of the Givers on projects that help impact the lives of vulnerable and marginalised communities, with a bias towards health interventions and access to clean water. 

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 40 of your pregnancy

Congratulations, you’ve reached the milestone that you’ve been counting up to from the beginning. It may feel surreal to think that 40 weeks ago you had your last period and now you’re about to welcome your new baby into your life. The third trimester of your pregnancy may have been fairly difficult, as your baby and belly take up more room, and your body adjusts to accommodate your growing little one. Your body at week 40 At week 40 your body is ready to give birth after housing and growing your baby for 9 months. So close to birth you may notice changes in your baby’s fetal movement, however, they will still be moving around, so if you notice a big decrease in movement, contact your doctor. Until birth, you’ll experience typical pregnancy symptoms, including leg cramps, back and pelvic pain, trouble sleeping and diarrhoea, which is normal close to birth. Your baby at week 40 At week 40 your baby is now full-term. When your baby is born you’ll notice that they are covered in a mixture of blood, vernix and amniotic fluid. On average, baby’s at week 40 weigh about 3,5 kg and they’ll be roughly the size of a pumpkin. Even though they are just about to be born, the lungs, liver and brain are still developing. Things to keep in mind at week 40 Labour can be overwhelming, and it’s important to remember that you can do this. While your doctor will have given you a due date, it is possible that your baby won’t arrive on the dot. So make sure that you keep aware of the signs of labour and have your birth plan, hospital bags and any additional plans ready (such as making sure you have someone to look after your other kids if you have).

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 39 of your pregnancy

You’re now one week away from week 40 – the final week of your pregnancy. Strange to think back 39 weeks, where you wouldn’t even have known you were pregnant. Lots has changed since then, and a lot will continue to change before and after birth. Your body at week 39 At this point, you’ll definitely be feeling your pregnancy. Braxton Hicks contractions, leaking colostrum from your nipples and the frequent urge to urinate may all be part of your daily life. You may be having trouble sleeping, struggling with pelvic and back pain, and your vaginal discharge may be tinged with pink or brown as the blood vessels n your cervix rupture. It is possible to be diagnosed with preeclampsia in your last weeks of pregnancy. This is high blood pressure in pregnancy and is accompanied by protein in your urine and swelling of the hands and feet. Vomiting, nausea and dizziness are also symptoms you may have preeclampsia, and if you suspect you have it you’ll need to contact your doctor right away. Your baby at week 39 Your baby is now roughly the size of a honeydew melon and is considered full term if they’re born this week. At this point, their lungs are producing surfactant so that when they take their first breath, the air sacs won’t stick together. Things you should keep in mind at week 39 You may be wondering if you can still keep doing light exercise, or what you can do to keep active during this time. Exercise in late pregnancy is still doable and is a good idea if you’re feeling up to it. Although you may be worried about damaging your growing baby, exercise during this time is beneficial as it can help strengthen your body for delivery and birth. That being said, it’s important to clarify what you plan on doing with your doctor, and focus on short, low-intensity exercises such as certain yoga and water aerobics.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 38 of your pregnancy

There are now two weeks left of your official pregnancy span, however, there is even a chance that you may get to meet your little one sooner, as about 5% babies are born before or after their due dates. Your breathing may be feeling easier, as your baby moves lower down into your pelvis. But this can leave you with an increasingly shrinking bladder and smaller tasks that used to feel easy are now more difficult. Your body at week 38 Don’t be surprised if your nipples start leaking colostrum around this time. You may also be experiencing frequent Braxton Hicks contractions (which will be helping to prepare you for the real deal) and your nesting instincts may have kicked in, leaving you with a strong urge to clean and organise your house. Other common pregnancy symptoms at this time are frequent urination and pressure on your pelvis and hips as your baby has dropped lower into your abdomen. You may also be struggling to sleep, have swollen feet and ankles and your vaginal discharge may be tinged pink or brown. Your baby at week 38 Your little one is almost ready to meet the world! Your baby has probably shed the soft hair, lanugo, which covered their body (although some are born with patches). Although they are mostly fully developed, if born now, they will be considered early term. They are still continuing to add fat on their body, and the brain and nervous system are continually developing. Things to keep in mind at week 38 One of the questions you may have going through your mind, is how will you be sure that labour has started? Birthing classes are a good way to get to know what to expect, but if you haven’t been able to attend any of those, there are other ways to know that your baby is on its way. Your cervix will start dilating, which your doctor will be able to track in weekly check-ups. You may experience diarrhoea and during labour  you’ll have frequent contractions which will grow stronger over time.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 37 of your pregnancy

You are now in the final stretch of pregnancy, and at the end of this week you’ll only have 3 weeks left until your due date. 37 weeks ago you had your last period – a lot has changed since then! Although 40 weeks is the official length of time for pregnancy, many women give birth before or after this time. If your baby is born between week 37 and 38, they are known as early term babies. Your body at week 37 At this point in your pregnancy you may often feel tired, and this is usually made worse by the fact that you are generally getting a poor night’s sleep. Normal pregnancy symptoms are abdominal pressure, the frequent urge to urinate, a sore back and pelvis, Braxton Hicks contractions and stretch marks. Your baby at week 37 At this point almost all babies will have moved downwards into your pelvis, most commonly they will be in the cephalic presentation, which is head down, facing your spine. There are other positions that you baby can be in, such as cephalic posterior position, which is when they face outwards, or a breech position, which is feet first. If your baby is in an awkward position such as a breech, your baby may be delivered by c-section so as to minimise the risk to you and them. Things for your to keep in mind at week 37 Around week 37 of pregnancy you may start to experience the urge to organise and clean your house in preparation for your new baby. This is known as nesting and is an instinct shared with many other animals.  Nesting may have you rearranging your household to make it more baby friendly and you may feel the need to limit social interactions. While this most commonly occurs when your delivery date is close, it can happen at any time during your pregnancy – or sometimes not at all.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 36 of your pregnancy

