Bonitas - Parenting Hub

Pregnancy, your body and your baby – week 17 of your pregnancy

Week 17 your baby is getting bigger, and this week they’ll start developing more fatty tissue. You may have started to notice an achy back and pelvis, and getting a good night’s sleep may have become increasingly more difficult. Your body at week 17 At week 17 you may see an increase in your appetite, a far cry from the nausea you experienced in your first trimester. Your breasts are also increasing in size as they prepare for milk production – for some women this growth is more than others. Your growing baby’s weight can also put added strain onto your spine and pelvis, meaning you could start to experience backache. Prenatal yoga and supportive chairs and shoes, are all ways in which you can help your body feel more comfy. Your baby at week 17 Your baby is now the size of an onion or orange, and at this time her fatty tissue is starting to form – this will help keep her warm after she’s born. Although the head is still the biggest part of the body, the body proportions are starting to become more even as your pregnancy progresses. Your baby is now learning to suck, so that when they’re born they can easily feed, although this reflex won’t mature until later in your pregnancy. Around this time, your baby’s finger prints will also form. Things to remember at week 17 Your pregnancy changes your whole life, including the way you sleep. Even though the position you sleep in is something fairly simple, which you probably hadn’t put much thought into before. As your pregnancy progresses, a good night’s sleep is something that may become increasingly difficult. It’s recommended that you avoid sleeping on your back in your second and third trimester, as your uterus and baby can put pressure on your spine and vena cava. Sleeping on your left side is ideal as this supports optimal circulation. Once your belly gets bigger, you can even look into getting a pregnancy pillow, which offers support for your entire body.

May 6, 2024

Pregnancy, your body and your baby – week 16 of your pregnancy

You are now 4 months pregnant, and have 24 weeks left to go before you birth day, although this may seem far away your baby has done so much growing in these past 16 weeks and still has lots left to do before they are born. Your body at 16 weeks Your pregnancy hormones can make your veins stretch, giving you varicose veins. While these distinctive purple lumps are the prettiest sight, generally they are painless and harmless. Pregnancy brain is another sign of a baby that you may have noticed, many moms-to-be notice they may become more forgetful or inattentive. The exact reason for this isn’t clear, however, stress and having many items on your to-do list could be contributing factors towards this. You may also notice some pregnancy weight gain (which is normal and nothing to worry about!) and your boobs will have probably gone up a few cup sizes as your body preps for breastfeeding. Be sure to invest in comfortable bras, such as maternity or sports bras, as this can help ease any discomfort. Your baby at 16 weeks Your baby is now the size of an avocado. This week may be the one that you first start to notice small kicks from your little on moving around. Another exciting marker of this time is the fact that your baby can start hearing your voice, so make sure you chat to them throughout your day. This’ll also be roughly the time that their eyes become more sensitive to light, their bones and muscles are hardening and strengthening and their eyebrows, hair and lashes are forming. Things to take note of around this time. During pregnancy you may struggle with constipation. This is a fairly common pregnancy complaint thanks to pregnancy hormones and the extra iron you’re taking in your prenatal vitamins. Eating more fibre, drinking lots of water, and exercise can help keep you regular. If you’re still struggling, chat to your doctor and they may prescribe stool softeners to help.

May 2, 2024

Measles – it’s a serious illness

The World Health Organization (WHO) has warned of an ‘alarming’ increase in measles cases – almost 45-fold in Europe last year – but outbreaks of new cases and even deaths are being reported globally. WHO believe this is a result of fewer children being vaccinated against the disease, especially during the Covid pandemic. However, measles is preventable, thanks to a vaccine that was introduced in 1963. Since 2000, the measles vaccination programme has averted an estimated 57 million deaths worldwide. However, the Covid-19 pandemic disrupted global vaccination activities which, in 2021, resulted in the lowest measles-containing-vaccine first-dose (MCV1) coverage levels since 2008. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund takes a look at this ‘childhood’ disease to remind us about what causes it, the symptoms and why we should vaccinate. What is measles? Measles is caused by a virus and can affect anyone but is most common in children. It infects the respiratory tract and then spreads throughout the body. Some of the more common measles symptoms include: High fever Cough Runny nose Red, watery eyes (conjunctivitis) A rash all over the body (3-5 days after symptoms begin). Complications of measles can lead to: Ear infections Diarrhoea Pneumonia (infection of the lungs) Other respiratory infections Encephalitis (inflammation of the brain) which occurs in about one in every 1 000 people with Measles. Blindness Measles can be serious Measles is so much more than just a fever and rash that clears up in a few days. It can cause serious health complications, especially in children under the age of 5 and adults over the age of 30. If a woman catches Measles during pregnancy, it can be dangerous for the mother and can result in her baby being born prematurely with a low birth weight. Even with the best care, people can still die after contracting measles (1 to 3 out of 1 000 people). Being vaccinated is the best way to prevent getting sick with measles or spreading it to other people. Measles is contagious Measles is easily spread through the air when an infected person coughs or sneezes. It is very contagious: One person can infect up to 9 out of 10 people around them if they are not adequately protected. In fact, an infected person can spread measles to others even before they know they have the disease – from up to four days before developing the measles rash to around four days afterwards. The measles vaccine The best protection against measles is the Measles-Mumps-Rubella (German Measles) (MMR) vaccine. The MMR vaccine provides long-lasting protection against all strains of measles. Your child will need two doses of MMR vaccine for best protection: The first dose at between 12 and 15 months of age The second dose at between 4 through 6 years The Measles-Mumps-Rubella-Varicella (MMRV) vaccine, which protects against four diseases, is also available to children from 12 months through 12 years of age. Treating measles As measles is caused by a virus, there’s no specific medical treatment, it has to run its course. However, if your child has measles they need to drink plenty of liquids, get lots of rest and stay at home to prevent spreading the infection. Measles outbreaks The people most at risk during a measles outbreak are non-immune person (not vaccinated or vaccinated but did not develop immunity). Unvaccinated young children and pregnant persons are at highest risk of severe measles complications. The fact is that measles is still common and with a break in the vaccination regime we are seeing more outbreaks. The best way to fight it and prevent it spreading is to vaccinate. Did you know? South Africa follows International Guidelines in providing vaccines to children. This programme is known as the Expanded Programme of Immunisation (EPI). Parents need to take responsibility to ensure their child is vaccinated on time: Not only to help protect the child against certain illnesses but also to contribute to the overall health of children in the general population. ‘Childhood vaccines are a critical part of a child’s health, they work by stimulating and teaching the immune system how to fight certain infections,’ explains Dr Hadebe. ‘Bonitas recognises this and we cover immunisation, on most plans, according to EPI up to the age of 12.’

April 25, 2024

Pregnancy, your body and your baby – week 15 of your pregnancy

Congratulations, you and your baby are now at week 15, while your baby still has lots of growing to do, you should make sure that you make the most out of feeling more energetic during trimester two. Join prenatal classes, enjoy walks outside and start planning how you’ll rearrange your house for the arrival of your new bundle of joy. Your baby at week 15 Your little one is now roughly the size of an apple or pear, and at this point your baby’s ears and eyes are starting to become more developed, and are moving into the correct place on their head. Soon they may even be able to hear the sound of your voice. During this time their bones and muscles are also getting stronger, not only this but her limbs are getting longer and are able to move. You won’t be able to feel any movement just yet, but it won’t be long! Your body at week 15 At week 15, your increased energy levels may also mean that you may experience increased libido. Although you may have higher energy levels, you’ll probably also notice that your expanding belly is itchy, thanks to stretching skin. If you are feeling increasingly hungry, thanks to a reduction in morning sickness, be aware of what you’re putting into your body. Certain foods, such as ripened cheese, can be damaging to your baby. However, the inclusion of healthy snacks can be beneficial to both of you, and by doing research or chatting to a dietician, you can make sure that you include food groups that’ll be nutritious to you and your baby. Things to keep in mind at week 15 Another pregnancy symptom is sensitive gums and teeth. The reason for this is hormonal changes which increase the blood flow to your gums, making them swell. Not only this but you may be more susceptible to gum disease and pregnancy gingivitis (which about half of all women experience during pregnancy). Because of this it’s important that you look after your teeth and gums, and check in the dentist during your pregnancy.

April 22, 2024

Pregnancy, your body and your baby – week 14 of your pregnancy

Week 14 of your pregnancy and you’re in month four of your pregnancy with five to go – almost half way already. Trimester two of pregnancy means you should be feeling renewed levels of energy and you may even notice that your appetite has increased thanks to morning sickness slowly easing up. Your baby in week 14 Your baby is now the size of a peach, and now often moves her arms and legs – but you won’t be able to feel this yet. If you could see into your belly, you may even notice your little one sucking their thumb! Around this time the grasp reflex is evolving, and hair growth is starting as follicle under the skin, so that when they’re born your baby should have silky strands of hair. Your little one’s genitals are now also fully developed, but it’ll still be difficult to tell their gender on ultrasound. Your body in week 14 Luckily during your second trimester you’ll be feeling more yourself, with rising energy levels, breasts that are less tender and dissipating nausea. You’ll also probably starting to show a bit as well, however, some moms, especially those expecting multiples, may start showing sooner. This is because your uterus is rising out of the pelvic region and into your lower abdomen. During the second trimester you’ll also notice that you’ll start to put on weight, don’t be alarmed by this as it’s completely normal and healthy during a pregnancy. Things to take note of If you found that during your first trimester your pregnancy symptoms meant that you generally stayed away from exercise, embrace your renewed energy levels and start doing gentle exercises such as water aerobics, prenatal exercise classes and gentle walks. This’ll be beneficial to both you and your growing little one.

