Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Making changes to your medical aid

Wherever possible, consumers are tightening their belts and looking at ways to consolidate expenses and save money. Healthcare is no exception. Traditionally, members of medical aids re-evaluated their medical cover annually, to coincide with increase announcements as well as changes to plans and benefits which come into effect on January 1 each year. However due to the pandemic, a number of medical aid schemes have deferred or postponed their increase announcements. This new pricing is being introduced at different times during the year and at varying percentages – often above inflation. ‘This has caused some confusion and challenges,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund – which opted not to defer increases. ‘Members are free to change their options, once a year, during the open period. However, with deferred increases, this often falls out of the open period. This means members start paying the increased premium after to change options has closed.’ Callakoppen explains that the medical aid industry is highly regulated with specific rules and regulations that could impact changing plans and moving schemes. These include waiting periods, late joiner fees and accumulated savings – that all need to be considered when changing plans Can you change your membership any time during the year? You can change at any time but usually this happens during open period. When changing, waiting periods might apply and the savings allocation of the plan may be affected. Make sure you have not already used more than a pro-rated percentage of the benefits or you might have to replay it. This will happen if you have depleted the savings’ portion before the end of the year and switch to another medical aid. What is a waiting period? According to the Medical Schemes Act, medical aid schemes are entitled to impose waiting periods – there are two categories: General waiting period (up to three months) and a condition-specific waiting period (up to 12 months). This protects other members of the Scheme by ensuring individuals can’t make large claims shortly after joining and then cancelling their membership. When do waiting periods apply? Waiting periods generally apply if you move from one medical aid to another, you or your dependants were not on a medical aid for a period of at least 90 days before you joined, or you have never been a member of a medical aid. Can these be waivered? Waiting periods can be waivered but this depends on the medical scheme. Do you pay premiums during a waiting period? Yes, you continue to pay your full premium during the waiting period. What if you change from one scheme to another? Your specific details and medical history will be considered, for example pre-existing medical conditions, how long you have belonged to a medical aid, etc., and underwriting may apply. What is a late-joiner penalty? Schemes can impose late-joiner penalties on individuals who join after the age of 35, who have never been medical aid members or those who have not belonged to a medical aid for a specified period of time since April 2001. Can you move directly from hospital insurance to medical aid? Late-joiner penalties will apply if you are over the age of 35 and move from a hospital insurance to any form of medical aid (including a hospital plan). Does the late-joiner penal reduce over time? No, unfortunately not. Once you are paying a late-joiner penalty, it remains in place. ‘The bottom line is that members need to do due diligence if they are considering switching medical plans or schemes. They need to evaluate the monthly contribution against the benefits being offered and make sure they will cover their healthcare needs,’ says Callakoppen.

June 21, 2022

Exploring male menopause

Recently there has been increased discussions around male menopause. However, research shows that not all doctors and psychologists agree that there is a definitive male menopause or andropause. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, says this is because not all men experience it and, for those who do, they often don’t express their feelings as freely as women – as a result only a few men exhibit ‘midlife crisis’ symptoms. What is ‘male menopause’? It is the decline in the levels of the male hormone testosterone in men, just as women’s levels of estrogen begin to decrease, any time from the age of 40+. Some doctors refer to it as low testosterone. It is normal to experience a decline in the production of the male hormone testosterone with ageing but this also occurs with conditions such as diabetes. This gradual decline of testosterone levels is called late-onset hypogonadism or age-related low testosterone. It is a more gradual than female menopause where ovulation ends and hormone production plummets during a relatively short time. When does ‘male menopause’ start? Andropause or male menopause can begin at about age 40 (but can start earlier) and continue into the 70s. Why is it not talked about more? There is not much research into the subject, probably because you don’t die from the reduction in gonadal hormones and the withdrawal of hormones is not as dramatic as in women. Together with the reduction in hormones, there are often other factors involved when men experience this. For example, work pressure, marital pressures, life management and lifestyles exacerbate the problem. Many practitioners believe that balanced, youthful levels of human hormones improve the quality of life. What are some of the symptoms? Decreased mental sharpness (poor concentration, depressed mood) Decreased energy and strength Weight gain, decreased muscle and increased fat Depression and/or loss of eagerness and enthusiasm Irritability Sore body syndrome (feeling stiffness) Hot flushes or sweats Cold hands and feet Itching Poor sexual function Height loss Dr Mkhatshwa says some men feel the pressing need to make major changes because they feel ‘life is too short’ or have a feeling of dissatisfaction with their career, marriage and health. This can lead to restlessness about changes in appearance and making out of character choices, such as having an affair or a sudden desire for excitement or thrilling experiences. Getting help Men cope with menopause in different ways, it depends largely on their personality. The reduction in hormones often coincides with children leaving home, friends getting sick, marriages in trouble and job horizons narrowing. Combined with physical, psychological and sexual symptoms it is critical for men to acknowledge the challenges and seek the help of their family doctor, spouse, friends and support groups. How does one test for male menopause/andropause? It’s best to make an appointment with your GP who will: Perform a physical exam, ask about symptoms, order tests to rule out medical problems that may be contributing to the condition and do blood tests, which may include measuring testosterone level. Helping your body and mind cope with andropause Diet: A healthy diet, which includes a balance of vegetables, fruits, meats, fish and dairy products Fitness: Engage in regular exercise, including aerobic, muscular and flexibility exercises Get regular health check-ups including cardiovascular, prostate and testicular cancer Check hormone levels as you get older. Generally, between 40 and 55 several important hormones in a man’s body begin to decline Reduce stress in your life. Exercise and relaxation help to reduce stress, as does talking to your partner, friends and family about your problems Although sex is still important as you go through male menopause, you will start to view sex as a part of a loving relationship which includes friendship, intimacy and sharing Get plenty of sleep What about Testosterone Replacement Therapy (TRT), does it work? Medical experts are divided on this. It may improve the sexual function to some extent but there is no evidence that it improves any other symptoms. Are there any dangers or side effects? Men should avoid TRT if they are at high risk of prostate cancer, have severe urinary symptoms from prostate enlargement, have diagnosed heart disease, sleep apnea, a combination of risk factors for a heart attack or are prone to thrombo-embolic events. TRT does have associated risks, including: Worsening sleep apnoea (a potentially serious sleep disorder in which breathing repeatedly stops and starts) Causing acne or other skin reactions Stimulating noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer Enlarged breasts Limiting sperm production or causing testicles to shrink Stimulating too much red blood cell production, which contributes to the increased risk of forming a blood clot Fluid retention, etc. Unlike menopause in women, Dr Mkhatshwa believes more research is needed on andropause or male menopause to completely understand it and determine what can be done to assist men through this phase of their lives.

May 31, 2022

Morning sickness – what to expect and how to deal

Being pregnant is an exciting time of your life, but it can be a little daunting. Morning sickness is one of the aspects of pregnancy that can be difficult to deal with. It is estimated that over 70% of women deal with nausea and vomiting to some degree. The name morning sickness is also misleading, as unfortunately you can feel sick anytime of day. Morning sickness is often one of the first signs of pregnancy, beginning in the first trimester. Unless vomiting is so frequent that it leads to weight loss and dehydration (this is known as hyperemesis gravidarum), morning sickness is considered a normal (albeit unpleasant) part of pregnancy. What causes morning sickness? There is no one cause of morning sickness, and severity varies amongst women, and between pregnancies. Some women deal with feeling nauseous the entire pregnancy, whereas others will find that symptoms abate within the second trimester. Luckily, even though you may be feeling miserable, morning sickness is often seen as a sign of a healthy pregnancy and doesn’t harm your baby. Morning sickness is thought to be caused by hormonal changes during pregnancy, specifically the pregnancy hormone, known as human chorionic gonadotropin. How to deal with morning sickness? Unfortunately there isn’t anything you can do to fully alleviate the nausea and vomiting, however, there are things you can do to help fight feeling sick. Making sure you stay hydrated, eating a bland diet, such as rice, bananas and crackers, as well as eating small amounts frequently are all things that can help quell the queasiness. Try staying away from strong smells and spicy foods, as these can trigger nausea. If your morning sickness is bad, speak to your doctor, and be sure to consult with them before trying any medication or alternative remedies.

May 26, 2022

NEW PARENTS AND YOUR BABY’S HEALTH

Becoming a parent is a joy but it can also be overwhelming and just a little daunting. There is no degree or diploma, you are simply propelled into it. It’s a steep learning curve. You instantly have a new life depending on you and, combined with sleep deprivation, the challenges of adjusting to being a parent and wanting to do the best for your child, you need all the help you can get.Becoming a parent is a joy but it can also be overwhelming and just a little daunting. There is no degree or diploma, you are simply propelled into it. It’s a steep learning curve. You instantly have a new life depending on you and, combined with sleep deprivation, the challenges of adjusting to being a parent and wanting to do the best for your child, you need all the help you can get.

May 11, 2022

Talking about TB

Ten people die in South Africa every hour from Tuberculosis (TB). It is and has always been, a serious public health issue that needs to be brought under control. Even though effective treatments are available and there has been considerable progress in fighting the disease – about 450 000 people develop TB every year. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, talks about the state of our nation in terms of TB, the leading cause of death in our country. Of the 450 000 people who develop TB every year, just over half are living with HIV. Although most cases are drug-sensitive and respond well to standard treatment, failure to complete the full course encourages the development of multi-drug resistant TB (MDR TB), which is difficult to treat and has poor outcomes. Is TB a pandemic like Covid-19? TB is considered an endemic but arguably has the criteria to be given pandemic status. According to the World Health Organization (WHO) a pandemic is when: The disease causes death There is persistent transmission between people It spreads in multiple countries An endemic is when the disease is still circulating but at a lower, more predictable rate. The only plausible reason is that the levels of TB are consistent and predictable, rather than the ‘boom and bust’ waves of Covid-19. That said, just because it’s endemic doesn’t mean to say it’s not serious. Smallpox, for example, was endemic for thousands of years and a third of the people who were infected, died. Malaria is also endemic and causes around 600 000 deaths a year. Dr Thandi Dlamini-Miti, senior technical advisor: TB at health NGO Right to Care says, ‘Undiagnosed TB is driving transmission of the disease. Many people with TB don’t know they have it because they don’t have symptoms but they are infecting those around them with this potentially deadly disease.’ Is there enough research and development for TB drugs? The short answer is no. Countries with resources, funds and technical capacity (developed countries) have not invested in the field of TB because the disease has not affected them. It is a disease that flourishes in developing countries, where living conditions are often poorly ventilated and over-crowded. Over 95% of cases and deaths are in developing countries. Another factor to consider is that, although the poor bear the brunt of the burden of ill-health (up to 13X greater incidence of TB), they also have access to far fewer services compared to the rich. Some good news recently came from Right to Care though. Dlamini-Miti says, ‘Since July 2020, a TB prevention treatment called 3HP has been piloted. It is considered a game changer because treatment is shorter, less toxic, promotes better adherence, has a higher barrier to resistance and is safe with first-line antiretroviral therapy.’ Latent TB, HIV/AIDS and immunity TB can be ‘latent’, in other words you have TB in your body but it is not active. You aren’t ill and you can’t spread it. However, if your immune system becomes weak for some reason, the TB becomes active and will make you ill. Having HIV/AIDS is a key factor in the TB epidemic which is why it’s imperative that the almost six million people living with HIV are screened and treated. Latent TB treatment is fairly low cost and can be taken together with anti-retroviral drugs. Despite this, the number of people on medication is only a fraction of those who are eligible. Diagnosing TB Diagnosis is quite complex (particularly for those living with HIV) since many symptoms are similar to those for other common diseases. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics. The aim is to move from identifying fewer than 70% to 90% of all cases. Currently the process of testing most of the population is a protracted one. The TST (skin test) 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. This is both costly and time consuming. A quicker, cheaper method of testing would certainly assist to diagnose TB. Treating TB Current treatment for TB still includes many of the original antibiotics that were developed in the 1950s and 1960s. While newer antibiotics have been introduced, they are still used in combination with the originals whose side effects cannot be ignored. Similarly, BCG is still the only known TB vaccine administered to children in developing countries. Is there a vaccine that can protect adults? Unfortunately not, there is only the BCG for babies, which has become the most widely used vaccine and provides protection to children against miliary and meningeal TB. It provides limited protection against pulmonary TB, which is the most common form of TB. Has TB been affected by the Covid-19 lockdown? Yes, it has reversed years of global progress in tackling TB and, for the first time in over a decade, TB deaths have increased, according to the WHOs 2021 Global TB Report. How is TB contracted? It is transmitted through the air, not by surface contact. Transmission occurs when a person inhales droplets with TB nuclei and it travels though the mouth or nasal passages via the respiratory tract into the lungs to reach the alveoli of the lungs. Each person with TB can spread the disease to another 15 individuals over a year. Who is most at risk of contracting TB? People living with HIV (especially those newly diagnosed or not virally suppressed), 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, smokers, mineworkers, prisoners and pregnant women. How prevalent is TB amongst medical aid members? Protocols required by the National Department of Health dictate that all TB positive patients must be referred to the state for treatment. This means