Congratulations, you’ve almost made it to the last month of pregnancy. This last month you’ll likely feel both excitement and nervousness, and your belly may feel cumbersome as you go about your daily life. Your body at week 36 of pregnancy As your uterus takes up more space in your abdomen you’ll find it increasingly difficult to move with ease. This is also likely to be accompanied by an achy back and lower abdomen, leg cramps, Braxton Hicks contractions, constipation and difficulty sleeping. Your baby at week 36 of pregnancy Your baby is roughly the size of a large cabbage and is almost the weight they’ll be born at. Not only that, but they are gaining weight, looking more like the chubby baby you’ll meet at birth. Your little one’s kidney and liver are beginning to function normally,  and they’ll also almost be ready to start breathing on their own. At this point your baby should have dropped lower into your pelvis, getting ready for the big day. Although this may allow you to breathe easier, it’ll put more pressure on your bladder. Things to keep in mind at week 36 Although your belly may be feeling cumbersome it’s still important that you remain active during this time (if you’re feeling up to it) – as little as 20 mins a day is likely to boost your energy levels and help ease some of your pregnancy symptoms. Exercise in the third trimester will have to be more carefully considered than before but it is possible. It’s a good idea to clear what you plan on doing with your doctor first, so that they can chat to you about any potential issues or give advice on what would be best. Walking, swim aerobics, yoga and pilates are all low impact ways to stay fit and healthy.

Bonitas – innovation, life stages and quality care

Nipping allergies in the bud

Spring has sprung and while most of us welcome the warmer weather and seeing blossoms on trees, carpets of wild flowers and new buds, millions of people dread this time of the year because of seasonal allergies.  In fact, around 27% of the world’s population suffer with seasonal allergies twice a year – during spring and autumn.   Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, gives us the low-down on seasonal allergies: What they are, how they can impact your life, avoiding triggers, how to alleviate the symptoms and when to seek help. What are seasonal allergies? Often referred to as hay fever or allergic rhinitis, these are triggered by airborne allergens, which are tiny particles that enter the body through the respiratory system.  These particles include pollen released by trees, grass and weeds, mould spores and dust mites.   When these allergens enter the body, the immune system mistakenly identifies them as harmful and releases chemicals, such as histamine, to fight them off.  The symptoms  Symptoms can last for a few weeks to several months, depending on the severity of your allergies and the length of the pollen season. Most common are: Sneezing Runny or stuffy nose Itchy or watery eyes Coughing or throat irritation Sinus pressure and headaches Fatigue Postnasal drip Ear congestion Less common symptoms include: Headaches Shortness Of Breath Wheezing Coughing If you suffer from asthma as well as hay fever, it is very likely that the seasonal allergy may trigger an asthma attack. Dr Hadebe advises asthma sufferers to take extra precautions and to carry an asthma pump. Impacting your life ‘Whatever the cause of your seasonal allergy, it can make you feel miserable,’ says Dr Hadebe. ‘Allergies can leave you feeling drained and exhausted. ‘This is usually because of disrupted sleep due to congestion and sinus issues, decreased productivity at work or school from fatigue and poor concentration, curtailed socialising by avoiding outdoor activities and compromised quality of life for those with asthma, as allergies can worsen respiratory symptoms. ‘They can cause significant discomfort, disrupt daily activities and your quality of life.’   Try over-the-counter remedies (OTC) Your pharmacist can recommend several types of non-prescription medications to help ease your allergy symptoms. Antihistamines are the first line of defence in treating seasonal allergy symptoms. They work by blocking the action of histamine  Decongestants help to relieve a stuffy nose by shrinking the blood vessels in the nasal passages. However, decongestants may raise blood pressure and should be used cautiously by people with cardiovascular conditions Nasal sprays can help reduce inflammation in the nasal passages and relieve congestion Eye Drops can relieve itching, redness and watery eyes Saline Nasal Irrigation. Using a saline rinse can help flush out mucus and allergens from your nose providing relief from congestion and a postnasal drip When to see a doctor While most seasonal allergies can be managed with OTC treatments, there are times when professional medical advice is needed. You should consider consulting a doctor if: Symptoms persist despite using OTC medications regularly You have breathing difficulties, particularly if you have asthma. Sinus infections or other complications develop  You experience severe reactions such as hives or swelling after exposure to allergens ‘Your doctor may prescribe stronger or more personalised treatment,’ explains Dr Hadebe.  ‘Immunotherapy, in particular, can provide long-term relief by gradually desensitising the immune system to allergens.’ Managing season allergies  Beyond medications, there are lifestyle changes you can make to minimise your exposure to allergens and reduce symptoms: Stay indoors during high pollen counts, especially in the morning when levels tend to peak Use air purifiers with HEPA filters to remove allergens from indoor air Shower and change clothes after spending time outside to remove pollen from your body and clothes Close windows in your home and car to keep pollen from entering Monitor allergy forecasts and take preventative measures when pollen levels are high If all else fails If your seasonal allergies are really bad and nothing else seems to work, your doctor may recommend that you have skin or blood tests to find out exactly what triggers your symptoms.  This can help determine what steps you need to take to identify which treatments are likely to work best for you.  ‘Seasonal allergies are a common but manageable condition,’ says Dr Hadebe.  ‘With the right combination of OTC medications, lifestyle adjustments and, in some cases, professional medical advice, you can reduce the impact allergies have on your life. Always pay attention to your body’s response and don’t hesitate to seek medical advice if your symptoms worsen or persist, despite treatment.’