April 15, 2024

Pregnancy, your body and your baby – week 13 of your pregnancy

At week 13 of your pregnancy you are now in your second trimester. This trimester is often nicknamed the honeymoon period, as your pregnancy symptoms should have started easing up, and your baby is still small enough that you don’t feel uncomfortable. Your body at week 13 At week 13 your energy levels should start increasing, but if your nausea and fatigue don’t disappear just yet – don’t despair, some moms experience these for longer than others. This increase in energy won’t stick around forever, so make the most of this time while you can and tick important to-dos off your list. Your blood flow will also increase during this time, and because of this you may see blue streaks under your skin from your veins and experience an increase in libido. Your baby at week 13 Your baby is now the size of a lemon and her body proportion is slowly starting to change, although the head is still the biggest part of the body. Your baby is growing rapidly, and during this time, her intestines are moving from the umbilical cord into the stomach. Her eyelids are shut to protect the eyes as they develop and her vocal cords are also developing, so that when your baby is born she’ll be able to cry and laugh and eventually say her first word. Things to remember in this week Around this time is when some people choose to tell family, friends and employers that they’re expecting. You should pick when you feel most comfortable to tell everyone, however, this time is often chosen, as your risk of miscarriage will have decreased and you’ll have had your first pregnancy ultrasound, which should confirm that your baby is healthy.

April 8, 2024

Pregnancy, your body and your baby – week 12 of your pregnancy

This is now the last week of your first trimester, which is week 1 to 12. Your clothes are probably starting to feel a little tighter than they used to, but the good news is that some of the first-trimester pregnancy symptoms, such as morning sickness and fatigue should be easing up soon. During the first trimester, your baby will have grown from an egg to a fully formed baby (with lots of growing to do) and you’ll have had your first check-up and ultrasound. Your body at week 12 At week 12 you’ll probably notice that your morning sickness may start to subside. This is because the hCG hormone is starting to level off. However, not all moms are this lucky, as some experience nausea in their second trimester as well, or even throughout their whole pregnancy. Stomach pain, cramping and constipation are also pregnancy symptoms you may be experiencing. Not all women experience constipation, however, it is fairly common thanks to pregnancy hormones. If you experience sharp or severe pain, it’s important to seek medical help as quickly as possible. Things to keep in mind Throughout your pregnancy both your mental and physical wellbeing is important. Many articles on pregnancy neglect to explain the mental challenges that expecting moms can struggle with during this time. Pregnancy hormones, the added stresses of a new life growing inside you and previous or current depression and/or anxiety can mean that you may also struggle with antenatal depression and anxiety. Tell-tale signs of antenatal depression are feeling sad or anxious all the time, and lack of interest in things that used to. If you do feel that you’re struggling it’s important that you reach out to a health care provider and rely on family and friends for support. Joining a support group of moms, or moms-to-be in a similar position can also help you feel more at ease. Where is your baby at in week 12 Your growing baby is now roughly the size of a lime or a plum. At this point all your baby’s important features, body parts and organs are in place, they just have lots of growing and maturing to do. Your baby’s tiny developing bone marrow is starting to make white blood cells and their muscles and nervous system are maturing.

April 1, 2024

Pregnancy, your body and your baby – week 11 of your pregnancy

You are now almost at the end of trimester one, which is good news as the second trimester is often seen as easier than the first. Both you and your baby will have undergone many changes during these first 11 weeks, and you’ll have gone from a hoping-to-be-mom to an expecting one. Pregnancy has its ups and downs, so it’s important that you look after yourself (and by default your growing baby) at this time. How you’ll be feeling at week 11 At week 11 your baby bump may be beginning to show, but don’t worry if your baby bump isn’t showing yet, as this varies from pregnancy to pregnancy. It’s likely that if this is your first pregnancy and you don’t have multi babies inside you, you won’t start showing as quickly. If your morning sickness if beginning to ease you may notice that you’re feeling hungrier than normal. If this is the case, make sure that you fuel up on healthy snacks that are nutritious to both you and your growing baby. You may find that your cravings are completely different from what you’d normally eat, and your old favourite food is one you that makes you feel queasy. Hormones, senses that are heightened and a need for comfort food are all reasons behind these strange (but normal) pregnancy cravings and aversions. Your baby at week 11 Your baby is now the size of a lime or a fig, and their body is slowly starting to straighten out. At this point, your baby’s hands and feet, as well as their ears, nose and mouth are becoming more developed. Hair follicles are beginning to form, as well as nail beds and their reproductive organs are developing, however, you won’t be able to tell gender via ultrasound just yet.

March 22, 2024

TB – Serious but Curable

Tuberculosis (TB) is a serious public health issue in South Africa. 280 000 people fell ill with TB during 2022 and, of these, an estimated 54 200 died from the disease. South Africa is one of the 30 high burden TB countries, contributing 87% of the estimated cases worldwide. According to the Department of Health, the main driver of TB infection is HIV, with around 48% of TB patients living with HIV. As a member of the United Nations, South Africa has committed to reducing new TB cases by 80% by 2030, compared with 2015 levels. Clinical data presented by the World Health Organization (WHO) indicates that our country is meeting some of its targets but there are still too many people falling ill and dying. ‘It is important to remember that TB is curable’, says Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund. ‘However, we all need to be more aware of how contagious it is, the symptoms, the impact of the disease, the importance of getting medical attention and adhering to the treatment regimen.’ ‘TB also has a big impact on the economy, not only in terms of healthcare expenses but lost productivity – due to absenteeism and the direct and indirect costs to business. ‘We know that not everyone has access to private medical care but public healthcare facilities offer free testing and treatment. If you test positive for TB, the Department of Health will provide the necessary medication. Crucial to overcoming this disease is to follow and complete the treatment regimen as advised by your healthcare giver.’ Some TB facts: What is TB? It’s a disease that mainly affects the lungs but can also be found in any other body organ. It is caused by an organism (germ) called Mycobacterium Tuberculosis which is found in the sputum (a mixture of salvia and mucus) coughed up by someone with TB of the lungs. The organism (germ) usually destroys the soft tissue of the lungs resulting in difficulty breathing and blood can be coughed up in severe cases. If untreated, TB can cause death. How is TB contracted? The disease is passed on from one person to another. The germs spread into the air via microscopic droplets if an infected person sneezes, coughs or releases saliva. The incubation period is 6 weeks. TB Symptoms If you are concerned about your health or having been exposed, you must get tested urgently. Symptoms of the TB include: Excessive coughing – a cough that has been present for more than two weeks and is productive, (a cough that has phlegm) Chest pains Loss of appetite and weight Low grade fever Night sweats Chills Coughing up blood In children the symptoms may present as a cough for 2 weeks or more, loss of energy and appetite and quite often a mild fever. Who is most at risk of contracting TB? People living with HIV/AIDS Living in the same house as someone who has had or has TB Anyone who has had active TB in the last two years Those with diabetes Residents of informal settlements Children under five The undernourished Alcoholics and smokers Mineworkers Prisoners Pregnant women Can you have TB and not be sick? TB can be ‘latent’, in other words it’s in your body but not active and therefore you not capable of spreading it. However, if your immune system becomes weak, the TB can become active and you become ill. Having HIV/AIDS is a key factor in the TB epidemic which is why it is so important that the people living with HIV are screened and treated. How is TB diagnosed? Diagnosis of TB is quite complex since many symptoms can be quite similar to those of other common lung diseases. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics. TB testing and treatment is free. The Mantoux Tuberculin Skin Test (TST) and blood tests do not differentiate between latent and active TB which means a sputum sample needs to be taken or a chest X-ray. Treating TB TB is definitely treatable. However, medication must be started as soon as possible, and it must be taken regularly – as per the instructions. Also important is to finish the course of medication. It takes six months for TB to be cured completely but, within 2 weeks of starting treatment, the person will no longer spread the disease. Treatment must be completed. If treatment is missed, the risk of a drug resistant strain of TB is possible, which is difficult to treat and requires a longer treatment period. How can TB be prevented? People on TB medication must complete their treatment, this prevents the spread of TB Cover your mouth and nose when coughing or sneezing Wash hands with soap and water Immunise of all babies at a clinic within 1 year of birth Keep your body healthy by eating balanced meals and exercising Stop smoking Keep your windows open in your home if living with someone with TB – fresh air blows the TB germs away and sunshine kills the TB germs. TB in the workplace If any employees display TB symptoms, they should stay home and limit contact with others as much as possible until the results from a TB test are known. Once a person has been on TB treatment for 2 weeks, they are no longer infectious and can continue to work.