April 8, 2022

Ten tips for flu and Covid-19 vaccines

The seasons are changing and with winter on its way, which heralds the start of the ‘flu season’. We chat to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund on why a flu vaccine is recommended, not just by the Scheme but also the World Health Organization (WHO). 1.Why should I get a flu vaccine? Although the flu vaccine will not eliminate your risk of developing flu, it helps reduce your chances of severe infection. Annually, seasonal influenza (flu) kills around 11 500 people in South Africa which is why it is a good precautionary measure to take. 2.How are Covid-19 and flu viruses similar? WHO says that Covid-19 and influenza viruses are similar in disease presentation. ‘Firstly, they both cause respiratory disease, which presents a wide range of illness from asymptomatic or mild through to severe disease and death. ‘Secondly, both viruses are transmitted by contact, droplets and any material that can carry infection. As a result, the same public health measures such as hand hygiene and social distancing is recommended.’ 3.What are the essential differences between Covid-19 and flu? Flu is an acute viral respiratory infection, transmitted by the influenza virus. There are three types of influenza, namely Influenza A, B and C. Covid-19 and influenza are essentially different viruses with SARS-CoV-2 being a newly discovered coronavirus that causes Covid-19. 4.Why do I need a flu shot every year? The flu virus changes every year, this means last year’s vaccine will not keep you safe this year. The vaccine helps your immune system fight off the virus by producing antibodies – the soldiers in your body that battle the flu virus. 5.What vaccines have been developed for 2022? The flu vaccines available for this year are: The Vaxigrip Tetra, Influvac and Influvac Tetra. 6.Can I get the flu vaccine and a Covid-19 vaccine together? As per the National Covid-19 Vaccination Programme Circular 3 of 2022, the answer is yes. However, it is recommended that if you decide to have both vaccines at the same time, then one should be on the left arm and one on the right. 7.Who should get a flu vaccine? It is recommended that anyone in the High-risk groups including: Healthcare workers Individuals over 65 years of age Individuals with chronic diseases – or comorbidities – for example: Cardiac disease, hypertension, stroke, diabetes, asthma, chronic obstructive pulmonary disease, kidney diseases, etc. Pregnant women People living with HIV/AIDS 8.Who should NOT have the flu vaccine? Individuals who are allergic to eggs or egg proteins as the manufacturing process for the vaccine involves the use of chicken eggs Infants under 6 months of age – the vaccines are not licensed for use in such young children Individuals who may have had a severe reaction to a flu vaccine in the past – if you are unsure discuss with your healthcare provider Individuals who may be suffering from flu symptoms already 9.Will the flu shot give me a mild flu? According to the Centre for Disease Control (CDC), ‘A flu shot cannot cause flu. Flu vaccines are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious or with no flu vaccine viruses at all. The most common side-effects from the vaccine are soreness, redness, tenderness or swelling where the shot was given. Serious allergic reactions to flu vaccines are very rare.’ 10.Still not convinced? Flu viruses spread very quickly from person to person. Even if the flu vaccine is not 100% effective against the current flu strain, it will reduce your risk of getting flu and, if you do get it, it will be a great deal milder. More importantly, by having the flu vaccine you protect others, who may be vulnerable family members, small babies, the elderly or those who are immune compromised. As with Covid-19, the more people vaccinated the closer we can get to ’herd immunity’.

March 25, 2022

Advice from the experts

The puzzle that is Autism

Autism, is currently referred to as Autism Spectrum Disorder (ASD) although people with ASD themselves consider Autism a neurodiversity rather than a disorder. Almost 2% of the world’s population is diagnosed as being on the Autistic spectrum. “Spectrum” because some people appear to be mildly affected and others profoundly so. Since each person is an individual and presents differently, the diagnostic process involves a number of professional assessments to identify strengths and areas of difficulty. Neurodiversity is not anyone’s fault and the causes of Autism are continuously being researched. There is no link whatsoever with vaccine treatments and the diagnosis of ASD. There does appear to be a genetic link, but the genes are not necessarily passed down from parents, since some genetic differences occur spontaneously. Autism can be understood from a medical perspective, as a condition with symptoms that can be improved but not cured, or from a more relevant social perspective, as an alternate way in which the world is experienced. It is not a sign that a person is ‘stupid’, defiant, sick, selfish, crazy, flawed or weird. All people are unique and that is why there are a number of professionals involved in the diagnosis. Paediatricians are perfectly positioned to follow a child’s developmental progress and although Autism isn’t fixed and changes over time, they may be the first professionals who detect neurodiversity in a child. Often paediatricians will refer their patients to other professionals if they detect a difference or delay in the child’s development. Parents can be overwhelmed by the process and feel isolated, but it’s important to remember that this team of professionals is there to support the entire family. Parents may also benefit from speaking to other parents in similar situations. A psychiatrist may assist with high levels of anxiety, attention difficulties, poor sleeping patterns, worries and extreme emotional fluctuations commonly experienced in Autism. There is no medical cure for Autism however prescribed medication is often helpful in reducing these difficulties. A psychiatrist will often refer their patients with Autism to a psychologist, to facilitate an understanding of Autism with the whole family and assist them to address difficulties with acceptance, emotional responses, behaviour and self-expression. People with Autism DO feel emotion and empathy but may battle to communicate those feelings. Psychologists are often also responsible for administering educational testing, to determine existing academic levels and potentials, for correct school placement. Success at school is largely dependent on the learner’s innate cognitive ability boosted by a support team and up-skilled educators. People with Autism often experience the sensory information in their environments differently to the way in which neurotypical people do. This has an impact on the way they behave in different environments and situations, as well as on their emotional resilience and well-being. This is why extremely picky eating; a strong need for predictability and structure; and specific skill sets and interests are often associated with Autism. Occupational therapists are a vital element in the team supporting children with Autism in this regard. The way in which sensory information is processed can fluctuate throughout the day, as well as from one situation to the next. Common responses for children with Autism include either “shutting down” and withdrawing from or avoiding engagement, or “melting down” and having temper tantrums or emotional outbursts and parents and teachers should understand and support this necessary ‘escape’. Neither of these is misbehaviour, but rather an instinctive response to the environment and the way in which sensory stimuli are being perceived. e.g. in a noisy chaotic place, noise reducing earphones may minimise the overload The use of Ayres Sensory Integration® in occupational therapy sessions goes a long way to helping children and adults with their ability to process the sensory information in their environments, thereby facilitating optimal function in daily activities whether they be daily hygiene activities, learning/work activities and/or social activities. A visual schedule at home and school is helpful for the child to anticipate what is coming during the day since people with Autism like predictability and structure and are thrown by unexpected changes in their routine. Occupational therapists can also provide support with motor and visual-perceptual development should this be required. Communication is another significant aspect to consider in the diagnosis of Autism. A speech therapist will support the development of communication skills for developing and maintaining relationships. Often more subtle aspects of communication are missed by a communication partner with Autism e.g sarcasm, facial expression, body language and tone of voice, leaving the person with ASD confused and excluded. While they may be able to define sarcasm for example, they may not realise when it is being used. Parents and teachers may need to point out social cues that have been missed. Fluctuating auditory perception and difficulty starting, maintaining and following a conversation can lead to communication breakdown. This is not necessarily related to the child’s understanding of the topic of conversation so rewording may be necessary. Learners with Autism favour facts and brevity over figurative and inferential information, impacting on academic comprehension and output, and social interaction. People with Autism are not deliberately rude but are to the point, often without an awareness of how their communication is perceived so it may be beneficial to discuss the effect of their own communication on others. Social norms are not always innate in neurodivergent children and adults. They may incessantly discuss a subject of their own interest and pay no attention to their conversation partner’s interest or disinterest in what is being said. Reciprocity in conversation may also be limited, leaving the listener with a sense of frustration and annoyance, shutting down opportunities for socialisation and relationship building. A speech therapist would encourage awareness and understanding of communication behaviours to minimise linguistic, social and emotional misunderstandings. Academic support teachers are the touchstone between learners with Autism, their specialist team and the school setting. They facilitate recommendations from the team to the school and vice versa to maximise the learning potential and happiness of the

April 7, 2021

How to support a child diagnosed with autism spectrum disorder: tips and strategies

After receiving an autism spectrum disorder (ASD) diagnosis, it can be overwhelming for the parents or caregivers of an autistic child to cope with the various challenges ASD may present. However, with the appropriate support structures and strategies in place, caring for an autistic child can become more manageable. Also read: Autism 101 – what is it and what should you look for? Support strategies for managing ASD Many autistic people are likely to experience communication difficulties, especially difficulties with social communication and understanding other people. Autistic children are also easily frustrated and made upset by unexpected events. Often, these feelings of frustration lead to intense meltdowns, and parents can help alleviate such feelings and prevent breakdowns by having support strategies in place. Prepare for future events Autistic children may become easily overwhelmed by minor changes in routine. Parents and children can benefit from preparation for the day’s or week’s events. Parents also need to ensure that structure and routine are upheld in the household so that the child knows exactly what to expect. Make use of visual aids Visual aids can assist autistic children in improving their skills in processing information, understanding and using language, and becoming more interactive within their environments. Visual aids can be used to communicate with autistic children to inform them of what is happening at present, what will happen during the day, and what will happen during the coming days. Examples of how to use visual aids include: Showing the child a picture of relatives who may visit Showing them photos of the dentist or doctor before a visit Creating a picture chart with the steps to follow when using the bathroom or getting dressed in the morning Not only are visual aids helpful for communicating information to autistic children, but they also help ensure that autistic children are well-informed of daily events. When children are informed, the likelihood of intense meltdowns is significantly reduced. Avoid sensory overload Sensory overload is commonly found in autistic children and is a contributing factor to meltdowns. Sensory overload means that autistic children may sometimes experience certain sounds, textures, tastes, lights, and sensations as painful and intolerable, which may lead to a meltdown. Parents can try to prevent a sensory overload by identifying their child’s specific trigger(s) and reducing the number of triggering stimuli in the environment. It may be helpful to reduce loud noise and avoid bright lights. Ease children into public spaces Trying to reduce noise and avoid bright lights is often impossible in public spaces like shopping malls or grocery stores. That is why it is essential to ease a child into visiting public spaces by starting with preparation using visual aids and very short visits. Once a child can manage a short trip, gradually increase the time of the visit. The same strategy can be used when visiting friends, family, or relatives. Autistic children may develop an attachment to a particular item, for example, a toy or a blanket. It may help to bring this item along when going into public spaces because it gives the child a sense of familiarity and comfort, which may help keep the child calm for the duration of the trip. Plan ahead when eating at restaurants Visiting a restaurant can be challenging for an autistic child. To make the outing manageable for a child, it may be helpful to do the following: Make a reservation at the restaurant ahead of time Visit restaurants during their quieter hours Request seating in a booth away from the play areas or bathrooms to reduce sensory stimulation Pre-order meals Request the bill before dessert to prevent the child from getting frustrated with waiting Additionally, parents should request permission to bring the child’s favourite food along, as some autistic children have very specific dietary preferences. Try rewards charts Some autistic children exhibit defiant behaviour, and, therefore, it is crucial to utilise strategies to encourage compliance. One strategy that can be used at home and at school to achieve cooperation is a rewards chart. Also read: How to reward your kids the right way Since many autistic children often have very particular interests, it is vital to ensure that the rewards chart is meaningful and appealing. For example, if a child has an intense obsession with a particular superhero, the rewards chart should incorporate that infatuation to gain a child’s interest and, consequently, compliance. When trying to encourage compliance from autistic children, parents are advised to provide as much praise as necessary and to reduce such praise gradually as children exhibit increased cooperation. Take care of yourself Lastly, parents are very often the primary caregivers of autistic children. To be able to give to others, your cup cannot be empty. It is, therefore, crucial that parents attend to their needs and mental wellbeing such that they are well-equipped to face the challenges that accompany caring for an autistic child. Parents should make time for self-care and join support groups to draw social support to prevent feelings of isolation they sometimes experience. Although the challenges are present, they do not make parenting any less rewarding. By implementing tips and tricks in your daily life, caring for an autistic child may become more manageable. by Dr Jeanné Roux – educational psychologist