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 35 of your pregnancy

You are now 5 weeks away from your due date, should everything go according to plan. This can be both an exciting and nerve-wrecking time, especially if this is your first pregnancy and you’ve never experienced birth first hand. Your body at week 35 At week 35 you’ll probably be feeling tired and heavy – your body will probably be feeling the strain of growing a baby. Frequent urination, lower back and abdominal pain, constipation, Braxton Hicks contractions, tender breasts and trouble sleeping are all normal symptoms at this time. When your baby moves further down into your pelvis (to get ready for birth) you may notice that your shortness of breath improves. While this may help your breathing, it probably won’t help your frequent need to urinate. Your baby moving down is known as lightening or dropping. Your baby at week 35 Your baby is now roughly the size of a pineapple or melon, has lungs that are almost developed, and a brain and nervous system that are still developing. The musculoskeletal system and the circulatory system are fully developed at this point, and if your baby was born premature they will have a very good chance of survival. Babies born between 34 and 37 are called late preterm, and while they may look like a smaller full term baby there are some challenges that they’ll face being born earlier.  Your baby will also start to move into position for birth around this time, moving down into your pelvis. Things to keep in mind at week 35 During the third trimester it is recommended that you go for a group B streptococcus test. Although this is a common bacteria in the gastrointestinal tract, it can be harmful to newborns. If your test is negative you won’t need to do anything, however, if you are positive you’ll be given antibiotics during labour which will lower the risk of your baby contracting early-onset GBS.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 34 of your pregnancy

You have now reached week 34 of your pregnancy. Your birth date is ticking closer and closer, it’s less than two months away now. During this week your baby may drop lower into your abdomen, getting ready for the big day. Your body in week 34 Your body may be feeling the strain of your growing baby. Your breasts are becoming fuller as you approach the final stages of your pregnancy, which could mean they are feeling tender and itchy as the skin stretches. Be sure to invest in a supportive bra to help with the discomfort. Your back and pelvis may also be feeling the strain, and this is generally accompanied by shortness of breath. Leg cramps, worry about your pregnancy and the frequent urge to use the bathroom can mean that your nights are lacking in sleep, leaving you feeling tired and drained during the day. A pregnancy pillow is one way which can help you feel more comfortable at night. Something else to keep in mind, is to be aware that your pregnancy hormones will have made your ligaments looser and muscles more relaxed, so take care when exercising so as to avoid injury. Your baby at week 34 Your little one is getting bigger, and is now roughly the size of a melon. The space inside your womb is also getting tighter, and you might see a little hand or foot pushing a bulge into the side of your belly when they kick. Things for you to keep in mind at week 34 Whether it’s a home birth or hospital that you have chosen, make sure that you feel familiar and comfortable with the process to eliminate any unexpected surprises. If you’ve chosen a hospital, make sure you know which buildings and rooms you need to be in beforehand, and make sure you know where the emergency exit is, just in case. The same goes for the prep of a home birth, ensure that you have a solid back up plan, should anything go wrong during the process.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 33 of your pregnancy

You now are in your thirty third week of pregnancy, and at the end of this week you’ll only have 7 more left to go (that’s just under two months!). You are probably often thinking of how your life is going to change with the newest addition to your family, and your sore and aching body serves as a constant reminder of what big changes are on their way. Your body at week 33 Your body may be feeling tired and run down. Pain and discomfort are fairly normal to you, and your body has changed significantly since week 1 of pregnancy. Common pregnancy symptoms at this time are shortness of breath, forgetfulness, constipation, heartburn, leg cramps and a sore back. Your baby at week 33 Your little one is now developing their own immune system, thanks to the antibodies being passed from you to them – enabling them to fight off germs once they are born. All five senses have developed now, and your baby can both hear and see (changes in light) in your belly. Their eyes stay open more regularly while awake and they are able to coordinate sucking and swallowing – an important skill to have once born. Things to keep in mind at week 33 You may notice that you feel irregular contractions from time to time, and these are known as Braxton Hicks contractions. However, it is a good idea to be aware of the difference between Braxton Hicks and the real deal. Braxton Hicks contractions are normally sporadic, irregular and don’t last long periods of time. These false labour pains aren’t painful and they may even stop when you change position or start doing a different activity. True labour contractions in contrast come in regular intervals and the contractions get stronger and closer together as time passes. The contractions won’t go away if you change your position and the pain from these contractions can be felt throughout your abdomen and lower back. If you go into labour before 37 weeks this is known as preterm labour. If you think you are going into preterm labour, call your doctor immediately, as they can do alot to delay your delivery.  Treatment for preterm labour isn’t guaranteed to work but it can help you stay pregnant longer – and therefore increase the likelihood that your little one is born healthy and happy.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 32 of your pregnancy

You officially have 8 weeks until delivery, but this is likely not to be exact, as many babies aren’t born on their due dates. Your body may be feeling sore and tired, thanks to the strain your growing little one puts on you. Your body at week 32 As you get closer to delivery day, you may notice more frequent Braxton Hicks contractions, which is just your body’s way of preparing for the real-deal. Your feet and ankles may be swollen and your back and pelvis are probably taking strain. Constipation, shortness of breath, fatigue, a sore mouth and leg cramps are also all common pregnancy symptoms at this time. Look after yourself (and your baby) and don’t be afraid to ask for help or to put your feet up for some well earned rest – growing a baby is hard work! Your baby at week 32 Your little one is now roughly the size of a melon and they are practicing breathing, sucking and swallowing to prepare their body for the outside world. Your baby is also busy shedding the lanugo, which is the fine hair covering their body. Most of it will be gone by the time they are born, although some babies are born with some lanugo covering parts of their body. Your baby’s finger and toenails are also growing – you may even find them fairly long when they are born. Things to keep in mind at week 32 of your pregnancy You may be wondering how realistic your due date is, although pregnancies are 40 weeks long, as little as 5% of moms give birth on their due date. Most women give birth to their babies between week 37 and 42, although about 11% of moms-to-be deliver prematurely. If you don’t go into labour within a week of your due date, you will most likely have a nonstress test which monitors your baby’s heart rate and checks they are reacting normally to stimuli. When you hit 42 weeks, your doctor may induce labour.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 31 of your pregnancy