March 20, 2024

Pregnancy, your body and your baby – week 10 of your pregnancy

At week ten, you are officially a quarter of the way through your 40-week pregnancy with only a few more weeks left of trimester one. In your first trimester, you won’t look it but your body will have gone through many changes to accommodate your growing baby. This trimester its particularly important to keep taking prenatal vitamins containing folic acid as your babies spinal tube and organs develop. Your baby at week 10 Your little baby is now the size of a strawberry and is now referred to as a fetus and not an embryo. She is growing rapidly inside you and is slowly started forming bones and ligaments, their little arms and legs are slowly becoming more functional and your baby’s jawbone is also started developing. Nerves are starting to form in their spine and her kidneys are starting to function. Your body at week 10 At week ten your baby bump may be starting to show, but it may be a few weeks before your family and friends notice or you decide to tell anyone. Because of your slowly growing baby belly, it may be a good idea to invest in your first few items of maternity wear, as pants that are too tight around your waist is an added discomfort that you shouldn’t have to deal with. You’ll still be managing a variety of pregnancy symptoms, from morning sickness to frequent urination. You may still be struggling with fatigue, but thankfully this pregnancy symptom should lessen in your second trimester. Things to keep in mind Week ten (between week 10 and 12) is roughly the time that you would choose to have your baby genetically tested. Genetic testing isn’t required but it is a good option to consider so that parents-to-be are alerted to potential genetic disorders before birth. A genetic test is particularly important if you have hereditary genetic problems in your family, or if you and your partners are carriers for a particular disorder.

March 15, 2024

Pregnancy, your body and your baby – week 9 of your pregnancy

At week 9 of your pregnancy, you’re probably more aware than ever of your growing baby inside of you, as the first two months of pregnancy are now behind you. You may be dealing with a variety of different pregnancy symptoms as your baby slowly grows bigger. Your baby at week 9 At 9 weeks in, your baby is looking more human, with mini arms and legs developing, and the tail which was initially present is slowly disappearing. Your baby is now the size of a grape or a cherry and her facial features are also becoming more prominent. At week nine your baby is also becoming more active and beginning to move around. However, you won’t be able to see or feel this just yet – but it’ll be visible on ultrasound. If you’re struggling with painful breasts, a maternity or sports bra can offer you more support and help alleviate some of your uncomfortableness. When your body becomes more used to your pregnancy hormones, it’s likely that some of your pain may ease, but throughout your pregnancy, it’s a good idea to find clothes that you feel comfortable in. How you’re feeling at 9 weeks At nine weeks you may be feeling a variety of emotions, alongside the many other pregnancy symptoms, such as morning sickness, which peaks at around week 9. Your symptoms may be particularly difficult to deal with if you’re still keeping your pregnancy quiet from your colleges and friends, but if you are struggling emotionally open up to your partner or health care provider. Things to keep in mind At this point, it may be a good idea to chat to your doctor about possibly restructuring your exercise routine. It could be a good time to start incorporating prenatal yoga or pilates as these activities help you get ready for labour and childbirth. Staying active is also a great way to keep healthy during your pregnancy, but depending on what activities you did before getting pregnant, you may need to think about adjusting your training program.

March 8, 2024

World Hearing Day

World Hearing Day is an annual event organised by the World Health Organization (WHO). Held on 3 March, it’s a global campaign to raise awareness around the prevention of hearing loss and the importance of hearing health and ear care. To help create more awareness, Bonitas Medical Fund is offering free online hearing screening for all South Africans, over the age of 18. Hearing loss is an under-diagnosed medical condition that significantly impacts the physical and mental health of those who have any degree of hearing difficulty. Disabling hearing loss is often called the ‘invisible epidemic.’ It affects more than three million South Africans and over 1.5 billion people globally. With the theme ‘Changing mindsets: Let’s make ear and hearing care a reality for all!’ World Hearing Day emphasises the significance of early identification and interventions in preventing hearing loss. Hearing is vital in that it connects individuals to their surroundings, enabling communication, learning and social interaction. Yet millions of people, worldwide, face hearing challenges which can impact their quality of life. Free online hearing test ‘Last year we partnered with hearConnect and introduced a free online hearing screener for members on our website,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘Through this partnership we have extended this functionality and made it available to all South Africans.’ How it works The online, validated, speech-in-noise hearing test, uses the latest in audiological technology combined with the highest standards of clinical expertise. Go to https://www.bonitas.co.za/hearing-screening and, in just two minutes, you can test your hearing status. All you need is access to a computer or your mobile, headphones or earphones, a quiet area and then you’re all set to take the test. Post the test If the screening test indicates you are experiencing hearing loss, hearConnect is available to guide you through the next steps. Alternatively, make an appointment with an audiologist, consult your GP and/or visit the nearest clinic. What causes hearing loss? Hearing loss can come about as you age or as a result of loud noises, illnesses and disease, genetics and trauma (contact sport). Other factors, such as too much earwax, also reduce your ability to hear. Hearing loss repercussions One of the biggest concerns associated with hearing loss, when it is not treated properly, is the long-term impact it has on the quality of life. Prevention and early detection are important, after all, hearing is the foundation for speech and language development, as well as learning and communication. There are many challenges associated with hearing loss. These include language development that impacts our ability to read, write, spell and concentrate. It affects social skills resulting in isolation, depression, loneliness, cognitive impairment, unemployment and an increased risk of dementia. World Hearing Day underscores the need for accessible and affordable hearing care services and encourages everyone to prioritise their hearing health. ‘As a medical scheme we know that patients with untreated hearing loss experience more inpatient stays compared to those without hearing loss,’ says Callakoppen. ‘There is a 17% increased risk of emergency department visits, readmissions and rate of hospitalisation as well as longer hospital stays. ‘Our partnership with hearConnect includes a full audiology benefit management programme on selected plans for our members to ensure they maintain ear health. This includes a follow up with ongoing treatment steps if hearing loss is detected.’

March 1, 2024

Pregnancy, your body and your baby – week 8 of your pregnancy

It’s week 8 of your pregnancy and your baby is beginning to look more like a little human. You’ll probably be feeling many of the first-trimester pregnancy symptoms but you shouldn’t be showing just yet, so enjoy your flat figure while it lasts! Your body at week 8 Even if you don’t outwardly look pregnant, you’re definitely feeling it. Your first trimester brings morning sickness (not just in the morning!), tender breasts, fatigue, pregnancy cramps and a heightened sense of smell. Dealing with morning sickness and fatigue its important that you remember to stick to a healthy lifestyle. Eating well, exercising often and trying to make sure you get enough sleep. It’s important that you take prenatal vitamins during this time as well. Where your baby is at Your baby is now roughly the size of a bean or a raspberry. They are becoming more distinctly human, developing arms and legs. Their digestive system also develops around this time. If you get an ultrasound you may notice that your baby has a disproportionate body, with a large head – this is because the upper body develops faster than the lower. However, in 32 weeks time, your baby will be a normal-sized little-human. Things to remember Your first prenatal check-up around this time, where you may have blood tests and an early ultrasound to check your baby’s growth and heart rate. If you have lots of questions for your doctor it is a good idea to write them down, so you don’t forget when you arrive – especially if this is your first pregnancy. During the first trimester, you are at higher risk for a miscarriage. It is estimated that 1 in 8 women experience miscarriages, often before they realise they are pregnant. Signs of a miscarriage are cramping and pain in the lower back and abdomen, as well as light spotting to heavy bleeding. If you suspect miscarriage, it is important that you contact your doctor so that they can help you during this time.