April 1, 2021

15 Facts about the Covid vaccine

Although the vaccine rollout for healthcare workers has begun, myths and misinformation continue to circulate around its development, efficacy and just how the vaccine will help manage or mitigate the spread of the virus. We asked Lee Callakoppen, Principal Officer of Bonitas Medical Fund for 15 facts about the vaccine. #1. How does the Covid-19 vaccine work? The Covid-19 vaccines produce protection against the disease by developing an immune response to the SARS-Cov-2 virus. The vaccine stimulates an immune response to an antigen, a molecule found on the virus and provides a supply of ‘memory’ T- and B-lymphocytes that help fight that virus in the future. There are four types of Covid vaccines and they are all trying to achieve the same things: Immunity to the virus, reduction of symptoms if you are infected and being able to slow down or stop transmission. South Africa is currently using the Johnson & Johnson (J&J) single dose vaccine but, regardless of which vaccine you receive, you won’t reach full protection until around two weeks after the vaccination. Your immune system needs this time to develop the antibody response. #2. It is safe? Yes. The vaccine that is being used in South Africa is safe and has been given to millions of people around the world. Although it was developed very quickly to save lives, it has gone through the same rigorous processes as other vaccines. All medical products – including the Covid-19 vaccine – have to be approved by South African Health Products Regulatory Authority (SAHPRA) before they can be administered. #3. Are there any side effects? Some individuals vaccinated with the J&J vaccine have experienced temporary, mild side effects. They are similar to those experienced with other vaccines, such as soreness at the injection site, muscle pain, chills and a headache. Some also experienced fatigue and nausea. These are nothing to worry about and will disappear within a couple of days. #4. Can you be allergic to the vaccine? People who are prone to allergies should inform the healthcare personnel administering the vaccine beforehand. This, in order for them to observed and monitored for a longer period after receiving the vaccine. However, if you experience a severe allergic reaction after getting a Covid-19 vaccine, vaccination providers – or your healthcare provider – can provide care rapidly and call for emergency medical #5. Can you get Covid from the vaccine? No. None of the Covid-19 vaccines contain the live virus that causes the coronavirus. The J&J vaccine uses a harmless, modified form of the common cold virus in humans, called adenovirus. The vaccine will help your immune system fight the virus but will not infect you with it. #6. How effective is it? No vaccine is 100% effective but fortunately, the emerging data on Covid-19 vaccines have a high efficacy, at least against some of the variants. If a vaccine has 70% efficacy, it means a person vaccinated in a clinical trial is around two-thirds less likely to develop the disease than someone in the trial who didn’t receive the vaccine. Due to the severity of the virus, a 50% efficacy threshold was set for Covid-19 vaccine. #7. Am I forced to have the vaccine? No. Having the Covid-19 vaccination remains a personal choice as confirmed by President Cyril Ramaphosa. #8. Do I need the vaccine if I have already had Covid-19? Yes, the advice is that you should still be vaccinated even if you have had Covid-19 or if you have a positive antibody test. Research indicates that the natural immunity from having Covid does not last which means the best way of fighting the virus is a combination of being vaccinated and following the protocols. #9. Will I be immune after the vaccine and will this be forever? It is too soon to know how long the vaccine will last as it is still being researched. Of the people who have received the vaccine, we know that they have been protected from Covid-19 for at least 4 months. The risk of Covid-19 infection in vaccinated people cannot be completely eliminated. #10. Can you have the vaccine if you are pregnant or breast feeding? None of the vaccine trials included pregnant individuals, so direct knowledge is limited. However, the Centres for Disease Control and Prevention (CDC) as well as a number of other medical organisations agree that any of the currently authorised Covid-19 vaccines can be offered to people who are pregnant or breastfeeding. #11. Is it safe to be vaccinated if I’m living with HIV/Aids? Yes. There is some evidence that people living with HIV may be more vulnerable to developing severe Covid-19 symptoms and so getting vaccinated is even more critical if you are HIV positive. The Covid-19 vaccinations are the most powerful tools available to help prevent severe disease due to SARS-CoV-2. The vaccines are not live and are safe for people with compromised immune systems. It’s too early to tell how effective the vaccines will be at reducing transmission of Covid-19, but we do know that they are effective at preventing severe disease and death. #12. What does herd immunity mean? Herd immunity occurs when a large part of the population becomes immune to a virus, through vaccination or infection. South Africa’s Department of Health (DoH) is aiming to vaccinate 67% of the country’s population against Covid-19 – this equates to around 41 million people – to achieve herd immunity and slow down the rate of transmission of the virus. #13. How does the vaccination process work? Everyone over the age of 18 will be vaccinated in line with the Government’s Covid-19 vaccine roll out plan. You have to be registered on the national Electronic Vaccination Data System (EVDS) and then a 3-phase approach (starting with healthcare workers) is being adopted to ensure there will be enough vaccines to meet the demand. #14. Can you elaborate on the EVDS? The EVDS is based on a pre-vaccination registration and appointment system. Individuals have to

April 1, 2021

Making your medical aid benefits last

Around 9 million South Africans are members of medical aid schemes to ensure they have access to private healthcare. As each new year begins, members start with a clean slate, with new benefits and replenished savings. However, across the industry, members often complain that their benefits seem to ‘run out’ early on in the year. If you manage your medical expenses correctly you can avoid out-of-pocket expenses and limit the possibility of running out of benefits. Here are 8 tips from Lee Callakoppen, Principal Officer of Bonitas Medical Fund, on how to stretch your medical benefits to maximise your value. 1. Use DSPs or networks Medical schemes negotiate preferential rates with providers – known as Dedicated Service Providers (DSPs) – who have partnered with them. This allows schemes to ensure that members get the best quality services at the most cost-effective rate so that benefits are optimised and the scheme at large is sustainable. Using network doctors is an invaluable tool to helping make your medical aid last longer because it means you won’t be charged more than the negotiated amount. With over 6 000 GPs, Bonitas has the largest network in South Africa 2. Ask your pharmacist Buy over-the-counter medicine to treat less serious ailments and always, where possible, use generic medicine which has the same active ingredient, strength and dosage as the original brands and are just as effective. Pharmacists are able to provide sound medical advice on problems such as rashes, colds or illnesses that are not severe, simply ask! 3. Managed Care benefits Some schemes offer programmes to help you manage severe chronic conditions such as cancer, diabetes, HIV/AIDS and back and neck problems These programmes are usually covered from the risk portion of your medical contribution and are not funded from your savings account. They help you use your benefits to maximum advantage while ensuring you receive quality care by using specific providers. Other benefits – such as maternity consultations, wellness benefits, preventative care and dentistry – are also paid from risk by some schemes. Again giving you more value for money and are in addition to your savings and day-to-day benefits. Carefully read through what your plan offers and choose wisely to make sure you find the right plan to suit your specific healthcare needs. 4. Go virtual Look out for telemedicine or virtual consultation options – which are cheaper. A doctor will engage with you in a virtual video consultation on any medical issue and advise you on the most clinically appropriate steps for further care. 5. Be aware of consulting after hours In an emergency one has no choice but be aware that after hours consultations are expensive. 6. Know the facts If you do need to be hospitalised and it’s not an emergency, ensure that the healthcare practitioner is on your medical aid’s DSP list. Talk to your doctor or specialist to find out all the facts in terms of what they will be charging and compare this to what your scheme will cover. If the difference is substantial, negotiate. Approach your doctor and ask if he/she is prepared to adjust their fee. Alternatively, you can also check if there are other healthcare providers on your scheme’s network that will charge you a better rate. You can also avoid the unwelcome surprise of a co-payment or sub-limits by: Making sure you obtain pre-authorisation Making sure the medical practitioner uses the correct ICD-10 codes Getting a quote from the doctor, hospital and anaethetist and submit it to your medical aid to see which additional costs will apply (if any), what costs will be covered and how you can avoid these. 7. PMBs If you suffer from a Prescribed Minimum Benefit (PMB) condition, understand what benefits are provided as part of PMB conditions and use the service of a DSP to ensure your claims are paid from risk rather than from your medical savings account. 8. Keep moving One of the best ways to manage your health and the associated costs, is to live a healthy lifestyle and this includes getting enough exercise. Try different exercise routines and find one that works for you. Whether it is a regular short power walk, playing tennis or soccer, riding a bike or attending a yoga or pilates class, it will be beneficial to your mental and physical wellbeing. ‘Be informed’ says Callakoppen. ‘Your health is important, as are your finances, so take the time to research and understand the medical aid plan you’ve chosen. Even if you have not changed plans your benefits and savings differ year-on-year. Make sure you read the information sent to you, including the fine print to understand the Scheme Rules fully. If in doubt, phone the call centre, your broker or financial advisor. This will go a long way in helping you know your rights and making the most of your benefits.’

April 1, 2021

Plant-based pregnancy

As the wife of ultra-endurance triathlete and Ironman Africa Champion, Kyle Buckingham, Lauren, knows a thing or two about needing to look after her body and keep energy levels high. So when Kyle made the move to a fully plant-based diet over a year ago, Lauren, followed suit and honestly believes that this is what has contributed to her feeling so amazing through the last 6 months of her pregnancy. “From the time I found out I was pregnant at 5 weeks, nothing had changed,” says Lauren. “I didn’t even feel pregnant until I went into my 2nd month, after which I had occasional afternoon nausea until I went to bed. And just as fast as that feeling started it stopped on the first day of my 3rd month!” “I am still working as a sports massage therapist, dealing with athletes on a daily basis which requires a lot of my energy and input, and then just getting on with my normal daily things. I have yet to experience a drop in energy and I am into my 6th month now!” So how has Lauren coped with any cravings she has had during the past 6 months? “I have only had one craving so far and thankfully that only lasted two weeks. All I wanted was a cheese sandwich dipped in tomato soup! I was able to change dairy cheese for a vegan cheese option which was great, it was the weirdest combo, but I loved it!” While Lauren and Kyle made the switch to a plant-based diet quite quickly for Kyle’s training, Lauren realises that this might not be as easy for others. “If you are thinking of moving to a plant-based diet, I would suggest starting with either replacing one meal a week or possibly having one day a week that is only plant-based,” explains Lauren. “That way you can slowly get used to the various options and see what works for you.” “Fry’s started Meatless Monday’s which is a great place to start, they also have a few tasty recipes on their website that are super easy to try out!” What has been the biggest advantage that Lauren noticed since being on the plant-based diet? “Energy levels, when I made the switch my energy levels never dipped and throughout my whole pregnancy so far I have not gained extreme weight!” Here are some of Lauren’s favourite recipes for you to try out! Versatile Veggie Chilli by: Jamie Oliver INGREDIENTS – 500 g sweet potatoes 1 level teaspoon cayenne pepper , plus extra for sprinkling 1 heaped teaspoon ground cumin , plus extra for sprinkling 1 level teaspoon ground cinnamon , plus extra for sprinkling olive oil 1 onion 2 mixed-colour peppers 2 cloves of garlic 1 bunch of fresh coriander (30g) 2 fresh mixed-colour chillies 2 x 400 g tins of beans, such as kidney, chickpea, pinto, cannellini 2 x 400 g tins of quality plum tomatoes lime or lemon juice, or vinegar , to taste METHOD + Preheat the oven to 200˚C/400˚F/gas 6. Peel and chop the sweet potatoes into bite-sized chunks, then place onto a baking tray. Sprinkle with a pinch each of cayenne, cumin, cinnamon, sea salt and black pepper, drizzle with oil then toss to coat. Roast for 45 minutes to 1 hour, or until golden and tender. Peel and roughly chop the onion. Halve, deseed and roughly chop the peppers, then peel and finely slice the garlic. Pick the coriander leaves, finely chopping the stalks. Deseed and finely chop the chillies. Meanwhile, put 2 tablespoons of oil in a large pan over a medium-high heat, then add the onion, peppers and garlic, and cook for 5 minutes, stirring regularly. Add the coriander stalks, chillies and spices, and cook for a further 5 to 10 minutes, or until softened and starting to caramelise, stirring occasionally. Add the beans, juice and all. Tip in the tomatoes, breaking them up with the back of a spoon, then stir well. Bring to the boil, then reduce the heat to medium-low and leave to tick away for 25 to 30 minutes, or until thickened and reduced – keep an eye on it, and add a splash of water to loosen, if needed. Stir the roasted sweet potato through the chilli with most of the coriander leaves, then taste and adjust the seasoning, if needed. Finish with a squeeze of lime or lemon juice or a swig of vinegar, to taste, then scatter over the remaining coriander. Delicious served with guacamole and rice, or tortilla chips. SERVE with rice and pappadums Chunky Veg Yellow Thai Coconut Curry INGREDIENTS Yellow or Green Thai paste 1 can coconut milk (extra if necessary) 1 medium onion, diced ½ red bell pepper, roughly chopped (bite size) ½ yellow bell pepper, roughly chopped (bite size) 3-4 mixed courgette, chopped bite size pieces 1 cup chopped butternut (bite size) 2-3 carrot chopped (bite size) handful chopped baby spinach leaves Flexitarian optional -Add strips of tofu or calamari METHOD Add oil and Thai paste to pan allowing paste to warm and release flavours. Add can coconut milk and mix with paste. Bring to a simmer. Add onion, butternut and carrots first until semi firm (15-20min) with lid to keep moisture in. Add remaining veggies except the spinach, simmer about 30 min or until all veggie are soft enough to eat but not soft enough to mash. Al dente. Add spinach and stir together until wilted. Add extra coconut milk, water or oat milk to top up the sauce. Add tofu or calamari strips to pan and simmer in coconut milk until turns white. SERVE with sushi rice and pappadums.