Your baby is getting bigger and plumper – looking more like the chubby baby you’ll expect to meet. You may be feeling a dip in your energy levels, thanks to a sore body and a less-than-ideal night’s sleep. Your body at week 31 Your breasts and belly are growing, preparing your body for birth and beyond. Your baby’s kicks may be uncomfortable (yet still a comforting reminder that everything is going well in there) and you may find yourself constantly feeling tired. A good night’s sleep may be harder to come by, so it’s important that you eat healthily and exercise as this can help your energy levels. Other common pregnancy symptoms are aching and swollen feet, a sore back, constipation, stretch marks and feeling bloated. Your baby at week 31 Your baby is now roughly the size of a coconut and their bones are slowly hardening. Their skull is soft and made up of unfused bone, so that delivery is easier and brain growth can easily be accommodated. Your little one will be moving around quite a bit at this point, and you may even start to notice some patterns in their movement. However, if you notice a sudden change or stillness in their movements, it’s important to call your doctor quickly as there may be an issue. Things to keep in mind at week 31 As your belly grows, you may find sleeping harder as it becomes more difficult to find a good position to lie in. It is recommended that you sleep on your side. In particular the left side is preferable as this allows optimal blood from the inferior vena cava and takes pressure off your organs. However, don’t worry if you lie on your right as well, whatever makes you feel most at ease.  You may feel more comfortable with your knees bent and a pillow tucked between them, and you could pop a pillow under your tummy for added comfort.

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Strokes in children and adults under 45

Strokes, often associated with older adults, can also affect young people. Understanding the causes, risk factors, symptoms and preventive measures is crucial for addressing this serious health issue.  It is considered to be an early stroke if the person is younger than 45 – although not as common as older people, about 10-15% of strokes occur in children and adults under 45. Unfortunately, that number is rising.  A stroke changes your life in an instant and, although survival rates are high, around two-thirds of stroke survivors live with a disability. Dr Themba Hadebe, Clinical Executive with Bonitas Medical Fund, takes a look at some of the causes and risk factors associated with strokes as well as symptoms, treatment and preventative measures. What is a stroke? There are two main causes of stroke: Ischemic (caused by a blocked artery in the brain) and haemorrhagic (related to bleeding in the brain). A stroke may strike seemingly out of nowhere but, approximately 12% of patients may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA) or mini stroke up to 90 days before a full-blown stroke. TIAs may cause symptoms similar to an intense migraine when a clot temporarily blocks a blood vessel but gets dislodged. And a silent stroke? According to Harvard Medical School, ‘A silent stroke refers to a stroke that doesn’t cause any noticeable symptoms. Most strokes are caused by a clot that blocks a blood vessel in the brain, preventing blood and oxygen from reaching that area, resulting in brain cells dying.   Depending on the location of the clot, this can cause symptoms such as weakness in an arm or leg, trouble speaking or seeing. Sometimes, the area of damage is small and occurs in a part of the brain that doesn’t control any vital functions, so the stroke remains undetected. Causes and risk factors ‘There are a number of genetic conditions that can lead to a stroke,’ explains Dr Hadebe.  Hereditary conditions, such as sickle cell disease or connective tissue disorders Heart problems: Congenital heart defects, arrhythmias or infections like endocarditis  Blood vessel abnormalities: Conditions like arteriovenous malformations (AVMs) or aneurysms Blood clotting disorders: These can lead to the formation of blood clots that travel to the brain Infections and inflammatory conditions: Certain infections (like meningitis) or autoimmune conditions (like lupus) can cause inflammation and increase stroke risk Hormonal factors: Use of oral contraceptives, particularly in combination with smoking Trauma: Head or neck injuries can damage blood vessels, leading to a stroke He also lists some lifestyle factors that can add to the risk of having a stroke: Smoking Diabetes High cholesterol Heart disease Alcohol Obesity High blood pressure Lack of exercise Unhealthy diet Drug abuse (especially cocaine and methamphetamines) Signs and symptoms ‘The symptoms of a stroke in young people are similar to those in older adults,’ says Dr Hadebe. ‘In the youngest of stroke patients, congenital heart abnormalities or heart valve problems that lead to clot formation can cause a stroke. Most important is identifying a stroke and getting medical assistance quickly, the sooner you get treatment the better your chances are of survival and making a full recovery.’  He says you need to BE FAST when remembering stroke symptoms. Balance – trouble walking, dizziness or lack of coordination Eyesight changes – trouble seeing in one or both eyes Facial drooping Arm weakness, especially on just one side Speech difficulty – confusion and trouble speaking Time to get to hospital Women may experience other seemingly unrelated signs of stroke, such as difficulty breathing, general weakness, fainting, hallucinations or nausea and vomiting. Treatment for a stroke An IV injection of recombinant tissue plasminogen activator (TPA) is the gold standard treatment for ischemic stroke.  It breaks up the blood clots that block blood flow to your brain however, this type of medication must be given within 3 hours after stroke symptoms start. In cases of haemorrhagic stroke, surgery might be needed to repair blood vessel abnormalities. Recovery time Every stroke is different, the quickest recovery takes place in the days and weeks immediately afterwards but can continue for months and years. For all patients, the recovery process involves making changes in the physical, social and emotional aspects of their life. The injury to the brain can lead to widespread and long-lasting problems with rehabilitation and long-term support needed to help regain as much independence as possible. Brain exercises can help survivors regain thinking, reasoning and memory skills. Other activities include eating a heart-healthy diet, getting regular exercise and limiting alcohol consumption.  Mitigating the risks A healthy lifestyle – no matter what your age – that includes regular exercise and a balanced diet can certainly reduce, if not minimise, the risk of having a stroke.  Dr Hadebe says, ‘Many strokes can be prevented. Make sure you go for wellness screenings to check your blood pressure and cholesterol levels and work with your clinician to control health conditions that raise your risk. Being aware of the symptoms and following a healthy lifestyle can possibly prevent a stroke from happening in the first place.’ 