March 1, 2024

Key facts about Cholera

South Africa had recorded at least 46 suspected cholera cases in the first month of 2024. According to the Minister of Health, three of these cases were due to cross-border travel. With these outbreaks making headline news, Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund has put together eight key facts about cholera. Researchers have estimated that each year there are around 1.3 to 4.0 million reported cases of cholera, resulting in between 21 000 to 143 000 deaths. However, general consensus is that this is under-estimated because of low reporting and limited laboratory services. What is Cholera? Cholera is an acute diarrhoea disease caused by the bacterium Vibrio cholerae. It can either be mild or without symptoms or severe and life-threatening if left untreated. Who is at risk? The highest at-risk populations are more often in underdeveloped countries where poor sanitation and inadequate hygiene practices contribute to its spread, especially in areas with limited access to clean water and proper sanitation facilities. Cholera can be endemic or epidemic. A cholera-endemic area is where confirmed cholera cases were detected but not brought in from somewhere else. A cholera outbreak/epidemic can occur in both endemic countries and in countries where cholera does not regularly occur. How is it spread? It is primarily spread through contaminated water and food. Ingesting water or food contaminated with faeces containing the bacterium can lead to infection. It is not likely that cholera is spread directly from one person to another. What are the symptoms? The symptoms of cholera typically include profuse watery diarrhoea, vomiting, and dehydration. In severe cases, rapid fluid loss can lead to electrolyte imbalances, muscle cramps and shock. Without prompt treatment, severe dehydration can be fatal within hours. How long before you show symptoms? It takes between 12 hours and 5 days for a person to show symptoms – which could include acute watery diarrhoea with severe dehydration. How serious is it? According to the World Health Organization (WHO) only around 25% of infected persons become symptomatic. Of these, 10 – 20% experience severe disease. How do you treat Cholera? Cholera can be effectively treated with rehydration therapy, which involves replacing lost fluids and electrolytes. This can be orally – in non-severe cases – or via intravenous fluids for more severe cases. Antibiotics may also be prescribed to shorten the duration of illness and reduce the severity of symptoms. Immediate treatment in an outbreak is essential which is not always the case in poverty -stricken areas. Can you prevent Cholera? Yes, you can, it involves improving sanitation and hygiene practices, ensuring access to clean water, and promoting proper food handling and preparation. Measures such as boiling, filtering or treating water with chlorine tablets can help reduce the risk of contamination. Additionally, practising good hand hygiene, especially before eating or preparing food, can help prevent the spread of the disease. A global strategy on cholera control was launched in 2017: ‘Ending cholera: a global roadmap to 2030’, had a target to reduce cholera deaths by 90% as well as timely access to healthcare services during outbreaks. Remember, your GP should be your first port of call for all your healthcare needs. Bonitas believes there needs to be coordination of care and encourages you to see your GP who can refer you to a specialist or auxiliary provider as and if the need arises.

February 28, 2024

Talking about HPV and cervical cancer

The theme for 2024 Cervical Cancer Awareness is, ‘Learn. Prevent. Screen.’ South Africa has a high rate of cervical cancer which has been attributed to the fact that not enough women are screened regularly. Screening can detect early changes in the cervix, which can be treated and may save your life. Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, gives the low down on cervical cancer – caused by persistent infection with the Human Papillomavirus (HPV), why it is essential to screen for the virus and the development of a vaccine to 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. ‘For this reason, we have expanded our preventative care benefits to include the HPV vaccine across all plans, to help prevent cervical cancers,’ 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 also essential to mitigate the risk of developing cervical cancer. Screening aims to identify cervical cell changes and detect early cervical cancers before they cause symptoms. Two screening tests help with detection: Pap test (Pap Smear) Cervical cancer is usually a slow-growing cancer that may not have immediate symptoms but can be found with regular pap smear tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). The test looks for cell changes (pre-cancers) in the cervix that may progress to cancer if not treated. HPV test Looks for the virus, particularly HPV-16 and HPV-18 that cause 90% of cervical cancers. 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 can 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. Staging of cervical cancer Just like other cancers, cervical cancer is graded according to the severity. From in situ, which means it hasn’t spread to nearby tissue, through stage one: It’s still in the original organ and is small. If it progresses it spreads to the surrounding lymph nodes and, in the most severe form, the cancer has metastasized to surrounding tissues and other lymph nodes. As cervical cancer develops, the following may occur: Abnormal bleeding, for example bleeding after sex Pelvic pain unrelated to the menstrual cycle Heavy or unusual discharge Increased urinary frequency Pain during urination ‘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.’

February 26, 2024

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

By now you probably know that you’re pregnant, but some moms only find out during this week or later. Even if you haven’t started looking outwardly pregnant, there is a good chance you’re definitely feeling it, with the likes of fatigue and morning sickness. Your baby is going rapidly day-to-day, with continued brain and body development for the next 33 weeks. Where your body is at This week you’ll likely be feeling some or all of the symptoms generally experienced during the first trimester of pregnancy. It’s important throughout your pregnancy that you maintain a healthy lifestyle, even if doing so feels tough at times. Eating the correct foods and taking prenatal vitamins will ensure that your baby gets the correct nutrients from you. It is important to remember that during pregnancy your needs will change, so you should keep this in mind when tailoring your diet. Miscarriage and ectopic pregnancies are both serious complications that can happen during early pregnancy. Miscarriage is the spontaneous loss of the foetus before week 20, unfortunately, this is not reversible and is usually due to abnormal development. Ectopic pregnancy often shows around 7 weeks and is when the fertilised egg implants outside of the uterus. Unfortunately, neither complication can be reversed, and losing a baby early in pregnancy is likely to be very traumatic for the mom-to-be and family. It’s important that you seek medical and psychological support if you are struggling post ectopic pregnancy or miscarriage. What your baby is doing Your baby is now the size of a blueberry but is shaped more like a tadpole than a human, however, their tail is getting smaller and will soon disappear. At this point, your baby has continued to develop limbs, facial features, spinal cord and lungs, heart and kidney.

February 19, 2024

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

Week 6 of your pregnancy At week 6 of your pregnancy you’ll most likely know that you’re pregnant now, although some mom’s realise as quickly as 3 weeks or as late as 12. Every week your body is changing to accommodate for your growing little one. Your body at 6 weeks 6 weeks in and you may be experiencing a range of pregnancy hormones. One of the most common and challenging first trimester pregnancy symptoms is morning sickness, although these waves of nausea can strike at any time. It is important to eat bland foods little and often. Even though this nausea may be uncomfortable to deal with, it’s nothing to worry about unless you can’t keep any food down throughout the day. Fatigue is another unpleasant aspect of pregnancy that you may have started experiencing in your first trimester. Napping often, letting others take over some of your chores and work, as well as keeping hydrated are ways in which you can help yourself. Your pregnancy fatigue may be worse during your first and third trimesters. Exercise and a healthy diet are also important (at this point and throughout your pregnancy) and you’ll probably be able to do most of the exercise you’re used to – just stay away from anything heated (such as heated yoga) or high risk. Your baby at 6 weeks Your baby is now the size of a pea, still tiny enough that you won’t be able to spot a tell-tale pregnancy bump. Your uterus has begun expanding to accommodate your new baby, and may have started pressing down on your bladder (que the frequent urge to use the bathroom). Inside you, your baby is starting to look more like a little human, and her eyes, nose, ears as well as limbs have started slowly forming. Liver, kidneys and lungs are also starting to take shape.

February 12, 2024

10 ways to manage your medical expenses

‘As you begin 2024 with a clean slate in terms of medical aid benefits, it’s a good time to look at ways to manage medical expenses,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. Here are 10 tips to empower yourself in managing medical expenses. Designated Service Providers (DSPs) and networks Healthcare costs in South Africa are generally unregulated which means providers are free to charge any tariff. ‘Using DSPs and hospital networks means that favourable tariffs for members have been negotiated,’ explains Callakoppen. ‘Using networks also means you can reduce or eliminate co-payments.’ Tariffs and rates of payments The Scheme Rate is the amount a scheme will pay for specific treatments and procedures. However, 100% of the scheme rate doesn’t necessarily mean 100% of the account will be paid. Ask for a quote from your practitioner and/or hospital ahead of any procedure. If there is a major discrepancy, try and negotiate an adjusted fee. The value-add benefits Make use of the free wellness screening and testing offered by your medical aid. There has been an intensified drive to detect, prevent or manage various chronic conditions as well as vaccinate against potential diseases and conditions. ‘After completing an online wellness questionnaire or a wellness screening, you are able to access the ‘Benefit Booster’ providing access of up to R5 000 in additional funds to use for out-of-hospital expenses.’ The Bonitas ‘Be Better Benefit’ includes an annual wellness screening, per beneficiary, to check blood pressure, blood glucose, BMI and cholesterol. It’s about being on the right path to good health and wellness. Other benefits include Flu vaccines, HIV tests, lipograms, mammograms, prostate screening, pap smears, pneumococcal vaccines, whooping cough boosters, HPV vaccines, stool tests for colon cancer, dental fissure sealants, online hearing screenings and contraceptives. Ask your pharmacists Ask your pharmacists for over-the-counter medications for less serious illnesses. Pharmacists are able to provide sound medical advice about problems like rashes, colds or illnesses that are not severe. Also use generic medications where possible. A generic’s active ingredient or drug content is identical but is between 30% and 80% cheaper. Managed Care The prevalence of Non-Communicable Diseases (NCDs) has been increasing year-on-year, so have mental health issues, which is a risk factor for NCDs and vice versa. For this reason, it is important to make full use the Care programmes your medical aid offers. ‘At Bonitas we offer support for NCDs through a range of Care programmes including Audiology, HIV/AIDS, cancer, diabetes, mental health, back and neck, hip and knee replacements as well as hospital-at-home.’ Remember to pre-authorise Pre-authorisation is required for all hospital admissions, out-of-hospital screenings and procedures. Always ask if there are any co-payments or sub-limits that will apply and how to avoid these. For planned procedures, make sure you use a DSP or check whether the procedure can be in the doctor’s rooms or a day clinic. Be aware of consulting after hours Be careful about using after-hours consultations or emergency rooms unless it’s absolutely necessary. In a bona fide medical emergency, one has no choice and this usually results in admission to hospital. Manage your chronic medicine correctly The golden rule for chronic illness benefits is to try to use the medication on the scheme’s formulary and to obtain this from a specified pharmacy, either on the network or a DSP. PMBs Make sure you understand what is covered under Prescribed Minimum Benefits (PMBs) and to use a DSP to ensure that claims are paid from risk, not from your medical savings account. Gap Cover Gap Cover is designed to cover the difference or part of the difference between what the medical scheme pays and the service provider charges for in-hospital procedures/treatment and specified outpatient procedures. Ensuring you ‘work smarter’ with the benefits and medical expenses during the year, is a win-win situation for your health and pocket.