March 30, 2021

Autism 101 – what is it and what should you look for?

What is autism? Autism spectrum disorder (ASD) is a range of developmental disorders that impair a person’s ability to communicate and interact with other people. As the name suggests, ASD refers to a broad range of conditions characterised by a person’s challenges with social skills, repetitive behaviours, speech, and nonverbal communication. Despite ASD consisting of a range of conditions, there are no subtypes since ASD may present very differently from person to person, along with differences in presentation among genders. How does autism present? Every person will have a different set of strengths and challenges but still fall under ASD. People diagnosed with ASD may present with more mild symptoms, while others may present with more severe symptoms – such individuals require significant support to function in their daily lives. As aforementioned, the presentation of ASD may differ between people in both severity and characteristics. People with ASD may also differ in their level of intelligence, as some have average or above-average intelligence while others may have a learning disability and require assistance with daily functioning. Common characteristics of ASD Characteristics that have been noted with some typicality include: Challenges with communication and interaction with others; Difficulties in reading social cues (i.e. how others may think or feel); Challenges in expressing their thoughts and feelings; Sensory sensitivity (e.g. bright lights, loud noises, etc.) which causes these individuals to become overwhelmed, stressed, or uncomfortable; Repetitive behaviours; Becoming anxious, upset, or angered by unfamiliar situations or changes in routine; Taking additional time to process information. Verbal ASD challenges It is common for roughly 40% of ASD individuals not to speak at all, while between 25 – 30% of others will develop language skills. Some language and speech challenges may include: Delayed speech development; Using a flat, robotic voice or speaking in a sing-song manner; Echolalia; Difficulties with pronouns, i.e. using I/me/he/she/they incorrectly; Rarely using physical gestures; An inability to stay on topic. Behavioural ASD challenges Autistic people may also display or engage in behaviours such as: Repetitive behaviours; Specific rituals; Fixation on certain activities, objects, or topics; Constant pacing back and forth; Fussy eating habits (many ASD individuals have textural issues); Not participating in pretend play; Impulsiveness; Aggression; An inability to pay attention or a short attention span; Clumsiness. What causes ASD? Several factors may influence the development of ASD, but there is no known singular cause. There have been rumoured causes of ASD such as diet, infections, or vaccines; however, each of these has not been conclusively proven to cause ASD. Typical comorbidities include medical challenges such as gastrointestinal disorders, seizures or sleep disorders, and mental health challenges such as anxiety, depression, and attention difficulties. How to identify autism Signs of ASD typically appear by the age of two to three years. Some children present with developmental delays as early as 18 months. In other rarer cases, ASD may be picked up by caregivers and teachers only later in the person’s life. Typically, when making a diagnosis of ASD, it will either have been identified by a doctor during early check-ups or when a parent becomes concerned and consults a multidisciplinary team of teachers, occupational therapists, psychiatrists, psychologists, and doctors. Also read: Might my child have ADHD? Signs of ASD Signs of ASD to which a parent/teacher may want to pay special attention include: Preference for solitary time; Avoidance of eye contact; No response to their given name by their first birthday; Lack of response to the emotions of others or appearing not to understand the emotions of others; An unwillingness to be comforted when upset; Avoidance or rejection of physical contact; Meeting of some developmental milestones but later losing them; Appearing to have a lack of facial expressions (i.e. smiling); Challenges with abstract thinking; Fixation on or a very clear preference for certain subjects; Challenges in making friends or maintaining friendships. Also read: Parental self-care If your child is experiencing one or a combination of these signs or symptoms, they may need professional help. Consult a psychiatrist or psychologist to determine the correct treatment and course of action for your child. by Dr Jeanné Roux – educational psychologist

March 26, 2021

World Down Syndrome Day: What to expect parenting a child with Down Syndrome

Finding out that you will be a parent is an exciting time for many. But finding out you will be a parent to a child with Down Syndrome, is often met with shock. If you will be raising a child with Down Syndrome, it can be challenging, so make sure you have a good medical team who can support you. 18 March 2021: With the world observing World Down Syndrome Day (WDSD) on 21 March, it is a good time to demystify what parents can expect from the first few months of life if they are expecting a child with Down Syndrome. This is especially so given that there are many cultural taboos around talking about, or having a, child with Down Syndrome. “The most important thing to understand is that raising a child with Trisomy 21 is challenging, given that the entire family dynamic will be affected. High levels of support and understanding are essential,” says Dr Iqbal Karbanee, paediatrician and CEO of Paed-IQ BabyLine, a trusted telephonic medical advice service for the first 1000 days of a child’s life, starting from conception to birth and beyond. Down Syndrome is caused by the triplication (trisomy) of the 21st chromosome and affects approximately 1 in 800 newborns. According to Dr Karbanee, it is the commonest chromosomal abnormality. He says that there are many features of Down syndrome that can be picked up during pregnancy and screening is readily available. The screening is offered mostly in high risk cases of which the commonest is an older expectant mom. “If you are pregnant and are diagnosed, it can be a major shock and parents have to face the choice of carrying on with the pregnancy or not. This is an intensely personal decision and should be carefully considered after discussion with all involved, and importantly, also the medical team.” Babies affected by Down Syndrome have a higher risk of abnormalities affecting multiple systems of the body. Parents will need to understand that the newborn will require a cardiac assessment as well blood tests to ensure the body’s systems are functioning normally. Feeding can be a problem as low muscle tone is associated with Trisomy 21. “The best way to approach this is to ensure the medical team is involved often as regular follow-ups and check-ups will be important. You need to make sure you can trust your medical team; this will be essential to getting the help your baby needs,” says Dr Karbanee. He adds that if you already have other children in the family, the needs of the child with Down Syndrome will be different to other children and will require everyone to adjust accordingly. “Developmental milestones will be delayed so expect the baby to sit and crawl much later than normal. Special schooling will be necessary as well as ongoing visits for physiotherapy and possibly Occupational and Speech Therapy,” says Dr Karbanee. “Having said that, while having a child with Down syndrome may be a huge adjustment for the entire family, the good news is that children with Down syndrome tend to have a pleasant personality and parents report that they are a delight to the family. “Speak to your paediatrician about all of your concerns, fears, or expectations, as it is her or her role to co-ordinate the care of the child and ensure that the health of the child is optimised,” concludes Dr Karbanee. About Paed-IQ BabyLine Paed-IQ BabyLine is a trusted, telephonic medical helpline for pregnant moms and new families. With healthcare advice given by qualified, experienced and medically trained nurses, we aim to improve health outcomes during the first 1000 days of a child’s life, starting from conception to birth and beyond. We are there for mommies-to-be at all stages of their maternity journey as well as new parents or caregivers to young children. By offering early and appropriate medical intervention through advice, we have helped to safeguard the health of over 10000 children, and helped moms and families successfully navigate the medical concerns of their young children. Visit https://paediq.com/ for more.

March 18, 2021

Hospital Plans vs Hospital Insurance: Knowing the difference

In times of economic pressure we all relook our monthly expenses to see where we can save on costs but having access to quality healthcare remains a priority – even more so during a global pandemic. Hospital insurance may be cheaper than medical aid hospital plans but is definitely not the same product. We asked the Principal Officer of Bonitas Medical Fund, Lee Callakoppen, to help us understand the two different products offerings. Regulation ‘Firstly, before I take you through the benefits and possible shortfalls of hospital plans as opposed to hospital insurance, it is important to point out that hospital plans are part of the offerings provided by medical aids. This means the product is regulated and overseen by the Council of Medical Schemes and in accordance with the Medical Schemes Act 131 of 1998. Hospital insurance (or medical insurance) is part of the umbrella term, health insurance and includes hospital insurance, hospital cash back plan and gap cover. Hospital insurance is not part of a medical aid but is governed by the Financial Services Board (FSB) and the Long-term and Short-term Insurance Act,’ explains Callakoppen. Medical Aid Hospital Plans A hospital plan provides you with basic, yet important medical cover. The product differs from scheme to scheme but in essence this plan is offered by a not-for profit medical scheme and will cover you in hospital for emergency and planned procedures In the case of Bonitas – you also get access to some additional benefits for wellness and preventative care The hospital plan ensures that when you are admitted into hospital for a procedure or due to an accident or illness, your expenses are covered – within the limits set by your particular plan There are 27 chronic conditions that all medical aid plans must cover, so the hospital plan also covers these which are known as Prescribed Minimum Benefits (PMBs) This type of plan does not cover you for other day-to-day medical costs like visits to the doctor, specialist or medicine It is tax deductible Hospital Insurance Hospital insurance is not a medical aid, it pays you for the time you spent in hospital but not for the treatment you receive It provides cash benefits depending on the number of days you are in hospital due to illness or an accident The insurer pays the money directly to you, you are able to use the money however you please – to pay for daily household costs or the hospital, doctor and specialist bills This often seems more attractive than a hospital plan and has a cheaper monthly premium however, the daily amount you receive is often way below the medical expenses incurred while in hospital It is governed by the Short or Long-term Insurance Acts Does not cover Prescribed Minimum Benefits (PMBs) May include Personal Accident risk cover such as disability and loss of limbs, inability to work, salary protection, death and/or funeral covers Is not tax deductible The limitations of hospital insurance It is a set amount which might not cover your hospital or medical bills, leaving you financially short and, in some cases, has a waiting period New regulations state that pay-outs are limited per insured life, per hospital stay with an annual limit Typically people buy the policy that pays less than R1 000 per day If you have one of the top plans, the daily pay-out during your stay in hospital may sound like a lot of money however, it usually falls short of actual costs charged by hospitals, doctors and specialists For example, a caesarean birth costs around R30 000. This can be much more if complications occur. Remember that hospital insurance companies are ‘for profit’ unlike medical schemes who are ‘not for profit’. The recommendation by most financial advisors is that a hospital insurance product should be used in conjunction with medical aid, or hospital plan, as income replacement rather than medical aid cover. And what is GAP cover, how does it work? Callakoppen provides an update. Minding the gap At times there may be a shortfall between what the medical scheme pays and what the hospital or specialist charges. You are responsible for paying the difference There is an insurance policy called gap cover which you can take out to pay for this shortfall The amount you receive depends on your policy but there is an overall annual limit Some gap cover policies have a waiting period for certain conditions Most people usually take gap cover together with a medical aid hospital plan It is important to know that gap cover, like hospital insurance, is an insurance ‘policy’ and is registered as Short-Term insurance policies Gap cover premiums are not tax deductable ‘There has been a growth in health insurance products over the past few years and they appear to provide medical cover, but actually don’t,’ says Callakoppen. If you choose to take out health insurance, do so as complementary to medical aid, not a substitute. ‘My advice: Shop around to find the best plan that covers your health needs and suits your pocket. A number of Low Cost Benefit Options have been introduced by Medical Schemes – these offer more affordable plans that give you peace of mind in terms of access to quality healthcare. Interrogate the benefits you receive on the plan you are considering versus the monthly contributions but, above all, never compromise on your health.’