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 30 of your pregnancy

You now officially have ten weeks left of your pregnancy, this can be both an exciting and overwhelming realisation, and feelings of anxiety during this time are normal. Your little one’s kicks and growing baby bump are reminders that your due date is increasingly getting closer. Your body at week 30 Your back and feet may be increasingly getting more painful as your baby grows in size. Swollen ankles and feet are normal, so remember to give yourself some time to put your feet up and invest in some comfortable footwear. Bloating, constipation and  stretch marks are normal at this point in your pregnancy. The fatigue you felt in your first trimester may be returning. You could be struggling to sleep at night, which will leave you feeling drained during the day. Don’t be afraid to ask for help at this time, you’ll need extra hands now and after your baby has been born. Your baby at week 30 As your delivery date grows closer, your baby is constantly growing in size, and at this point she is roughly the size of a cabbage. Your little one is also prepping for the big day and they should have (or will be soon) changed position, facing head down with their face towards your back (known as the occipito-anterior position) – ready to enter the pelvis. This is the ideal position for birth, however it is possible for your baby to be lying another way inside you. Some babies will only turn this way closer to your due date. Things to keep in mind at week 30 It’s normal to feel anxious about your approaching delivery. Going to antenatal or birth classes can help you feel more prepared for what is to come. Do exercises that can help you prepare your body for what it will go though, certain yoga and pilates positions can strengthen your muscles and help make the process quicker and smoother. If you find that your anxiety is overwhelming, chat to a health professional, as you may be experiencing antenatal anxiety. This is nothing to be ashamed about, and is something that can be managed with the help of professionals.

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Pregnancy, your body and your baby – week 29 of your pregnancy

Week 29 of your pregnancy and you may notice that your body is taking more strain. Be mindful of this and don’t be afraid to take it easy if needed. Make sure that you’re still eating healthily (and remembering to take your prenatal vitamins) and exercising gently, both are important to your health as well as your growing baby’s. Your body at week 29 You are now entering the last phase of your pregnancy, and because of this you may find this very challenging, both physically and mentally.  Your back, pelvis and feet are probably aching, and you’ll experience constipation, frequent urination and shortness of breath. Your baby at week 29 Your baby is now filling more of your womb, this means that any kicks, which used to be soft and barely notable, may feel more like hard pokes now. Your little one is also growing rapidly, and will probably have doubled in weight before birth. At this point many of their organs are almost fully developed, meaning they have a good chance of survival if born premature. That being said, their lungs still have lots of developing to do, which is why preemies need help breathing via a ventilator. Things to remember If you haven’t already, start planning your maternity leave. In South Africa, moms are entitled to four months of unpaid leave. If you’re still feeling able to work, you’ll probably want to keep most of your leave for after birth, so that you can spend as much time with your growing baby as possible. Generally speaking, maternity leave begins about a month before birth –  and the good news is dads are now entitled to 10 consecutive days of parental leave. Your employer is obliged to keep your job for you until you return from leave, so you won’t have to worry about losing your job.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 28 of your pregnancy

Welcome to week 28 of your pregnancy, you are now in your third trimester – the final stretch before birth! Your baby will do lots of growing during this time, and your body may start taking some strain in the final weeks before delivery. You’ll probably be feeling both nervous and excited, soon you’ll be able to take your little one home! How your body will be feeling at week 28 If you haven’t started experiencing it already, you may notice that back ache and pelvic pain are becoming an issue. This is due to the fact that pregnancy hormones cause your ligaments to loosen, which can cause lower back and pelvic pain. Your changing centre of gravity also puts strain on your back. Excruciating pain in your pelvic reason is cause for concern and the culprit could be symphysis pubis dysfunction (SPD). Luckily this isn’t harmful to your baby, but is probably very painful to you. Chat to your doctor if you’re feeling pain that you see as abnormal. They’ll probably recommend a physiotherapist to you as physio can help minimise your pain and improve your muscle function. Other common week 28 pregnancy symptoms include Braxton-Hicks contractions, frequent urination, swollen ankles and feet, sleeping problems, stretch marks, heartburn and indigestion and constipation. Your baby at week 28 Your little one is growing fast, and is now the size of a head of lettuce. Around this time your baby will begin to open and close their eyes,  and can sense changes in light. Your baby’s heart rate will have lowered to about 140 bpm (and at birth this will have dropped to around 130 bpm). If you were to have an ultrasound now you may notice hair on your baby – this is known as lanugo, which is fine hair that grows on babies before birth. This will disappear at birth or shortly afterwards.