February 7, 2024

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

Week five of your pregnancy is the week that many women find out that they are pregnant. You’ll notice the skipped period and your pregnancy test will come out positive, you’ll also start to notice some pregnancy symptoms if you hadn’t already. Your body at 5 weeks pregnant This week you’ll notice pregnancy symptoms, and this is just the beginning of a huge number of changes you’ll feel taking place in your body. At this point your pregnancy hormones will probably be affecting you, making you feel nauseous, your breasts tender. You could also be experiencing spotting and cramping, as well as frequent urination and cravings. The pregnancy hormone, human chorionic gonadotropin (hCG), is responsible for many of these changes, and this hormone is why your test shows up positive. Not only will your body physically change, but you’ll probably be dealing with mental changes as well. No only can your changing hormones cause your moods to fluctuate, but finding out you’re pregnant can also be an emotional experience. Remember any emotions are valid, even if you’re feeling overwhelmed and confused, as opposed to excited. If you’re struggling it’s important to reach out to those around you or seek professional help. Your baby at 5 weeks pregnant Your baby is now roughly the size of orange or apple seed and her tiny face is already starting to form, even though she looks more like a tadpole than a human. During this time your baby’s neural tube is developing – this will become their spine and brain – which is why folic acid is so important at this point. Folic acid taken daily reduces the risk of spinal tube defects. By 5 weeks your little one’s heart will have also started beating. If your pregnancy is healthy, you won’t be having an ultrasound before 8 or 9 weeks of pregnancy, so it’ll be a few more weeks before you get to see your baby.

February 5, 2024

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

This may be the week that you realise that you’re pregnant. Many women don’t notice so early-on, but if you’ve been trying for a while you may take a pregnancy test before when your next period was due. Your body at 4 weeks Although your body is changing, chances are you may not have noticed just yet – at the end of this week you’ll probably notice (or maybe earlier or later – depending on your menstrual cycle) that you’ve missed your period. This is one of the more obvious pregnancy signs, but your body is changing in other ways as well. When your fertilised egg implanted into your uterus you may have noticed some cramping and spotting. You may write -off other early pregnancy signs as pre-menstrual changes, however, there are some symptoms that are unique to having a baby. Such as nausea, spotting and cramping, and a raised body temperature. If you haven’t already, now is the time to quit any unhealthy habits, such as drinking alcohol and caffeine, and smoking. It’s also a good idea to take prenatal supplements if you haven’t started yet. If you’re feeling healthy and your pregnancy symptoms are all normal, you’ll only need to schedule an ultrasound at week 8. Your baby at 4 weeks Your baby is a tiny mass of cell inside you, roughly the size of a poppy seed, but just because it’s so small doesn’t mean lots isn’t happening. In the next few weeks, this tiny ball of cells will form the neural tube, which is the beginning of the brain and spine. At this point, the cells that are your baby are dividing up, becoming more defined. Three layers are developing – the ectoderm, the mesoderm, and the endoderm – and these will later develop to become your baby’s organs and tissues.

February 1, 2024

Radiology’s pivotal role in the detection of lifestyle diseases

Data from the World Health Organization (WHO) indicates a notable increase in Non-Communicable Diseases (NCDs) such as cardiovascular and respiratory diseases, diabetes and cancers. These diseases are major contributors to global morbidity and mortality. In fact, three years ago, the Human Sciences Research Council (HSRC) and the Medical Council described the increase in NCDs as an ‘emerging epidemic’ and the ‘biggest threat to South Africa’s health’. NCDs, known as chronic or lifestyle diseases, are medical conditions that are not infectious and cannot be transmitted directly from person to person. They progress slowly, often lasting for a long duration. The main categories include cardiovascular diseases (such as heart disease and stroke), cancer and chronic respiratory diseases and diabetes. Other examples include obesity, mental health disorders and musculoskeletal conditions. Lifestyle diseases were more prevalent in higher income brackets but currently, they are wreaking havoc amongst all South Africans. The good news is that the damage resulting from unhealthy lifestyles can be stemmed. Dr Jean de Villiers from SCP Radiology says medical imaging techniques play a crucial role in the early diagnosis, management and monitoring of lifestyle diseases. ‘The rapid evolution of high-quality imaging techniques, using reduced radiation dose, has positioned radiology ideally for this role. This contributes significantly to the understanding and treatment of these conditions.’ Why ‘lifestyle’ disease’? The conditions are called lifestyle diseases because they result from long-term, habitual behaviours and lifestyle choices. The terminology implies that their prevention, control, and management are often a result of an individual’s actions, such as: Poor diet: Diets high in processed foods, saturated fats, trans fats, salt and sugar Physical inactivity: Lack of regular physical activity Tobacco use: This is a major contributor to cardiovascular diseases, respiratory diseases and certain types of cancer Environmental factors: Including air pollution, water pollution and other environmental toxins can contribute to the development of respiratory diseases and other health problems Occupational hazards: Certain workplace exposures to chemicals and other hazards can increase the risk of specific NCDs Genetics: A family history may result in a genetic predisposition to certain NCDs Age and gender: The risk of developing NCDs tends to increase with age. Some conditions, like osteoporosis and certain cancers, may be more prevalent in specific age groups or genders Metabolic factors Obesity, high blood pressure and high cholesterol levels can increase the risk of developing cardiovascular diseases and diabetes Psychosocial factors: Chronic stress can contribute to the development or exacerbation of various NCDs Mental Health Perhaps surprisingly, mental health can also result in chronic diseases. According to Harvard Medical School, poor mental health can negatively impact on physical health, leading to an increased risk of some conditions. Depression has been linked to a 67% increased risk of death from heart disease and a 50% increase in risk of death from cancer. Mainly because people with mental health conditions are less likely to receive the physical healthcare. Preventing NCDs usually involves lifestyle modifications: Adopting a healthy diet, engaging in regular physical activity, avoiding tobacco and excessive alcohol consumption and managing stress. Early detection, through regular health check-ups and screenings, is also crucial for effective management and prevention of associated complications. The role played by radiology Diagnostic imaging: Helps in the early detection and diagnosis of lifestyle diseases. ‘For most of these conditions, early identification and diagnosis are crucial. X-rays, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), mammography, and ultrasound are ideally suited to visualise relevant internal anatomical structures and identify relevant abnormalities early,’ says Dr de Villiers. Monitoring disease progression: Radiological techniques can monitor the progression of lifestyle diseases over time. This is important for diseases like diabetes, where complications can affect the kidneys, eyes and blood vessels. Treatment planning: Aids in treatment planning by providing detailed anatomical information. For example, before certain surgeries or interventional procedures, imaging guides the medical team to target the affected area and minimising damage to surrounding healthy tissue. Screening programs: These are essential for the early detection of certain lifestyle-related conditions. For instance, routine mammography and colonoscopy for the early detection of breast cancer and colorectal cancer, respectively. Similarly, there are currently National pilot projects running to detect early lung cancer in high-risk individuals using low-dose CT scans of the chest. Research and clinical trials: Radiology plays a key role in research studies and clinical trials aimed at understanding the mechanisms of lifestyle diseases. Advanced imaging techniques can be used to investigate the effects of lifestyle interventions and assess the effectiveness of treatment. Patient education: Radiological images can be used to educate patients about the nature and progression of their conditions. Being able to see the affected areas can help patients understand the importance of lifestyle modifications and treatment adherence. In summary, radiology is an integral component of the multidisciplinary approach to the detection and management of lifestyle diseases. It facilitates early detection, accurate diagnosis and effective management, ultimately contributing to improved patient outcomes and quality of life.