March 18, 2021

Trimester two overview

Your second trimester begins in week 13 and ends at week 28. During this time your morning sickness will ease off, and initially your baby will be small enough that your body won’t be in too much discomfort, earning this trimester the nickname of the honeymoon period of pregnancy. During this trimester you’ll probably tell your family, friends and employees you’re expecting and your tummy will begin to show – time to upgrade your wardrobe! Your body during your second trimester During the second trimester the pregnancy you’ll hopefully notice that your morning sickness is easing up and your energy levels should begin to rise. While you will be feeling better don’t put pressure on yourself to exercise or socialise more than you’re comfortable with. This trimester your baby bump will go from barely noticeable to one that you may struggle to hide. Embrace your changing body and adapt your exercise plan to accommodate your baby, prenatal yoga and pilates classes are a great way to stay in shape, meet other moms-to-be and prepare for labour and delivery. A growing belly and breasts, Braxton Hicks contractions and leg cramps are all common pregnancy symptoms you may experience during this trimester. Not only this but you may experience dental issues, sore and swollen feet, and an achy back and/or pelvis. Your baby’s growth during the second trimester Your little one does lots of growing during your second trimester, and during this time you’ll begin to feel them moving around inside your belly (this is also known as quickening). Not only this, but during trimester two your baby’s ears develop to the point that they can hear your voice and other external sounds. During the second trimester your baby’s eyes and ears become more developed and you’ll soon be able to find out their gender on an ultrasound (if you want to!). Your baby’s muscle tone is also improving, they’ll be swallowing amniotic fluid and their sucking reflex will develop – they may even suck their own thumb. Important things to note during the second trimester At week 19 to 20 you’ll have an anatomy scan. In this scan your doctor will be able to see how your baby is developing, and if there is anything unusual that would be cause for concern. During this scan the doctors will also be able to tell you the gender of your baby – if you decide to be told you can start thinking of baby names! This trimester is also a good time to decide how and where you’d like to have your baby. Decide on if you like a hospital or home birth, and start putting together a birth plan.

March 16, 2021

What is Perinatal Distress… and what does it really look like?

Most of us have heard of perinatal distress, also known as postnatal depression or PND, but why is this common and treatable illness often misunderstood and underdiagnosed? I was propped up in bed trying to feed my one-week-old infant staring at a pamphlet titled: “Postnatal Depression”. I thought to myself, “oh that’s when a new mother lies in bed all day crying. I definitely don’t have that. I’m not even going to open this pamphlet. I’m exhausted, I have my hands full with a fussy baby, I don’t have time to read this and besides, I don’t have PND anyway.” Two months later, I was hospitalised for nearly two weeks, followed by months of therapy and medication. You guessed it: I had PND. This medical condition had gone undiagnosed long enough for it to ravage my body and mind, as well as tear a hole through our entire family. When I look back at that dark and difficult time, I often think to myself that if only I had understood then what PND truly looked like, this illness would never have been able to take such a powerful hold on my life. The jaw-dropping reality is that PND affects well over 10% of women within the first year of giving birth. Many of those women are never diagnosed and treated because they don’t know what PND is or may be too ashamed to seek help. Why do we know so little about PND? Let’s rewind a little. PND used to stand for Postnatal Depression, a mental health condition in which mothers would experience depression and anxiety after their baby’s birth. Fast forward to present day: PND now stands for Perinatal Distress, because experts now understand that this mental health condition can occur both before and after giving birth (yes you can have PND when you are pregnant!) and that mothers can experience a wide range of symptoms. These may include depression, anxiety, obsessive compulsive behaviours, sleep disorders, anger and more. In the most extreme cases (postnatal psychosis – a medical emergency) a mother may experience hallucinations or voices. The full list of symptoms is a long one, but may include some or all of the following: Feeling low, sad, tired, hopeless, alone, scared, angry, bored, irritable, guilty, on edge. Changes in appetite (either eating more or less than usual) Weight loss or gain Loss of interest in enjoyable activities; not looking forward to things. Lack of interest in the baby Panic attacks Overwhelming, scary thoughts. Even thoughts of harming yourself or the baby Changes in energy levels, sleep patterns or tiredness (hard to gauge with a new baby when you’re sleeping less anyway, but if you are unable to sleep when you are exhausted, there may be a problem) Mood swings, crying more often, restlessness and irritability Brain fuzz or racing thoughts Herein lies the Problem These symptoms cover most of the common emotions experienced by mothers in the perinatal period. Some of these symptoms are completely normal and result from extreme hormonal fluctuations associated with pregnancy and birth. However, these symptoms should only last for a couple of weeks after the baby is born (The Baby Blues). So how can a mother tell what is normal, and what is PND? A good rule is that if you feel like you’re not yourself, or you are not coping, have a chat to your healthcare provider. If you don’t feel like you can talk to your GP, obstetrician or clinic nurse, then turn to a trusted friend or family member. You do not have to suffer in silence. There are various treatment options available to you which are perfectly safe, both before and after giving birth. With the correct treatment, PND can be completely resolved. Left untreated, it may be fatal, to both a mother and her child. Why do most women have only a vague idea of what PND can actually look like? Because we don’t talk about it! Even in todays’ open-minded world of acceptance, there is still a heavy burden of societal stigma attached to a mother’s mental health. When a woman is pregnant or has a baby, she is expected to be happy! “You’ve been so blessed!”; “Enjoy every minute, they go by so fast!”; “You’ve got what you always wanted – you must be thrilled!” These are all phrases that most mothers have heard at some point. If she is struggling inwardly, she may feel guilty that she is not happy. Mothers are often wracked with insecurity, which they can keep well hidden. She may worry that she will be seen as ungrateful, or even unfit to be a mother. PND survivor Hayls Lieberthal wanted nothing more than to have a child, but as her pregnancy progressed, so did her self-doubt. “I was told all the time, ‘you are carrying life, you’re very blessed’ and ‘You have nothing to feel sad about!’” She vividly recalls a woman saying to her “look at you, you must be so excited!” and found herself lying behind a false smile: “I am so excited I can’t wait!” Meanwhile, on the inside all she could think was “I can’t do this.” From the moment your pregnancy is confirmed, healthcare professionals typically focus intensely on a mother and baby’s physical health, but less on a mother’s mental health. Even when a healthcare provider is aware of PND and asks the patient all the right questions, a mother may not divulge how she truly feels because she feels ashamed. After I had my first baby, I was overwhelmed by my new life and role. There were times that I thought I had made a terrible mistake, and that maybe I wasn’t cut out to be a mother after all. These feelings were shameful to me, and I didn’t feel like I could tell anyone. Little did I know that those feelings are incredibly common among new mothers, even mothers who do not have PND. The Truth about PND PND is not

March 15, 2021

When the stomach turns .. tummy bugs or COVID-19?

As South Africa nears the end of the second wave of Covid-19 and braces for a third, a stomach bug is circulating and spreading in schools and the community. Dr Morgan Mkhatshwa, head of operations at Bonitas Medical Fund, discusses the signs and symptoms of a stomach bug and common gastrointestinal (GI) viral infections versus the GI symptoms from Covid-19. He says, ‘Although the period between November and May usually coincides with an increase in diarrhoea and pneumonia cases, according to the MMC: Community Services and Health, Zahid Badroodien, it is significantly reduced with a 29% decrease in cases and a 15% decrease in hospital admissions. The decline is partially attributed to the increased adherence to health protocols for Covid-19 like hand-washing, sanitisation and wearing masks.’ However, the recent tummy bug that is circulating, is proof that the virus is still around, Dr Mkhatshwa talks about common GI viral infections and GI symptoms associated with Covid-19. What are the symptoms of a tummy bug? Stomach bugs (or stomach flu) are known as viral gastroenteritis and are characterised by the following symptoms: Diarrhoea Abdominal cramps Nausea Vomiting Fever Thirst Joint aches Headache General malaise How long does a stomach bug last? People typically develop stomach bug symptoms within 24 to 72 hours of being exposed to the virus. While most cases resolve in three to four days, it’s not uncommon to feel unwell for up to a week. How do I know if it’s food poisoning or a stomach virus? The symptoms of food poisoning and a stomach virus are very similar. However, food poisoning symptoms develop in as little as a few hours. Most people suspect food poisoning when symptoms develop shortly after eating food which may seem questionable. Covid and gastroenteritis Research consistently shows that approximately 10% of adults with Covid-19 report GI symptoms such as nausea, vomiting or diarrhea. Typically, patients will also have the more common upper respiratory symptoms that accompany Covid-19, such as a dry cough or difficulty breathing. How do you tell the difference between Covid-19 symptoms and ‘stomach flu’? So, how do you know which one you’re dealing with if you’re experiencing, for instance, a fever, vomiting, and diarrhoea? ‘Unfortunately, it is not always easy,’ says Dr Mkhatshwa, ‘if you have respiratory symptoms, (particularly chest pain) and loss of smell or taste, it is pretty clear cut. However, GI symptoms can occur on their own with Covid-19. A stomach bug also typically lasts only 72 hours while GI related symptoms with the coronavirus can last much longer.’ What should you do if you suspect the GI symptoms are in fact, Covid-19 related? Consult your doctor – via phone or virtually – to discuss your symptoms and if he/she feels you are displaying signs of the coronavirus infection, they will refer you for a Covid-19 test. How long are you contagious with a stomach bug? Stomach viruses are highly contagious and can spread quickly. People infected with a stomach virus are contagious from the moment they begin feeling ill and also for the first few days (up to 72 hours) after they recover. A stomach virus can spread in several different ways: Eating food or drinking liquids that have been contaminated with the virus Having direct or indirect mouth contact with an infected person or surface with the virus on it Unhygienic behaviour, such as not washing hands after toilet use, not washing fruits and vegetables before consumption The virus also inhabits the vomit and stools of people who have the infection How do you treat or get rid of a stomach bug? Supportive therapy that includes increased hydration, rest, electrolyte replenishment and medication for fever is usually all that is needed for viral illnesses. This is because viruses do not respond to antibiotics and simply need to run their course. If the infection is caused by bacteria, like Salmonella, an antibiotic may be prescribed. Viral gastroenteritis will typically resolve within a few days or less without medication. However, hydration is vital to a speedy recovery and prevention of complications. Here are a few steps you can take at home to aid recovery from a stomach virus or food poisoning: Try not to eat any solid foods until you feel better Suck on ice chips or take small sips of water to prevent dehydration Avoid juices or other beverages with a lot of sugar or sweeteners that can make diarrhea worse Ease yourself back into eating. Start with bland, easy-to-digest foods, such as toast and rice. Stop eating if a feeling of nausea returns Avoid dairy, caffeine, fatty foods and sugar until you feel better You should be cautious of taking over-the-counter medications, unless advised by a healthcare provider, as some can worsen the infection When to treat it seriously and consult a medical doctor? Seek medical attention if you have any of the following symptoms: A bloody stool or vomit Are unable to keep liquid down for 12-24 hours Feel dizzy or light-headed Have a fever above 40°C Are experiencing severe, unrelenting abdominal pain. Fortunately, thanks to the Covid-19 protocols which include wearing masks, social distancing and the washing and sanitising of hands the incidence of stomach bugs has been reduced. However, it is a virus and you may still be susceptible but remember it will run its course and you will recover. During the time you are experiencing symptoms rest, stay hydrated and stay away from others while you are still contagious.

March 10, 2021

Your second trimester – making the most of it

Your second trimester is from the beginning of week 13 until week 28, during this time your pregnancy will begin to show. However, you should feel like you have more energy than you did in trimester one. This is why this trimester is also nicknamed the honeymoon period of pregnancy – your baby isn’t big enough to make you uncomfortable and your pregnancy hormones should have eased up. During this time there are one or two things that you can keep in mind to make the most of this time while you’re feeling better, and to ensure that your baby (and you) are kept healthy and happy. Childbirth classes, preparing your mind and body Even if this isn’t your first baby, childbirth classes can help prepare you for what is to come. If you’re feeling anxious about labour and birth, these classes will help ease your worries, by informing you what is to come and how best to manage your mind and body coming up to, during birth and after birth. Prenatal exercise and a healthy lifestyle Stay fit and healthy during your pregnancy is important to both you and your baby. What you eat and regular exercise are both ways in which you can provide needed nutrition to your baby and keep yourself healthy. Low impact exercise, such yoga, swimming, walking and prenatal pilates can help improve your sleep, and increase your strength and muscle tone. Keeping active can even have the added benefit of helping prepare your body for labour and birth. Maternity wear and staying comfortable Not only is learning about your pregnancy and staying healthy essential but staying comfortable is also important. The second trimester is generally when your tummy will start looking and feeling bigger, so invest in some trousers that have more give in the waistline. Luckily certain fashion items, such as flowy dresses and layered knits, may even mean you can still keep using your pre-pregnancy clothes.