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Pregnancy, your body and your baby – week 27 of your pregnancy

Congratulations, you are now in the last week of your second trimester and approaching the third, which will start at the beginning of week 28 –  so you are nearing the final stretch of your pregnancy. You’ll find that you’re probably becoming more used to your little one moving around inside of you and while you may have enjoyed less fatigue during trimester two, this unfortunately may begin to change. Your baby at week 27 Your baby is starting to pack on the final pounds before birth (which should be in 13 weeks, but not all babies arrive at their due date). Inside of your uterus, your little one will be kicking and grasping, slowly developing their muscle tone before birth. Your baby will also be practicing breathing and swallowing with the amniotic fluid. Your body at week 27 Haemorrhoids are a common pregnancy, thanks to your uterus becoming larger and putting pressure on your veins. Haemorrhoids are swollen veins in the anus and rectum, and these are both uncomfortable and painful. While these are unwanted, they generally aren’t harmful to you or your growing baby and normally go away after birth. Other pregnancy symptoms common during this time are leg cramps, aching pelvis and back, heartburn bleeding gums,  constipation, trouble sleeping, frequent urination and stretch marks. Things to remember at week 27 At week 27, something you can start considering is putting together a birth plan. A birth plan is a written document that communicates your wishes during your pregnancy (think of the ideal way you’d like your birth to go) as when the time comes, you probably won’t be thinking clearly.  There is no right or wrong way to go about doing this – some may be detailed and others just cover the basics, the choice is yours!

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Pregnancy, your body and your baby – week 26 of your pregnancy

Although you are yet to meet your baby, they are slowly taking over your life and you may notice weekly and even daily changes in your body. Some days you’ll feel better than others, and it’s important that you take each day as it comes. Both by taking advantage of your good days, and being gentle on yourself on the bad ones. How your body may feel during this time Tiredness, an achy body, a sore mouth and stretch marks are all part of your pregnancy journey. Your belly and breasts are also growing, so make sure that you accommodate your body and dress in clothes that are both supportive and comfy. Your baby’s growth at week 26 Your little one’s lungs are now working hard, getting ready for the day that she’ll need to start using them. At this time the lungs start to produce surfactant, which’ll make it possible for your baby to breathe at birth. Your baby’s suck reflex is  growing stronger (they may even suck their thumb!), and their eyes may open for the first time around now and they’ll start to practice blinking. Not only this, but your little one also has eyelashes that are starting to grow. Now that your baby can hear you, you can also spend some time talking to them. Research has shown that babies prefer the sound of their mothers voices and you may even notice that they start responding to the sound of your voice, and by late pregnancy they should be able to distinguish between voices. What you should keep in mind at this time Something to keep aware of during your pregnancy is the possibility for gestational diabetes. Gestational diabetes is high blood sugar levels during pregnancy, and it’ll go away after birth. However, moms who develop gestational diabetes are at higher risk of developing type 2 diabetes after birth. Warning signs are unusual thirst, frequent urination and dizziness, if you feel like you are checking these boxes then it’s important to speak to your doctor about treatment. If treated effectively, there is no reason you shouldn’t have a healthy pregnancy.

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Debunking myths about Mpox

Myths are widely held beliefs about various issues, including illness and disease. They come about through frequent storytelling and retelling. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, helps debunks myths about monkeypox (mpox).  Myth 1: Mpox (formerly monkeypox) is a new disease created in a lab Fact: The mpox virus was discovered in Denmark (1958) in a colony of monkeys at a laboratory kept for research.  The first reported human case was in 1970 in the DRC. Mpox is a zoonotic disease, meaning it can be spread between animals and people. It is found regularly in parts of Central and West Africa and can spread from person to person or occasionally from animals to people.   Myth 2: Mpox comes from monkeys Fact: Despite its name, monkeypox does not come from monkeys. The disease earned the name when the ‘pox like’ outbreaks happened in the research monkeys. While monkeys can get mpox, they are not the reservoir (where a disease typically grows and multiplies). The reservoir appears to be rodents. Myth 3:  Only a handful of people have contracted mpox Fact: Globally, more than 97 000 cases and 186 deaths were reported across 117 countries in the first four months of 2024. South Africa is among the countries currently experiencing an outbreak.  On the 5 July, it was reported that the number of mpox cases in the country has risen to 20. This after four more cases have been confirmed in Gauteng and KwaZulu-Natal in the last few days. 15 patients have, however been given a clean bill of health.  Myth 4:  It is easy to diagnose mpox Fact: It is easy to mistake mpox for something else. While the rash can be mistaken for chickenpox, shingles or herpes, there are differences between these rashes. Symptoms of mpox include fever, sore throat, headache, muscle aches, back pain, low energy and swollen lymph nodes. Fever, muscle aches and a sore throat appear first. The rash begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet and develops over 2-4 weeks in stages. The ‘pox’ dip in the centre before crusting over. Laboratory confirmation is required. A sample of one of the sores is diagnosed by a PCR test for the virus (MPXV). Myth 5: Mpox is easily treated Fact: ‘Currently,’ says the National Institute for Communicable Diseases (NICD), ‘there is no registered treatment for mpox in South Africa. However, the World Health Organization (WHO) recommends the use of TPOXX for treatment of severe cases, in immunocompromised people’. However, the Department of Health (DoH) has only obtained this treatment, with approval on a compassionate use basis, for the five known patients with severe disease.  There is no mpox vaccine currently available in South Africa. Myth 6: You can get mpox from being in a crowd or from a public toilet seat Fact: Mpox is not like Covid-19 which is highly contagious. It spreads through direct contact via blood, bodily fluid, skin or mucous lesions or respiratory droplets.  It can also spread though bites and scratches. Studies have shown that the virus can stay on surfaces but it is not spreading in that way or in a public setting. The risk of airborne transmission appears low. Myth 7: Mpox is deadly Fact: While mpox lesions can look similar to smallpox lesions, mpox infections are much milder and are rarely fatal. That said, symptoms can be severe in some patients, needing hospitalisation and, in rare cases, result in death. It is, however, painful and very unpleasant. So, it is important to avoid infection. Myth 8: Mpox is sexually transmitted  Fact: You can become infected though close, direct contact with the lesions, rash, scabs or certain bodily fluids of someone who has mpox. Even though this could imply transmission though sexual activity, it is not limited to that.  You can also be exposed if you are in close physical proximity to infected people, such as spouses or young children who sleep in the same bed.  Myth 9: I can’t protect myself from getting Mpox Fact:  You can take precautions: Avoid handling clothes, sheets, blankets or other materials that have been in contact with an infected animal or person. Wash your hands well with soap and water after any contact with an infected person or animal and clean and disinfect surfaces. Practice safe sex and use personal protective equipment (PPE) when caring for someone infected with the virus. Myth 10:  You can’t stop other people being infected by you Fact: You may not protect them by 100% but you can isolate. Also, alert people who have had recent contact with you.  Wash your hands regularly with soap and water or use hand sanitiser, especially before or after touching sore and disinfected shared spaces.  Cover lesions when around other people, keep skin dry and uncovered (unless in a room with someone else).  Mpox is a notifiable medical condition but is treatable, if you are concerned, call the DoH toll free number of 0800 029 999 but remember, your GP is your first port of call for all your healthcare needs. 