January 25, 2024

Bursaries and boreholes – helping in the healthcare space

The partnership between Gift of the Givers and Bonitas Medical Fund has, and will continue, to have a positive impact in a quintet of interventions in the field of healthcare. The partnership, which began in 2018 continues into 2024, with an additional investment of R3.3 million. This includes bursaries to final year medical students at the University of KwaZulu Natal and the provision of boreholes at various health facilities across the country. Lee Callakoppen, Principal Officer of Bonitas says, ‘the association with Gift of the Givers goes back a few years, when we supported various projects on an ad hoc basis. The partnership is aimed at identifying health related projects being undertaken by the Gift of the Givers to which Bonitas can add value. ‘In 2022, we aligned our CSI initiatives to our mantra: ‘A Medical Aid for South Africa’. The purpose: To provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions. We wanted to assist in the social upliftment of South Africans, particularly in the healthcare space. And who better to partner with than this leading philanthropic organisation in the country.’ ‘Gift of the Givers continues to go beyond the call of duty to bring humanitarian aid where needed. It has built its reputation on the principles we, as a corporate citizen, also value: Respect, care, professionalism and dedication. We are proud to be partnering with them once again.’ Bursaries for 6th year medical students Eight medical students in their 6th and final year of study at the University of KwaZulu Natal, will receive bursaries. The bursaries cover outstanding and current fees, enabling them to complete their final year of medicine and graduate as a doctor at the end of 2024. The students were selected based on their academic results and financial needs and were vetted by the University as promising students in need. They are also diverse in terms of the background and locations, with a strong desire to enhance the healthcare landscape in South Africa. Boreholes at healthcare facilities Water is the gift of life and no more so than in a healthcare setting. It is essential to run a medical facility – whether it’s a hospital or clinic or the communities around them. Critical shortages of water are hindering the provision of quality healthcare in a number of public healthcare facilities. Six hospitals and clinics have been identified, by Gift of the Givers in partnership with Bonitas, as being in urgent need of water interventions. They are located in the Eastern Cape, Gauteng, KZN and Free State and the healthcare facilities include a psychiatric hospital, general hospitals, clinics and an orphanage. The due date for completion on these projects is April 2024. Dr Imtiaz Sooliman says, ‘All the projects we have partnered with Bonitas on have been a great success and we look forward to continuing working with them. In fact, soon after our staff became members of Bonitas in 2019, we knew there was synergy in our ethos, that a collaboration in the healthcare space with the Fund would be a success. ‘We are in the fortunate position of having the relationships in place to actively execute the necessary healthcare interventions, together with Bonitas. We are thrilled at the success of this continued partnership.’ An overview of the most recent projects Celebrating our nurses In collaboration with Gift of the Givers, Bonitas honoured 470 nurses at the Mahatma Gandhi Memorial Hospital in KZN in recognition of International Nurse’s Day. Nurses remain the backbone of the healthcare system and this gesture was to show appreciation for their exceptional service, especially in very trying times, such as the Covid-19 pandemic – when the entire healthcare environment was under enormous pressure. After the floods in KZN Bonitas responded to the disaster relief calls for assistance after the floods in KZN and donated R500k to Gift of the Givers to assist in rebuilding damaged healthcare facilities in the region. The gift of hearing This year Bonitas sponsored an Audiology Programme, in KZN which looked at testing the hearing of over 15 860 learners, at various schools during the year. ‘Children’s learning is substantially compromised with hearing difficulties, reducing the possibility for progress and achievement,’ said Dr Imtiaz Sooliman. ‘Appropriate, early intervention is critical to make a meaningful impact on the academic development of the learner.’ Disaster relief conference Bonitas was a key sponsor in the disaster relief conference held in Cape Town earlier this year. The conference, the largest of its kind in the world, was attended by various stakeholders responsible for community upliftment and healthcare delivery. Callakoppen says, ‘They say the best partnerships aren’t dependent on a mere common goal but on a shared path of equality, desire and no small amount of passion. Both Gift of the Givers and Bonitas have the drive to help others. And, in terms of the Fund, moving a step closer to providing quality healthcare for all South Africans.’

December 5, 2023

What is abdominal separation and how do I deal with it?

Abdominal separation or diastasis recti is the separation of the two parallel bands of muscle in your belly. This is common in pregnant women, and luckily often heals on its own, or with the help of exercises, after pregnancy. This condition is not only experienced by pregnant moms, but also by men, as well as women who’ve never been pregnant. You may be wondering how you’d know if you have abdominal separation, how to tell if it’s bad and what you can do to help your tummy return to normal. How do I know if I have diastasis recti? If your muscles have separated, you may notice a bulge in your abdomen where the two muscles have pulled apart. In addition to this, you may notice a sore lower back, constipation and bloating. Women who are expecting multiples or women who have been pregnant more than once (especially if the pregnancies are close together) are more likely to experience muscle separation. There is a way you can check if you have diastasis recti yourself. Lie flat on your back and then sit up slightly, engaging your core muscles. Put your fingers just above your belly button on the middle of your stomach. If you feel like the gap between your fingers is more than three fingers, then you probably have diastasis recti. However, this is not an exact science but rather a way to gauge if you may have a problem. How can I correct my diastasis recti? If you have a smaller separation, it may go away on its own or with the help of exercises, however, bad cases may need the help of a physio or even surgery. If you have a gap, chances are it’ll close up one or two months after birth. However, certain exercises may help the gap close up quicker. That being said, be careful of what exercise you do, some fitness practices make it worse. If you are worried about it, it’s best to talk to a health care professional and they can help you make the best choice for you and your body.

November 17, 2023

Movember – it’s not just about prostate health

November or Movember is traditionally when men around the world grow a moustache to raise awareness and funds for men’s health – specifically prostate cancer. And, although the campaign is synonymous with prostate cancer, it’s also about testicular cancer, mental health and suicide prevention. The clinical team at Bonitas Medical Fund take us through some of the essential health checks and screenings for men. These are tests to check for diseases and health conditions, even before you have any symptoms. By detecting diseases early, they are often easier to treat. Prostate cancer Prostate cancer is one of the most common types of cancer in men. It occurs in the small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm. The growth is normally slow, and it is the one type of cancer from which you have the best chances of recovery. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly. Most men with prostate cancer are older than 65 years and, with the correct treatment, have good outcomes. Men from the age of 50 (40 – 45 for those at high risk, with a family history of prostate cancer) should have an annual prostate examination. Checking for prostate cancer? Your doctor will recommend a blood test to check the levels of Prostate Specific Antigen (PSA) in your blood. PSA can be elevated in men who have prostate cancer. This must be supported by a rectal examination. For 2024, Bonitas has introduced the Be Better Benefit, paid from risk for a range of screening tests and benefits to allow for early detection. This includes an annual PSA screening test on all plans except BonCap. Factors that affect prostate health include Lifestyle: A healthy lifestyle that includes maintaining a balanced diet rich in fruits and vegetables, regular exercise and avoiding excessive consumption of alcohol and tobacco can contribute to prostate health Hydration: Staying well-hydrated is important for overall health. Drinking plenty of water can help flush out toxins and maintain prostate function. Medications and Supplements: Some medications and supplements, like alpha-blockers, 5-alpha-reductase inhibitors and saw palmetto, may be used to manage prostate conditions. However, it’s important to consult a healthcare professional before using any of these. In summary, maintaining prostate health and being aware of the risk factors and symptoms are essential aspects of men’s health. Regular check-ups, self-examinations and a healthy lifestyle can go a long way in preventing and managing these conditions. It’s crucial to consult with a healthcare professional for personalised guidance and early detection. Testicular Cancer Testicular cancer is relatively rare and typically affects young and middle-aged men. Here are some key points about testicular cancer: Regular self-examination of the testicles is essential. This involves gently feeling the testicles for any lumps, changes in size or unusual sensations. If any abnormalities are detected, it’s important to seek medical attention promptly. Common symptoms include a painless lump or swelling in the testicles, a feeling of heaviness in the scrotum and discomfort or pain. The main treatment is surgery to remove the affected testicle. Depending on the type and stage of cancer, additional treatments such as chemotherapy or radiation therapy may be necessary. The prognosis for testicular cancer is generally quite good, especially when detected early While the exact causes of testicular cancer are not well-understood, certain risk factors include a family history of the disease, undescended testicles and a personal history of testicular cancer Mental Health in men Mental health is of critical concern in South Africa, and it affects both men and women. Men, however, may face specific challenges and stigmas related to mental health. The clinical team at Bonitas stress that, ‘Mental illness is not a character defect, it is a health problem just like arthritis, diabetes or cancer. Fear and misunderstanding often lead to prejudice against people with mental illness and addiction which is a serious barrier to diagnosis and treatment.’ The economic uncertainty, political instability and poor socio-economic conditions in SA have also added to the burden of mental health issues. ‘We have seen a 25% increase in the number of mental health hospital admissions, indicating a need for additional support,’ says Lee Callakoppen, Principal Officer of Bonitas. ‘This need is particularly high in the 18 to 44 age groups. We have further noted that mental health was a key driver for absenteeism in corporate groups.’ Anxiety disorders and depression are the most common mental health problems but others include eating disorders, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), bipolar mood disorder as well as psychotic disorders such as schizophrenia and personality disorders. Substance abuse, such as drugs and alcohol, is also classified under mental illness. Here are some important points regarding mental health: South African men, like men in other parts of the world, may face societal pressures to conform to traditional notions of masculinity, which can make it difficult to express emotions or seek help for mental health issues. Mental health conditions may be underreported and untreated due to the stigma associated with them. Access to mental healthcare services can be limited in certain areas of South Africa, particularly in rural regions. This can create barriers to seeking help for mental health issues Substance abuse issues are often intertwined with mental health problems. Turning to alcohol or drugs will just exacerbate mental health challenges. In response to what is rapidly becoming a mental health crisis, medical schemes are stepping up. Bonitas, for example, has a Mental Health Programme (MHP) which is part of the Scheme’s Managed Care initiatives. The programme, which is primarily education driven, is aimed at improving quality of life and empowering people with mental health issues to manage their condition. In addition, Bonitas was the first medical scheme to offer it members Panda, a mental wellness app. Panda provides scientifically validated assessment tools to enable users to measure their mental wellbeing objectively. It also enables members to book one-on-one