March 9, 2021

Play has the power to help address kids’ anxiety

As restrictions around COVID-19 continue, parents continue to feel anxious – as do their children, who are facing yet another year of limited extra murals and social activities. Even though schools are open for the 2021 academic year, it’s under limiting conditions, which in turn is likely to increase anxiety among children. Anxiety manifests in various ways in children, including poor appetite, getting angry or irritable, worrying or having frequent negative thoughts, being fidgety, being clingy, or complaining of tummy aches or headaches. With the last year or so having thrust families into very different situations, with parents working from home and children kept distant from friends and teachers – whose facial expressions are hidden behind masks – anxiety is being seen in children as young as two years of age. This could be because they’re picking up on the stress their parents have experienced during the pandemic, or it could be that they’re accustomed to passive and isolated screen-bound activities, and they’re struggling to acclimatise to new interactions and activities on returning to school after a long break. “Children communicate and express themselves through play, which is a useful tool, both therapeutically and at home, to provide children with an arena in which to explore and express some of their emotions,” says Colleen Johnson, a Johannesburg child psychologist. “Playing with a child helps not only to connect with them on their level, but offers an opportunity to defuse power struggles, unearth some of their fears and insecurities, and to offer positive resolution through the medium of play. Playing with your child encourages secure attachment, connectedness and fun, which reduces feelings of anxiety.” Cape Town-based occupational therapist Anine van Schalkwyk suggests letting children play through scenarios that make them feel anxious. “Let them play through a situation after it’s happened, rather than asking them direct questions, like ‘how was your day’,” she suggests. “Give them the cues to build a situation, and let them allocate ‘roles’ to you and themselves. In creating the scenario, using their favourite toys, chances are that they’ll tell you the story of their day and what caused their anxiety – and you can help them talk through it.” Johnson adds that the type of play to help resolve anxiety depends on the child’s personality and specific needs at the time – children who are disorganised may benefit from structured play, such as building a LEGO® set together, following the visual instructions. Those that enjoy a less-structured type of play have the freedom to use LEGO® bricks to create builds that express their imaginations – or the issues that may be on their mind. “This helps reduce anxiety as the child feels safe by being able to follow specific guidelines towards a predictable outcome,” she explains. “However, allowing the child to engage in free play or fantasy play has tremendous benefits too, as the child feels in control of their environment, taking the lead and determining their own outcome.” The LEGO® Play Well Report, based of research conducted among children and families in multiple countries, including South Africa, found that parents believe that play develops a wide range of benefits, for their child, for themselves, and for the family unit as a whole. The research highlighted that 91% of respondents felt that play was important to help the family stay entertained, with 88% confirming that play helped them stay emotionally healthy. Van Schalkwyk emphasizes that parents should prioritise close contact play with their children – perhaps even more intensely than they would have before the pandemic, given that children are not getting the sensory and social input needed for appropriate development, because of rigorous social distancing in schools. “Hug your children tight, and often,” she says. “It’s a tough balancing act when you’re tired from working all day, but intense play is good for parents as well – it lowers adults’ anxiety too!”

March 9, 2021

Covid and flu – should you still have the flu shot?

Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund unpacks the differences and similarities between ‘flu’ and Covid-19, how it affects your body and offers compelling reasons why you should consider getting the flu vaccine this year. Every year, seasonal influenza (flu) kills around 11 500 people in South Africa alone. To date, Covid-19 has resulted in around 50 000 deaths in South Africa. While the true mortality of Covid-19 will take some time to fully understand, the crude mortality ratio (the number of reported deaths divided by the reported cases) is between 3-4%. For seasonal flu, mortality is usually well below 0.1%. However, mortality is to a large extent determined by access to and quality of health care. How has Covid-19 impacted on the flu virus? The Covid-19 pandemic has, however, had a significant impact on the 2020 flu season where decreased flu activity has been reported. This is most likely related to lockdown and additional hygiene measures. Bearing in mind that The World Health Organization (WHO) has recommended flu vaccines for 2021, circulating flu viruses evolve constantly so an accurate prediction for the upcoming season is challenging. Should you still have a flu vaccine in 2021? Dr Mkhatshwa recommends you do. Flu vaccines have been shown to reduce the risk of influenza illness, hospitalisation and death. Not only will flu vaccinations reduce the risk of getting flu but is an important conservation measure for scarce health care resources which remains a concern with the ongoing the Covid-19 pandemic. The flu vaccine should be given sufficiently early to provide protection for the coming winter. A protective antibody response takes about 2 weeks to develop. As there is limited evidence on the safety and effectiveness of receiving these vaccines simultaneously, Dr Mkhatshwa recommends waiting at least 14 days between having the Covid-19 and flu vaccinations. How are Covid-19 and flu viruses similar? WHO says, ‘Firstly, Covid-19 and influenza viruses have a similar disease presentation. That is, they both cause respiratory disease, which presents as a wide range of illness from asymptomatic or mild through to severe disease and death. ‘Secondly, both viruses are transmitted by contact, droplets and any material that can carry infection. As a result, the same public health measures, such as hand hygiene and good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing of the tissue), are important actions all can take to prevent infection.’ What are the essential differences between Covid and flu? Flu is an acute viral respiratory infection, transmitted by the influenza virus. There are three types of influenza, namely Influenza A, B and C. Influenza C is less common and produces milder disease. WHO says there are important differences between the two viruses and how they spread. This has important implications for the public health measures that can be implemented to respond to each virus. The two are essentially different viruses with SARS-CoV-2 being a newly discovered coronavirus that causes Covid-19. The speed of transmission This is an important point of difference between flu and the coronavirus. Influenza has a shorter incubation period and can spread faster than Covid-19. Further, transmission in the first 3-5 days of illness, or potentially pre-symptomatic transmission, is a major driver of transmission for influenza. Although with Covid-19, people can be infected by someone 24-48 hours before the onset of symptoms – this is not the major driver of transmission. The severity of illness While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be different. For Covid-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe, requiring oxygen and 5% are critical infections, requiring ventilation. These fractions of severe and critical infection would be higher than that of flu. Who is at risk? The Department of Health (DoH) together with the National Institute for Communicable Diseases (NICD) targeted the following groups for the 2021 campaign: Healthcare workers Individuals age >65 years People with comorbidities like heart disease, diabetes or lung disease Pregnant women People living with HIV and AIDS What are the signs and symptoms? In terms of symptoms, Covid-19 and flu can have varying degrees of signs and symptoms, ranging from none (asymptomatic) to severe symptoms. Common shared include: Fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue, sore throat, runny or stuffy nose, muscle pain or body aches, headache, some people may have vomiting and diarrhea, though this is more common in children than adults. Other signs and symptoms of Covid-19, different from flu, may include change in or loss of taste or smell. A Covid-19 test will confirm the diagnosis. Does the flu shot give me a mild flu? According to the Centre for Disease Control (CDC), ‘A flu shot cannot cause flu. Flu vaccines given with a needle are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious, or with no flu vaccine viruses at all. The most common side-effects from the shot are soreness, redness, tenderness or swelling where the shot was given. Serious allergic reactions to flu vaccines are very rare.’ Still not convinced? Flu viruses spread very quickly from person to person Even if the flu vaccine is not 100% effective against the current flu strain it will reduce your chances of getting the flu and, if you do get it, it will be a great deal milder More importantly, by having the flu vaccine you will protect others, via what is called ’herd immunity’. Others may be vulnerable family members such as small babies and the elderly as well as those who are immune compromised. While the world focuses on Covid-19, social distancing, wearing a mask and hand washing or sanitisation can help protect you from both Covid-19 and flu.

March 4, 2021

Keep on and power up immunity and antioxidants

The Covid-19 pandemic continues to teach us tough lessons and it’s an ongoing fight. The bigger picture is that whether we are travelling, at work, home or school, our bodies are continuously responding to tiny organisms that can cause disease. Germs like viruses and bacteria are everywhere, and it is our immune system which protects us. While there is no magic “healthy pill”, there are proven ways to boost our immunity superpowers. Proper face masking, frequent handwashing and sanitising and social distancing are a good start. But there’s more we can do to protect ourselves and our loved ones against threats to our health and wellbeing: Support your immune system with good nutrition that is packed with immune boosting nutrients and a variety of antioxidants. Eat at least two fruits and four portions of veggies a day. The deeper the yellow, orange, red or purple colours of fresh produce the better. Move more, especially if you are in a sedentary job. It has been shown that fewer sick days are taken by people who do regular aerobic exercise. Even 20 minutes of brisk walking for five or more days a week boosts our immunity. Sleep is essential for good health. Quality sleep helps us to be more resilient to everyday stress and, improves energy and moods. Supplement with protective antioxidants. A one-a-day, every day, immune boosting nutritional supplement like Nativa Immune Complex® contains a powerful combination of antioxidants, vitamins, mineral and herbals. These provide antioxidant protection and help strengthen natural immune defences. Around R126 for a month’s supply. Power up with extra Vitamin C when health needs or stress levels increase, if smoking, or during a change of season. High dose Vitamin C supports immune function and offers antioxidant protection to help maintain good health. Have a look at Nativa’s new Vitamin C range. It is suitable for children from 4 years old. 500 mg Vitamin C (from 4 years of age). 1000 mg Vitamin C (from 9 years of age). Around R80. Add in some sunshine power with Nativa Vitamin D3 which is essential for immunity, bone and brain health, and muscle function. Vitamin D3 is of value particularly for those who get little sun exposure or who have dark skins. 1000IU Vit-D (from 6 years of age) around R100. All products are available from Takealot, Dis-Chem, Clicks and selected pharmacies nationwide. WIN! Stand a chance to win a R500 Takealot voucher.

March 4, 2021

With you every step of the way Venavine® capsules and cream

What fun things do your legs help you do? When our legs are strong and healthy, we don’t give them a moment’s thought. But let them start being tired, heavy, crampy or swollen, then it’s time to give them special attention. Turns out, caring for legs early when they first ache for help will keep them happily twinkling along while you walk, run, carry the children, load the car, swim and dance. Why would legs complain in the first place, we’re all having such a great time, aren’t we? Well, if your working day keeps you seated for much of the time, or even if you are on your feet for most of the day, a medical condition can develop where the circulation of blood flow from the leg becomes impaired. The result is swollen legs, damaged veins, sensitive skin, and it can be painful. Tips to keep legs happy: When seated don’t ever cross your legs or scrunch them up, which puts pressure on veins and nerves. Stretch them to promote flexibility and get up and walk about at frequent intervals if you have a sedentary lifestyle. That relaxing walk around the neighbourhood is also a great idea. Here’s one from the professionals: Ballerinas lie down with legs raised to rest and drain them at the end of their day as part of their leg and foot care routine. Something for you and your legs to enjoy together: Soak in a hot bath. A scoop of Epsom Salts and some fragranced bath oil or foam adds to the feeling of indulgence and has a relaxing effect on muscles and veins. After bath, or even without bath, massage your legs by rubbing in easily absorbed Venavine® Intensive Cream. Massage combined with this specially formulated product improves circulation while giving a cooling and relaxing effect. Price: 125 ml around R117. Add a daily leg pick-me-up: Combine Venavine® Intensive Cream with a one-a-day Venavine® Capsule . It contains Red Vine Leaf Extract which has been well-studied for its use in supporting people with chronic venous insufficiency. The capsule should be taken for 12 weeks, but if symptoms do not improve after two weeks, consult a healthcare practitioner. Longer term use is possible in consultation with a doctor. Price: 30 capsules around R212 and 60 capsules around R382. Available from online suppliers like Takealot, Dis-Chem and Clicks and selected pharmacies nationwide. www.venavine.co.za Don’t forget to enter this month’s competition here!