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Pregnancy, your body and your baby – week 25 of your pregnancy

As you enter week 25 of pregnancy, you will be nearing the end of the second trimester and the start of the third. You may find that your rise in energy levels you felt at the beginning of your second trimester is now beginning to drop. Your baby at week 25 Your baby is now roughly the size of a cauliflower and they are slowly starting to become the chubby baby you’ll expect at birth, as fat is added to their body every day. Your little one is also starting to develop a sense of balance, becoming more aware of what is up and down. Not only this but your baby’s lungs are slowly developing closer to maturity, as blood vessels (caprillirs) grow and they start to practice breathing in amniotic fluid. Your body at week 25 As your baby grows, it is normal that your back and pelvis may be starting to take some strain. This is also thanks to pregnancy hormones which cause your ligaments to soften. To avoid any injuries, make sure you aren’t tempted to over stretch if you’re doing something such as yoga and don’t lift any heavy objects around the house or office. If your back is feeling sore, gentle exercise in water, such as aqua aerobics, can help alleviate the aching. However, if your back is seriously painful , chat to your doctor about finding a physiotherapist who can help you during this time. Other common pregnancy symptoms around this time are heartburn, sore feet and ankles, camping in your legs, swollen and bleeding gums, dizziness,  trouble sleeping and stretch marks. Although many aspects of pregnancy (and certainly afterwards) are rewarding, there are also many parts of it which can be uncomfortable. Things that you should keep in mind Cravings are a natural part of pregnancy (and these generally peak in your second trimester), and they are the sudden desire to eat a particular kind of food. These can be odd foods and combos that you’ve never had the urge to eat before, and generally these are personal to you. Strange combinations, such as pickles and ice cream, might suddenly be on your most wanted list. Just be aware of what you are consuming, as trying to keep things healthy will be best for your growing baby. Unfortunately big meals can also mean heartburn, so little and often can often be the answer here. The book: http://picklesandicecreamcookbook.com/

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 24 of your pregnancy

You’re a good few weeks past half way of your pregnancy, which means you are closer than ever to finally meeting your little one. In terms of months, you’re about 6 months in, which means you only have 3 left to go! Your Body at Week 24 As you near your third trimester, you may notice that your body is feeling more uncomfortable thanks to your growing baby. Back ache, tired swollen feet, leg cramps and constipation are all pretty common during pregnancy. You’ll also be gaining weight (which is completely normal) and your breasts are also bigger. Heartburn may be something that you’re struggling with and this is  normal during pregnancy thanks to hormones and your growing baby taking up space. Your pregnancy hormones are the reason the valve between your stomach and throat doesn’t close as it should, as the hormones relax the tight muscle between your stomach and your esophagus. Your growing uterus can also put pressure on the stomach, making it more likely that acid can spill out. Your Baby at Week 24 As your baby grows, they are putting on more and more weight, and their muscles are developing and gaining strength – which means their kicks are getting stronger and harder. Your little one also has hair at this point, however, none of it is pigmented yet. Your baby is pretty active now, and you should feel them move around regularly, however, unless you don’t feel your baby moving around for long periods of time, stillness is nothing to be concerned about. Things to take note of While it may seem obvious, eating healthily and frequent exercise are both ways to stay mentally, physically and emotionally happy and healthy during pregnancy. While a few stresses here and there are common, a constant state of worry or sadness is probably a sign of antenatal depression or anxiety. If you feel like you don’t have the energy for small tasks or every small detail of your pregnancy is triggering anxiety, it may be best to both seek the support of those you love, and medical professionals.