November 1, 2023

Breast Cancer – different screening tools

Radiologists from the SCP Radiology practice and Dr Lizanne Langenhoven, who specialises in the treatment of breast cancer, talk about the different kinds of screening for breast cancer. Dr Langenhoven says, ‘When you consider that around 90% of women find their own breast lumps, it is a very important part of the screening process. Although 80 percent of these lumps are not malignant, there are cases where women owe their lives to their own self-examination.’ A guide to self-examination: Lying down or in the shower: Place your right hand behind your head. Using the pads of the fingers on your left hand, feel for changes in your entire breast in a circular. Do the same above and below and in your armpit area. In front of a mirror: Check for any dimpling, puckering or changes in either nipple. See your doctor or clinic if you have any of these symptoms. Have regular screenings at your doctor or clinic. The different screenings include: Mammogram: Is breast imaging using low-dose X-rays to form a 2D image. The advantage is it often reveals abnormalities undetected in a clinical breast examination. Four images are taken, two of each breast. The breast is lightly compressed for less than 1 minute during the examination to improve diagnostic accuracy. Tomosynthesis: This is a form of 3D mammography and uses X-rays as well as sophisticated software to create a 3D image of the breast. It is considered better at detecting cancer and reducing false positives in dense breast tissue. It is invaluable in problem-solving and is used in combination with 2D mammography. Breast Ultrasound: Ultrasound is a supplementary investigation used to further evaluate morphology, blood flow, and consistency of masses and lymph nodes that are abnormal mammography. It uses no radiation but rather real-time imaging, using sound waves to create an image. It’s a slightly longer process and is also valuable in problem-solving. It is used in combination with a mammogram not in place of it. MRI: The digital MR image is created using strong magnetic fields and radio waves but no radiation. You will receive an intravenous injection and then lie on your stomach, in an MRI ‘tunnel’ for around 45 minutes. An MRI for breast screening is usually used for problem-solving, high-risk screening and for women who have breast implants. Biopsy: A breast biopsy may be recommended when a suspicious area is found in your breast, like a breast lump or other signs and symptoms of breast cancer. It is also used to investigate unusual findings on a mammogram, ultrasound, or other breast examination. Thermography: Thermography is a test that uses an infrared camera to detect heat patterns and blood flow in body tissues. Digital infrared thermal imaging (DTI) is the type of thermography that can be used to show these patterns and flow in the breasts.

October 23, 2023

Beating heatstroke

Bonitas Medical Fund offers some advice about heatstroke. What the symptoms are, how to avoid it and what to do if someone, child or adult, develops heatstroke.

October 20, 2023

Q and A – why are some women reluctant to go for a mammogram

The World Health Organization creates awareness around breast cancer in October. First initiated in October 1985, Breast Cancer Month has grown exponentially globally and this year is no exception. According to the Cancer Association of South Africa (CANSA), it’s far better to have an early-stage diagnosis, as it results in better breast cancer treatment and long-term survival. CANSA recommends monthly breast self-examination, annual medical check-ups, and screening. Radiologists from the SCP Radiologist Practice and Dr Lizanne Langenhoven, who specialises in the treatment of breast cancer, address some of the concerns around breast cancer screening. If early detection is recommended and provides the best outcome, why are women reluctant to screen for breast cancer? An informal survey amongst women, who are hesitant to go, even though they have the means to go, shows that the top reasons include the following: It’s going to be too painful Many women still rely on their mother’s experience with early mammograms which were painful. Mammography machines have progressed exponentially since the early days, so the level of discomfort experienced during the procedure is now significantly reduced. Modern technology and digital equipment allow us to use less compression and still obtain quality imaging. Also, the amount of pressure is different for each individual, depending on the breast size and composition. Pressure is often manually adjusted so speak to your mammographer if you experience any discomfort. Fear of exposure to radiation A mammogram uses relatively low-dose radiation. The total dose is approximately 0.5 mSv (2D mammogram). To put it into perspective, we are exposed to 3.0 mSv of background radiation from our natural surroundings per year. Radiologists also strictly follow what’s known as the ALARA principle – to always apply radiation “as low as reasonably achievable”. The benefits of mammography thus far outweigh the risks from this low dose radiation. Fear of finding out you have breast cancer Dr Langehoven says, ‘The good news is that our understanding of the different subtypes of breast cancer has improved significantly over the past few years! We no-longer follow a one-type-fits-all approach and many women may even safely be spared chemotherapy in a curative setting. ‘As with everything else in life, it is easier to address a ‘small’ or ‘early’ problem than it is to address a much larger problem! I’ve seen breast cancer diagnosed at a size of 2mm on mammogram – meaning that treatment is tailored to a very low risk situation. In short, the earlier we become aware of an existing problem, the sooner it can be addressed and with much less invasive treatment.’ I don’t go for mammograms, I only go for thermography At present, thermography cannot substitute mammography but may be used as complementary screening. Dr Langenhoven cautions that thermography is not all it is cut out to be. In order for the cancer to give off heat signals, it has to be significant in size. Mammography on the other hand can detect changes in the breast before they progress to cancer. A mammogram therefore picks up the disease course much sooner than thermography. Why mammography instead of ultrasound, which doesn’t use radiation? Mammography is our workhorse. We look for masses, calcifications, and architectural distortion. Ultrasound is a supplementary investigation used to further evaluate morphology, blood flow, consistency of masses, and lymph nodes that are abnormal on a mammogram. Tomosynthesis is also supplementary, used to further evaluate architectural distortion seen on a mammogram. They all work together. With denser breasts mammography is less sensitive, which is when we add the supplementary investigations to improve the sensitivity of detection. If am diagnosed with breast cancer I am going to die anyway, so I would rather not find out This statement is not true in the current day and age where 90% of women with early breast cancer can be cured of their disease, says Dr Langenhoven. ‘In the same way we don’t drive cars from the 50’s, our treatment is no longer ancient either!’ The side-effect profiles of our new drugs are aimed at improving quality of life during treatment, and the fact that we now identify and treat 4 distinct subtypes of breast cancer means that we can target the specific growth-pattern at play and avoid unnecessary treatment. Previously, because we didn’t know which women had aggressive breast cancers and who didn’t, all women were treated more or less the same up to a few years ago. This meant that women feared finding out they had breast cancer for fear of the radical and toxic treatment they would be subjected to. This has really changed over the past 10 or 15 years and our approach has changed to be specific and conservative when we advise treatment. It is tailored to the specific characteristics of each women’s disease. Surgical outcomes are so much better and very few women would ever be offered a ‘flat’ mastectomy as part of their treatment plan. We no longer approach breast cancer surgery without consideration of the cosmetic outcomes and quality of life of the woman behind the cancer. The notion that cancer means suffering and death comes from a bygone time and we should do all we can to change this outdated perception. The survival rate of breast cancer depends on a number of factors including the type of cancer, the immune receptors, the grade, and the speed at which it is growing – these all determine the survival rate. A big tumour that is slow growing and has a low grade has a more favourable outcome after treatment, than a small tumour that is high grade and fast growing. However, if a cancer is found early and the grade is established earlier, then tailored treatment can begin earlier which may slow down or limit the progress. An early diagnosis will improve treatment outcome. The advantage of screening is early detection for better treatment outcomes and prognosis. Dr Langenhoven adds that early detection really counts when it comes to treatment related side-effects and cost of treatment. An early cancer may very

October 16, 2023

DEALING WITH KIDS AND PREGNANCY

Dealing with pregnancy can be tricky on its own, but when you have a toddler or young kids to look after things can become more difficult. If this is your second pregnancy, you may be struggling with morning sickness, fatigue and a tired achy body and still having to look after another young child. You’re probably wondering how to manage, so we’ve put together some useful tips to help you the second time around. Be patient with them and yourself It’s important that you’re patient with your child. Initially, they may not understand the pregnancy which can make them act out in confusion. Getting them involved and feeling like a big sibling can help them to feel excited about the new addition to the family. That being said you should also be patient with yourself. You may be feeling unwell due to your pregnancy, and with looking after another child you may find things falling by the wayside. It’s likely that only you will notice these things, so don’t be too hard on yourself. Playtime for you and them You might not always be feeling up to playtime with your little one, so this is a good time to encourage them to play independently. This way you free up a little bit more time for yourself while keeping them entertained. As your pregnancy progresses, play in ways that you can manage. Instead of running around, focus on board games, drawing and puzzles. Allowing a little bit of screen time (even together) is another way you can easily entertain your kids. Help and schedules Don’t be afraid to ask for help. If you have a partner, they are the obvious person to lend a hand, but if you are by yourself, either reach out to close family or consider getting paid help for part of the day. Another way to find some time for yourself is to nap when your toddler naps. Syncing up your sleep schedules may mean that you find yourself a little bit more rest time for when you’re feeling tired or nauseous.