March 1, 2021

EXPLICIT AND CRINGE-WORTHY WOMB STORIES UNCOVERED IN LIBRESSE’S CAMPAIGN

Feminine hygiene brand, Libresse, has launched its most intimate campaign, yet. The compelling initiative empowers women to explicitly share honest, cringe-worthy experiences of womanhood. From the profound diagnosis and fertility treatments, to severe menstrual cycles. The Womb Stories series, features women of various ages and commits to nullify common myths that exist around their complexities. In mid-February 2021, Libresse introduced the powerful stories on its digital pages, collaborating with the voices of ordinary women around the world. The campaign stems from the social misinterpretations, lack of knowledge and stigma that linger around the female body. Commonly, women are deprived to speak out in confidence and unapologetically about what really happens to their organs- the effects thereof and the process it takes to overcome it. Libresse, as a personal care brand identified this as a concern and set out to drive these important dialogues. It distinguished itself in an audacious manner, outlining and showcasing the gruesome nature to which the uterus and womb experience change. The choice of words used are blunt and the visuals portrayed mirror the pain felt during this intimate journey. Endometriosis, Menopause, Hysterectomy and miscarriages are some of the issues that are covered. “This campaign highlights that a woman’s journey with her body is not simplistic. It reveals the emotional, complicated and sometimes painful realities of women’s intimate experiences. We want to reverse the stigma that is often associated with uteruses, periods and vaginas by encouraging women to have open conversations about their bodies, says Mpho Nojiwa, Marketing Brand Manager of Libresse. The campaign will further launch Womb Table, a video segment that will gather doctors and experts, Dr Sindi Van Zyl, Dr Boitumelo Makaulule and Dr Chriselda Kananda to further discuss some of the issues that resonate with South African women.

February 26, 2021

New Head of Operations for Bonitas

Bonitas Medical Fund has announced the appointment of Dr Morgan Busuku Mkhatshwa as Head of Operations. Dr Mkhatshwa is a medical doctor with extensive experience in the healthcare sector. He has a proven track record of spearheading the introduction of enhanced comprehensive healthcare services and programmes including occupational healthcare services. In addition, he has led organisational restructuring efforts within highly unionised environments, launching accelerated business expansion and improvement initiatives to maximise revenue growth. Compassionate about management, business development and stakeholder engagement, he began his career as a science teacher before he pursued his medical studies. He worked as a medical officer before progressing to principal medical officer in the public service. He spent some time as Hospital Manager at Life Healthcare and went onto become MD of one of the divisions in the company. After Life Healthcare he joined Lenmed Health as Group Business Development Manager and later became Group Head of Operations. ‘We are delighted to have Dr Mkhatshwa joining our management team,’ said Lee Callakoppen, Principal Officer. ‘He brings with him a wealth of knowledge and expertise, not only as a medical doctor but also years of experience in strategic planning and execution, general operations management, project management, coaching and mentoring. We know he will be a valuable asset to our team and our members.’ Dr Mkhatshwa has a BSc. (Biological Sciences), Bachelor of Medicine and Surgery (MBChB), Hons BSc (Limnology), Master of Science (Medical Microbiology) and Master of Business Administration (MBA). Oher achievements include the completion of the Harvard Business School – General Management Program.

February 26, 2021

Cheese, full of goodness and a lunchbox fav

Versatile and delicious, it’s incredibly easy to make cheese one of your family’s three-a-day dairy options, every day. Like other dairy, cheese is also a firm favourite with kids. Used as a tasty topping, an essential ingredient and a go-to sandwich filler, cheese also stands alone as a nutritious and satiating snack. Packed with protein, calcium, phosphorus and other essential nutrients, cheese, in all its many varieties, deserves its place as a healthy food item in your family’s diet. Understanding the benefits of cheese, how to choose it and how to use it will help you to plan, shop and enjoy including cheese across breakfast, lunch and supper, and the snacks in between. Natural cheese is a fermented food, and while its exact origins are unknown, there is evidence from Ancient Rome and Ancient Egypt that the goodness of cheese has been recognised for thousands of years. Cheesemakers use milk, salt, beneficial bacteria and a natural enzyme known as rennet as the foundations for producing a vast array of cheeses. Different formulae and ageing processes result in different textures, flavours and colours that are all packed with goodness. Maretha Vermaak, the registered dietitian at Rediscover Dairy says, “Cheese can make a significant contribution to your daily nutrient requirements – from the protein that supports healthy bone and muscle development and repair of body tissue; to the dental protection we get from the calcium and phosphorus by having cheese directly after a meal. As parents who are concerned about good nutrition for our growing children, it is great that cheese is also so completely delicious.” When it comes to choosing the cheeses we include in our family’s meals and snacks, value for money is often top of mind. Luckily, today’s cheese options range all the way from luxury to everyday prices and there’s something to fit every budget. Proper storage of cheese also impacts on affordability because you want to avoid any food waste. Many cheeses freeze well, enabling you to buy specials or cheaper bulk options and safely freeze for later use. It often works well to buy a big block of a harder cheese such as cheddar or gouda, grate it all before its use-by-date and freeze the surplus for quick and easy use. Processed cheese spreads can be stored in the pantry until they are opened, and some varieties of cheeses, including sliced processed cheese, have longer shelf lives in the fridge. It’s always important to check the labels when it comes to storage and the nutrient content of a food item. Proper meal planning, and shopping for value for money can help you to include more cheese, more often. Another factor for many busy parents is convenience. The reality of our daily lives is that we often need fast solutions and time-savers. It helps to have nutritious options such as cheese on hand so that we can quickly prepare daily meals, snacks and lunchboxes. A good example of this is glass jar cheese spreads which are healthier options than many other bread spreads, or sliced or portioned cheese products that are grab-and-go, and a great way to control portions. When it comes to lunchboxes, cheese is always a winner, some tips include: Plan for lunchboxes – plan before you shop, and pack lunchboxes before the morning rush Involve your children – in preparing their school snacks and lunches. They learn about nutrition and how to share chores, and you can have fun together Keep it different – it may seem easier to keep doing one thing but embracing a variety of lunchbox foods encourages your children to try new foods as they develop and prevents boredom and lack of interest in eating their school lunches Aim for balance – growing children benefit from a variety of nutrients, even when it comes to snacks and lunchbox lunches. Make sure you are including protein sources like cheese, milk and yoghurt as well as carbohydrate sources like bread and crackers. Don’t forget to add fresh fruit and veg too. Hydration is essential – dehydration can have adverse effects on your child’s performance at school. Water and milk are top choices. Rather avoid sugary drinks. For more dairy ideas join the Rediscover Dairy Facebook page: www.facebook.com/RediscoverDAIRY

February 23, 2021

A FRESH TAKE ON FROZEN

While trying to juggle all of our roles and responsibilities, there is an increased need for convenience, affordability and reduction of waste that aligns with today’s strongest dietary and lifestyle trends. Fortunately, we can call upon the friends in our freezer to meet these needs, and more! However, there are still many misconceptions about the quality and nutritional value of frozen foods. McCain and Sea Harvest, both leaders in the frozen foods category, are here to dispel some of the common misconceptions when it comes to frozen foods: It’s fresh – Fresh produce forms part of a healthy diet as it contains nutrients that are essential for good health. However, there are some disadvantages. The limited shelf life increases the risk of expiring before consumption, which results in more frequent visits to the store and higher expenditure on fresh produce. When cooking with trusted frozen foods brands like McCain and Sea Harvest, you can rest assured that all their produce is harvested at its peak, sustainably sourced and snap frozen within hours to maintain freshness and lock in nutrients. “Freezing is a safe and natural way of preventing bacterial growth and enzyme activity and eliminates the need for undesirable chemical preservatives,” explains Catharina Bester, Marketing Manager: McCain Foodservice & Retail. It’s convenient – There’s no way around it, frozen meals are a win on a busy weeknight. The cleaning, chopping, crumbing and portioning has all been done for you. All you need to do is take it out of your freezer, heat according to the on-pack instructions, and serve. It’s healthy – Contrary to popular belief, freezing causes very little nutrient loss and preserves the vitamins and minerals in food – so all those fantastic nutrients end up on your dinner table, meaning you get a nutritional meal every time. Frozen produce is packed with nutritional value and provides the easiest way for you and your family to get your daily nutrition. It’s affordable – Frozen vegetables and fish have a much longer shelf-life than fresh produce so there’s less wastage, meaning you get more broccoli for your buck. It’s constantly available – Buying frozen food means you can enjoy your favourite vegetables and fish year-round. And, because of its longer shelf life, you can make sure you always have a quick dinner-time solution in the freezer! “You have enough on your plate right now but when it comes to cooking you want a quick and convenient solution that will still offer great nutrition to your family and requires minimal time spent in the kitchen. Sea Harvest and McCain are the friends in your freezer, bringing consumers the fun and creativity back into your kitchen. You get all the health benefits and delicious taste, without the hassle,” says Sea Harvest Marketing Manager, Jared Patel. Reimagine mealtimes with #FriendsInYourFreezer and stand a chance to WIN 1 of 10 PlayStation 5 consoles. T&C’s apply. For more information, visit www.friendsinyourfreezer.co.za, McCain Facebook, McCain Instagram, Sea Harvest Facebook or Sea Harvest Instagram. You can also download this fun activity book to keep the kids busy!

February 19, 2021

Teen Suicide Prevention during COVID19 – Talk, Listen & Connect

Teen Suicide Prevention Week (14 – 21 February 2021) highlights awareness especially around teen Depression. As the COVID-19 pandemic has worsened across the globe and increased stressors for many, the mental health of children and teens has been affected to a large extent. Suicide is the 3rd leading cause of death in 15 – 19 year olds (WHO, 2020). The South African Depression and Anxiety Group (SADAG) is focusing on creating awareness for Teen Depression and Suicide, as South African teens are at a particularly high risk as the mental health impact of COVID-19 has been immense. South African teens (OUTare especially at riskas they) navigate a new world of online learning or delayed learning, social isolation, loss, grief and trauma, with increased anxiety and depression. Psychiatrist and SADAG Board Chairperson, Dr Frans Korb, says “There is a myth that depression or suicide doesn’t affect teens or children, in fact it is very real and affects more young people than we know, with teens being a particular high risk for suicide. Depression is the leading cause of suicide, it doesn’t discriminate against age, gender, race, religion or socio-economic background.” SADAG has seen an increase in the number of calls to the Suicide Helplines, and we encourage parents, teachers and family members to know the warning signs of depression and to reach out for help as soon as possible. Now more than ever, parents need to connect and engage with their children – ask questions, listen carefully to understand, get to know what is happening in their teens lives and what they are feeling and thinking,connecting to help if you pick up any warning signs for depression or suicide before it is too late – it could save a life. There is still a lot of stigma and fear around suicide, and many parents and teachers are afraid that if they talk about suicide to teens that it would cause them to take their life. SADAG’s Operations Director, Cassey Chambers explains, “Research shows that talking about suicide with a young person DOES NOT cause them to have thoughts of suicide or kill themselves. But NOT talking about it can lead to thoughts of suicide turning into action. Talking about suicide and depression create an opportunity to discuss feelings and thoughts that might have otherwise remain hidden. Most teens who are thinking about suicide are often honest and relieved when asked direct questions about their suicide thoughts or feelings.” But informing and empowering parents and teachers on how to have these conversations with teens is the first step to preventing teen suicide. SADAG will be hosting 2 free online CONNECT Webinars – one for Teachers (24 February, 3:30pm) and for Parents (25 February, 1pm) with experts to unpack how to identify warning signs of teen depression and suicide at home and in the classroom, self-help tips to deal with depression, how to talk about suicide with a teen, developing a suicide safety plan, and how to connect to help. Visit www.sadag.org for more details about these free Connect Webinars and RSVP for your free seat today. Miss SA will be using her Instagram platform to focus on Teen Depression for #MindfulMondays on Monday the 15th February at 7pm. SADAG will also be hosting an online #FacebookFriday expert Q&A on Friday the 19th February at 1pm-2pm and again at 7pm-8pm answering all your questions on teen depression, suicide prevention and how to get help LIVE on @TheSADAG. “Even if you notice 1 warning sign, don’t wait or leave it. Talk today, listen and connect to help – it could save a life,” says SADAG’s, Cassey Chambers. Possible Warning Signs of suicide include: Talking about suicide or death – could be writing or drawing about death and dying, or posting pictures, quotes, or messages on social media Writing or sending goodbye letters or messages or posting goodbye messages on social media Saying things like “Everyone would be better off if I was dead” or “I wish I wasn’t here anymore” or “I don’t want to be here anymore” Giving away prized possessions Signs of depression such as moodiness, hopelessness, withdrawal, drastic change in their appetite and sleep, and loss of interest in usual activities Increased alcohol and/or other drug use Behavioural changes and taking excessive risks SADAG runs the country’s only Suicide Crisis Helpline (0800 567 567) which is open 24 hours a day, 7 days a week, sms 31393 and a counsellor will call back or you can visit the online toolkit for teen suicide prevention on www.sadag.org. There is always help!

February 16, 2021

INTERNATIONAL CHILDHOOD CANCER DAY (15 FEBRUARY): EARLY DETECTION CAN SAVE LIVES!