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 23 of your pregnancy

Your growing baby is making her presence known, and you may regularly feel little kicks inside you when she is awake. Your body is also starting to take some strain, and you may have uncomfortable feet and back to name a few. While you are excited to meet your little one, you may notice this excitement in strangers who might attempt to touch your baby bump, and this added attention is not necessarily something you’re happy with. Your body at week 23 At week 23 you may be experiencing a variety of bodily aches and pains as your body takes on the strain of growing and carrying a small human. Leg cramps, swollen feet, bleeding gums and a tired, sore back are unfortunately all normal during pregnancy. During this time you may also feel stressed out and overwhelmed. Although pregnancy is a beautiful and exciting time, it can also be very stressful for moms to be. You may be under financial strain, and you may feel pressure at work to finish up pieces of work before going on maternity leave. All of this is normal, and if you feel like you’re not coping well it’s important to speak to a health professional who can help you through this tough time. Your baby at week 23 Your baby is now the size of a squash and in their 23 week, your baby is now able to survive outside your body if they are born prematurely (although they aren’t’ ready to be born yet and have lots of growing to do!). Their lungs are developing and their face is fully formed, it just needs to do some filling out first. Your baby is also gaining weight each week (they should double in weight in the next 4 weeks), so by the time your baby is born, she’ll be the plump, chubby little one you’re expecting. Their middle ear bone is also hardening, and they are able to hear you talking to them. Things you should remember at week 23 During your second trimester as your baby bump grows you may experience both wanted and unwanted attention to your baby bump, as well as advice from everyone – from strangers to your mother. Dealing with this added attention can be overwhelming at first, but be sure to state your boundaries clearly if strangers attempt to touch your bump. While some moms-to-be may not mind extra attention, others may not like the invasion of their space when strangers want to touch their growing baby belly.

Bonitas – innovation, life stages and quality care

Partnership with GOTG brings water to teaching hospital

When a hospital has interrupted water supplies, the consequences are dire. Water that is essential not only for handwashing, hygiene and drinking but for cleaning and sterilising instruments, laundry, cooling medical gas and suction compressors for patients on ventilators. The list is endless.  It is clear that both the patients’ health and the medical staff’s ability to provide quality healthcare will be severely compromised.  This is what happened at Kalafong Hospital – an 1 118-bed teaching hospital in Atteridgeville, Pretoria. The hospital was built in the 1973 and services a large population of residents in Pretoria and beyond. The University of Pretoria uses Kalafong Hospital as a training institute for the Faculty of Health Sciences.  They reached out to Gift of the Givers (GOTG) with respect to water challenges at the hospital and GOTG agreed to step up to another issue that required humanitarian aid.  ‘We rely on stable water supply to service patients adequately and provide a safe training environment for our students,” said Professor Priya Soma-Pillay, the Chairperson of the School of Medicine at UP.  ‘As the Chairperson of the School of Medicine at UP responsible for training at our health facilities, I’m grateful to Gift of the Givers Foundation and Bonitas for hearing our plight. With consistent and reliable water supply we can ensure the health and safety of patients, staff, students and the proper functioning of medical equipment.’    GOTG began exploring the possibility of a borehole to supply uninterrupted water and partnered with Bonitas Medical Fund for funding.  Drilling began on 20 January this year and by the 26 January they found water at 148 metres.  The borehole currently yields 8 000 litres per hour and is literally a fountain of life for this healthcare facility. In addition, 8 x 10 000 litre water storage tanks have been installed. The partnership between Gift of the Givers and Bonitas began in 2018, the key objective: To provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions.  Bonitas donated R1.2 million to the Kalafong Hospital borehole project. Lee Callakoppen, Principal Officer of Bonitas says, ‘This and the other projects carried out together with GOTG, align with the Scheme’s commitment to being the medical aid for South Africa.  It is the perfect partnership, as we have the same passion and drive to assist where it is needed most. ‘ The borehole will provide water to the hospital’s reservoir and supplement the municipal water supply by 150 000 litres a day. This is over half of the hospital’s daily consumption of between 200 000 and 250 000 litres.  It will also help lower running costs by reducing the water bill, these savings can be channelled into other operational costs.   Importantly though, when there are intermittent water cuts in the area, the hospital can rely solely on the borehole to continue to function efficiently.  The water was tested using The South African National Standard (SANS) 241 test – a drinking water specification that outlines the minimum requirements for potable water to be considered safe for human consumption, after an ultraviolet system was installed Other projects involving the partnership between GOTG and Bonitas include:  Sponsoring final year medical students who were struggling financially, water interventions at Tower Psychiatric Hospital, Senekal Orphanage, Cwebeni Village in the Eastern Cape, disaster relief after the KZN floods and the sponsoring an audiology programme testing the hearing of 16 000 learners in KZN. Dr Imtiaz Sooliman says, ‘We know what a difference this consistent water supply has made to Kalafong Hospital. After all, clean water is life and clean water is health.  We look forward to our continued partnership with Bonitas, always with the health and wellness of South African being the priority.’

Bonitas – innovation, life stages and quality care

Pregnancy, your body and your baby – week 22 of your pregnancy

Your second trimester has you feeling more yourself, and feeling your growing baby moving inside your tummy is bound to bring a smile to your face. Your body may be feeling some strain as your baby grows in weight and size, and you’ll need to remember to eat healthy in order to ensure that you little one receives all the needed nutrients from you. Changes to your body at week 22  Your body may be feeling slightly uncomfortable all round thanks to the changes that pregnancy has had on your body. You may notice your back, pelvis and hips aching, leg and foot cramps, as well as swollen feet. This can be alongside heartburn, constipation (and possible haemorrhoids) as well as stretch marks. Your baby’s growth at week 22 Your baby is now approximately the size of a coconut and is sleeping in cycles – the time that you don’t feel them moving around will be when they are asleep. At this time your little ones taste buds are developing, and what they find tasty later in life may be influenced by what you’re eating. So try to keep it healthy and to stick to fruit and wholesome veggies. Their eyes are almost fully developed but lack colour in the iris. Your little one is also becoming more sensitive to outside stimuli, so you may notice that they react to loud noises. Things to remember at week 22 During your pregnancy, eating healthily is something that is important to keep in mind. Afterall, what you eat is nourishment for your baby. During your second trimester try and eat foods that are rich in protein, calcium and iron. These will help your baby’s growth – protein helps in tissue development, calcium helps in the formation of bones and teeth, and iron helps carry oxygen to your developing baby.

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