October 6, 2023

Bonitas balancing increases with value and sustainability

onitas Medical Fund, one of the leading medical schemes in South Africa, announced its 2024 product line up today. Lee Callakoppen, Principal Officer of Bonitas says, ‘We appreciate that many of our members and South Africans in general, are faced with increasing financial pressures. We have therefore taken great care to balance our benefit enhancements to provide value to our members, while still ensuring that contributions remain affordable. ‘The percentage increase required is methodically worked out by our team of actuaries who determine the minimum increase against ensuring the financial sustainability of the scheme while meeting the regulatory guidelines and requirements. It’s a delicate balancing act,’ says Callakoppen. ‘For 2024, the weighted increase is 6.9% with the average increase across nine of our plans at 6%. This means that over 227 000 members – around 65% of our membership – will experience an increase below CPI.’ How we did this We conducted in depth research over the last year, which included stakeholder engagement, actuarial analysis and projections to look at how to enhance our benefits. In addition, we analysed feedback from over 10 000 member surveys, researched international healthcare protocols, trends and disease burden rates in South Africa. The result: We have stayed true to our ultimate commitment of giving more value to our members, by reducing out-of-pocket expenses, enhancing benefits and providing additional preventative and managed care. Our fiscal health The Scheme is financially sound, including financial indicators to claim’s paying ability and strong solvency levels. And, despite investing over R1.4 billion back to members in 2021 and 2022, we saw our reserves increase to R8.8 billion last year. A feat matched by no other open scheme. We have noted an erratic claims’ catch up emerge over the past 12 months and, it is for this reason that it’s essential to take a well-rounded approach and apply a modicum of conservativeness to our approach. This, to remain sustainable for our members, regardless of increased claim patterns. We also applied prudent investment management strategies that enabled solid returns for the members. Membership growth Membership grew by 62 000 principal members, 80% through organic growth – in a declining industry. New members are 13 years younger than the average, which means we have succeeded in attracting a younger, healthier profile which is coveted across our industry. We attribute this to offering a diversified product range from hospital plans to network options and Edge plans – driven by innovation and technology. So, what’s new? Our research identified various healthcare trends and needs and we have ensured these are met in our plan benefits and enhancements. Our solution to unregulated healthcare costs In South Africa, providers are free to charge patients any tariff they see fit. However, with the economic pressures faced by consumers, funding is usually in short supply. Through engagement and collaboration with healthcare providers we have found solutions to these challenges. We implemented networks at the most favourable tariffs for our members so that they can avoid out-of-pocket expenses and get more value from their medical aid. This applies to GPs, medication, dentistry, optical, specialists and hospitals. Not only do we direct members to the most efficient hospitals, with the best healthcare options but the discounted tariffs reduce co-payments or eliminate them. Specialist’s costs For 2024, we considered the input from specialists, regarding the cost of services and enhanced our specialist reimbursement rates. This allows 85% of our members to have full cover, wallet-free specialist visits. Our specialist network ensures members are covered with the top 15 speciality types contracted into the network. We have introduced three tiers of network specialist rates, based on experience and proximity. The key focus is on specialty types with high claim volumes and major medical costs such as gynaecologists, physicians and cardiologists. Managed Care enhancements Over the years the prevalence of non-communicable diseases, such as diabetes and hypertension, has increased year-on-year. This is further compounded by the increased burden of mental health which is an added risk factor. Mental health One of the key insights noted was that mental health prevalence is at an all-time high. This is exacerbated by factors such as an increased economic burden and increased psycho-social challenges, such as loadshedding. We have seen a 25% increase in the number of mental health hospital admissions, indicating a need for additional support. This need is particularly high in the 18 to 44 age groups. We further noted that mental health was a key driver for absenteeism in corporate groups. For this reason, we have included the Bonitas Mental Healthcare Programme across all plans for 2024 and included depression as a chronic condition. We also offer access to Panda, a digital platform available through the Bonitas app, giving members easy access to expert help, mental health information and community support. Back and neck programme We recognised that not all members have access to the DBC back and neck facilities so, in addition to adding a digital version of the programme, we have established a network of physiotherapists so members can access the benefits of the programme in more remote areas. Preventative screening A key trend across the healthcare industry has been the decline of preventative screening, including wellness checks and health risks assessments. We have taken up the challenge and have intensified our drive to increase screening uptake. Introducing the Bonitas Be Better Benefit! Funded completely from risk, this unique benefit provides a range of screening tests and benefits to ensure members have access to the necessary screenings, to allow for early detection and to be put onto a path to wellness. The Be Better Benefit is available on all options, except BonCap. This benefit is paid for from risk – helping families to get the best possible healthcare. As an added bonus for 2024, childhood immunisations following the State Vaccine Schedule will be added to six of our plans. HPV vaccine We’ve also taken great care to expand our preventative care benefits by including the Human Papilloma (HPV) vaccine on all

September 28, 2023

Bonitas Medical Fund: 2024 Product Launch round up

At a glance: 353 763 Principal members 727 041 Total beneficiaries 62 000 new principal members added last year 18.7% chronic profile Average age of beneficiary: 35.5 Average age of new members is 13 years younger than existing members R8.8 billion in reserves 41.3% solvency ratio AA+ Credit rating Plans Bonitas offers a wide range of plans that are simple and easy to understand. There are 15 options in five categories: Savings, traditional, hospital, Edge (virtual) and income-based. Increases The average increase, across all plans, is 6.9% The risk contribution on Primary, Primary Select, BonSave, BonFit Select, BonEssential, BonEssential Select, BonStart, BonStart Plus and BonCap is 6% These options contribute to over 70% of new business 227 000 members will experience an increase below CPI – approximately 65% of our membership Plan increases range from 2.7% to 9.6% Increased savings, for BonSave it’s an increase of 25% Note: Contributions from January 2024 Name of plan Type of plan Main member Adult member Child member % increase BonComprehensive Savings R9 853 R9 292 R2 006 9.6% BonClassic Savings R6 732 R5 780 R1 662 9.6% BonComplete Savings R5 359 R4 293 R1 455 9.6% BonSave Savings R3 447 R2 671 R1 032 6.8% BonFit Select Savings R2 295 R1 719 R 772 2.7% BonStart Edge R1 378 R1 378 R1 378 3% BonStart Plus Edge R1 754 R1 668 R 773 3% Standard Traditional R4 922 R4 267 R1 444 8.4% Standard Select Traditional R4 448 R3 849 R1 302 8.4% Primary Traditional R2 993 R2 341 R 952 7.2% Primary Select Traditional R2 619 R2 048 R 832 7.2% Hospital Standard Hospital R2 964 R2 497 R1 127 8.4% BonEssential Hospital R2 287 R1 690 R 739 7.1% BonEssential Select Hospital R1 998 R1 464 R 659 6.7% BonCap New and revised income bands Income-based 5.5% R0 to R10 680 R1 430 R1 430 R 673 R10 681 to R17 330 R1 745 R1 745 R 802 R17 331 to R22 541 R2 813 R2 813 R1 064 R22 542+ R3 453 R3 453 R1 310 What’s new? Mental Health: Due to a 25% increase in the number of mental health hospital admissions, the mental health programme has been included on all plans for 2024. Depression has also been added as a chronic condition on 11 plans The mental health app – Panda – is a free to download mental health and wellness mobile app available to all members Hearing: As part of the audiology programme, free online hearing screenings have been introduced DBC Back and neck programme: A physiotherapy network has been established Oncology: Increased specialised drug benefit on BonClassic, BonComprehensive, Standard and Standard Select International bone marrow searches allowed Introduction of a Be Better Benefit, paid from risk for a range of screening tests and benefits to allow for early detection (all plans except BonCap) An annual wellness screening (blood pressure, blood glucose, BMI, cholesterol) Flu vaccines HIV Lipograms Mammograms Pap smears Prostate screening Pneumococcal vaccine Whooping cough boosters HPV vaccines Stool tests for colon cancer Dental fissure sealants Online hearing screening Contraceptives Pharmacy network: Over 4 000 pharmacies to choose from including all Clicks, Dischem and Medirite branches HPV vaccine has been extended to all plans. 2 doses for females aged 9 to 14 years and 3 doses for females aged 15 to 26 years per lifetime HIV+ members: An annual test for HIV+ members who had a positive cytology test, as well as a choice between the 3-yearly basic cytology test or a 5-yearly HPV PCR test The Benefit Booster has been adjusted according to utilisation (10% monetary increase on 8 plans). The only benefit in the market which provides members with access to an additional amount to use for out-of-hospital expenses at no extra cost – effectively giving savings and day-to-day benefits a healthy boost Covers everything from additional GP consultations to acute medicine. Increased the child dependant age to 24 years, not just for students Partnered with What’s Up Doc: An innovative patient-driven WhatsApp service that allows doctors on the BonCap network to engage with members more easily – sharing prescriptions, blood test results, specialist referrals, etc – it’ll improve care coordination

September 28, 2023

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