Of the 800 to 1 000 children that are diagnosed with cancer in South Africa each year, more than half tragically go undiagnosed. Dr Charlotte Ingram, Medical Director at the SA Bone Marrow Registry (SABMR) says SA has among the highest childhood cancer mortality rates with two thirds of children never reaching a specialist treatment centre and when they do, their cancer is often at an advanced stage. “Many childhood cancers are treatable with cure rates of between 70% and 80% in well-resourced countries, while in contrast, eight in ten African children with cancer die without access to adequate care. Despite SA having an established oncology healthcare service, its infrastructure is overburdened, which is further impeded by low cancer awareness in the primary healthcare setting and widespread service delivery challenges.” She says unlike adult cancers, childhood cancer is difficult to prevent or screen for because the causative genetic and environmental factors are less understood, but if it is detected early, most children can be treated successfully. “Knowing what the early warning signs are is vital in order for treatment to commence as soon as possible. Unfortunately, among certain local ethnic groups, there is still a lot of stigma and myths that surround childhood cancer. Some of these include: Two of the most common childhood cancers in South Africa are leukaemia and lymphoma. Leukaemia is caused by a rise in the number of white blood cells in the body and accounts for a quarter of all childhood cancer cases in the country. Early symptoms include chronic fatigue, bone and joint pain, weakness, easy bleeding or bruising, recurrent nosebleeds, swollen lymph nodes, fever and unexplained weight-loss. Lymphoma is triggered by tumours that begin in the lymph glands, the spleen, thymus gland and bone marrow and can affect other organs throughout the body as well. Look out for painless swelling of lymph nodes in the neck, armpits or groin, persistent fatigue, fever, night sweats, weight-loss and itchy skin. If any of these signs or symptoms persist, its best to make an appointment with a doctor who will be able to conduct tests to rule out the possibility of blood-related cancers. Dr Ingram explains that in many cases, a bone marrow transplant, which is also referred to as a stem cell transplant is used to treat leukaemia and lymphoma and other blood and immune system diseases that affect the bone marrow. “Childhood cancers are different from those found in adults as most of them occur in developing cells such as bone marrow, blood, the kidneys and nervous system tissues. Chemotherapy kills both cancerous and healthy blood cells inside the bone marrow, which is why transferring a new, healthy set of blood stem cells by way of a bone marrow transplant, helps their immune systems to recover from the intense treatment. Replacing diseased or damaged cells with non-cancerous stem cells will help the body to make healthy cells. “At the moment, SA’s overall childhood cancer survival rate is at an unacceptably low 52%, nearly 30% less than in developed nations. In 2018, the World Health Organisation (WHO) established the Global Initiative for Childhood Cancer, which aims to achieve a global survival rate of at least 50% for all children diagnosed with cancer within the next decade. “To deliver on that promise, policymakers need to prioritise childhood cancer by: Debunking the misconceptions around childhood cancer among a large percentage of our population; Increasing our country’s capacity to deliver quality services for children living with the illness, along with access to care; Whilst also increasing the number of bone marrow donors. Currently, only 73 000 donors are part of the national registry, which is miniscule if you consider that more than 23 million people are eligible.” Do your bit by helping the SABMR spread awareness around childhood cancer this month by sharing its social media posts with family and friends: https://www.facebook.com/sabonemreg/ https://www.instagram.com/sabonemreg If you are between the ages of 16 and 45 and want to become a donor, contact the SABMR on 021 447 8638 or email: [email protected]. Financial donations can also be made via www.sabmr.co.za/donate to help boost funds for their Patient Assistance Programme.

February 12, 2021

Minimize added sugar in your child’s diet

It’s true. Your baby or toddler was born with a sweet tooth! Children this age naturally prefer sweet tasting foods, including breastmilk. Did you know that babyhood and toddlerhood are critical periods in shaping and influencing your child’s eating habits and taste preferences? Upon introducing solids, it’s important to offer a wide variety of textures and flavors. When it comes to food choices, quality matters most! After all, they have tiny tummies that can only hold so much at one time. Because of this, it’s especially important to offer foods that are rich in nutrients, without any undesirable extras, like added sugar or salt. Some foods naturally contain sugar, such as fruit, some vegetables and dairy products. Added sugar can be in obvious sources like desserts and sugary beverages. But added sugar can also sneak into less obvious sources including flavored yogurts, breakfast foods like cereals and waffles, and even condiments like spaghetti sauce and ketchup. While we want to include good-for-you sources of natural sugars (think fruits, vegetables and yogurts with no added sugar) in our baby or toddler’s diet, we do want to keep out the not so good-for you added sugars. Keeping the added sugars in your child’s diet to a minimum is important in helping reduce the risk of various health conditions. Unhealthy weight gain, tooth decay, and attention/behavioral issues have all been associated with excessive intake of added sugars. Because research shows diets with fewer added sugars are better for our health, there are new laws governing the inclusion of these on our food labels. Moving forward, the government will be requiring food manufacturers to include the amount (in grams) of added sugars on the Nutrition Facts Panel. This will give us a much better idea of what is actually in our foods, in terms of naturally occurring versus added sugar. Here are some other ways to limit your child’s intake of added sugars: Offer mostly whole foods. Serving foods in their natural state, such as fruits and veggies, allows you to know exactly what you are feeding your baby or tot. Processed foods like crackers and other packaged goods can be not- so- obvious harbors for added sugars, check labels and offer no added sugar versions. Be mindful of “kid-friendly” foods. Specific foods aimed towards kids, like yogurts and cereal bars, can still contain too much added sugar. Look for and choose products that don’t include any of these sugars. Be a food label decoder. In addition to seeing the word “sugar” on food labels and ingredients lists, other words can indicate the presence of a sugar that is not naturally occurring in the product. Examples of these include: honey, agave, fructose, dextrose, corn syrup, and molasses. Becoming familiar with the many names of sugar will help you better understand what is in specific products. Meal plan. Preparing meals at home gives you more control over what goes into the foods you make for you and your family. Avoid sugary drinks. Avoid offering your baby or toddler beverages that are high in sugar like fruit beverages, sodas and iced teas. Even though 100% fruit juices do not contain any added sugar, no fruit juice is recommended for infants younger than 12 months. For toddlers 1- 3 years of age the intake for fruit juice should be limited. Limiting your child’s exposure to added sugars will help contribute to a healthy start! We love… Super Smart Pouches: Retail Selling Price: R42,50 Nourish your growing tot with this tasty blend of organic bananas, beets, and strawberries. To help support brain health, each pouch contains 20mg of DHA and 100mg of choline making this pouch perfect for wholesome, on-the-go eating! Stockists: Happy Family Organics products are available at Baby City, Babies R Us, Wellness Warehouse, Clicks, Spar, Pick n Pay, Baby Boom, Dis-Chem, Medicare Pharmacies, Takealot, Babies Africa, Faithful To Nature.

February 12, 2021

The low down on Covid-19 test protocols

As South Africa finds itself starting to move out of the second wave of a Covid-19 outbreak, over 8 million Covid tests have been carried out in the public and private sector since the start of the pandemic. The global gold standard method to diagnose Covid is the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. It is currently the most accurate way to detect SARS-CoV-2, the virus that causes Covid-19. Will your medical aid pay for the test? According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘Funding is in accordance with the Council for Medical Schemes (CMS) guidelines, all clinically appropriate and referred diagnostic testing for suspected Covid-19 cases will be funded as a Prescribed Minimum Benefit (PMB) condition.’ Bonitas pays for up to three Covid-19 diagnostic tests from risk, whether the result is positive or negative. However, this is subject to the member or beneficiary being referred by a registered healthcare practitioner (doctor or nurse). This referral is dependent upon whether the member is showing symptoms, has been in contact with anyone who has Covid-19 and prior to hospitalisation. It should be noted that laboratories will not normally accept walk-ins for testing and require a referral or request from a healthcare practitioner. This is to ensure that we don’t test unnecessarily and jeopardise the availability of these tests for those who really need them. ‘Despite the PCR being arguably the most accurate laboratory methods for detecting, tracking and studying the Coronavirus, there are limitations in its widespread use,’ says Callakoppen. ‘These include: Access to the test kits; the complexity of performing them; the need for specialised staff to administer them; potential global shortages; high costs; the requirement for laboratory equipment and the delayed turnaround times. For this reason, testing should only be done when it is clinically necessary.’ What about Rapid Antigen Tests Immunoassay devices that detect the SARS-CoV-2 antigen within 15-30 minutes have also been promoted as a possible solution when access to PCR tests is a challenge. An antigen – detected in the blood or any other fluid – is any substance that makes the immune system produce antibodies. Viruses and bacteria are antigens. However, these tests are not as accurate as the PCR tests and have shown variable performance during evaluations, with sensitivities ranging from 0 to 94%. Test specificity has been high, but sensitivity has been erratic, which we need to bear in mind. Why is specificity and sensitivity critical? Sensitivity is the percentage of true positives (e.g. 90% sensitivity = 90% of people who have the target disease will test positive). Specificity is the percentage of true negatives (e.g. 90% specificity = 90% of people who do not have the target disease will test negative). These allow you to rule conditions in or out but not definitively diagnose a condition. What does the Council for Medical Schemes (CMS) say? The CMS currently still advocates the PCR test to diagnose Covid-19. The World Health Organisation (WHO) has also previously advised that the role of these rapid antigen tests must be evaluated and are “not currently recommended for clinical diagnosis pending more evidence on test performance and operational utility”. However, the WHO has now approved the use of antigen tests (and this is the South African approach as well) as an alternative to the more expensive PCR tests. This is however, in certain defined scenarios such as testing confirmed people in communities where infections have been detected, screening of high risk groups and individuals and for contact tracing purposes. They have also provided conditional recommendations for the use of these tests such as screening at ports of entry, routine screening for employees at their place of work, schools, prior to certain urgent medical procedures, etc. The challenge with these tests is that they are most accurate in patients between 5 and 7 days after showing symptoms – therefore the timing of testing becomes critical in order to ensure accuracy of the result. What about Rapid Antibody Tests? Many countries, including South Africa, are using antibody or serology tests such as the ones offered at various drive-throughs. These can detect whether someone has previously been infected and estimate how widespread the infection is but they are not recommended for diagnosis of Covid-19. For this reason, these are not funded by Bonitas Medical Fund as the use for these tests is limited for purposes of government surveillance and research rather than diagnosing Covid-19. If individuals want to know whether they have previously had Covid-19, for their own information, this test would be able to confirm that – but it is not used to identify whether you currently have the infection. If these tests are done too soon after the infection, they produce incorrect results as the antibodies (IgM and IgG) will not be detectable. There is also no scientific evidence that it provides any immunity to another Covid infection. ‘What is clear is that laboratory testing plays a vital role in the diagnosis and the prevention of the spread of the virus,’ says Callakoppen. ‘Nevertheless, it is important to understand that the timing and correct use of the different types of tests is crucial to gain the best results. We reimburse up to three PCR or rapid antigen tests done in or out of hospital for our members and recommend that this protocol for testing remains, until further research is conducted and evidence provided.’

February 12, 2021

Pregnancy and COVID

Looking back at last year, we had no idea how COVID-19 would change the way that we live. It has crept into every facet of our lives. We have had to change the way that we work, learn, bury our loved ones, and socialise. Nothing is “normal” anymore. COVID-19 has had a profound impact on women who are pregnant. The ability for pregnant women to receive health care and general support from friends and loved ones have changed drastically. Pregnancy is a time where a woman and her partner need to be supported and have their regular medical checkups to help them have a healthy baby. Our new normal does not allow for large baby showers, friends popping over for a chat and a cuddle of your baby. Grandparents can’t visit in hospital and in some NICU visitation to the baby is very limited. So how then does a woman and her partner prepare for pregnancy and the time when your baby comes home? Here are 5 topics to consider: Social distancing / Self Isolation during and after pregnancy: The current research suggests that women who contract COVID-19 while pregnant have an increased risk of severe illness and death compared to non-pregnant women. They also have an increased risk of having adverse pregnancy outcomes like prematurity. Over the last year we have learnt that it is almost impossible to have no risk of contracting COVID but if you do need to leave your house, you can consider the risk of the activity. This will allow you to plan and put in place ways to reduce the risks. There may even be some activities you will have to avoid. In general, the more people you have close and prolonged contact with will increase your risk of getting COVID-19. You also need to consider the actions of the people that you live with and how they are interacting with other people. The best way to protect yourselves from contracting COVID-19 is to limit interactions with people. Steps that you can take when you need to interact with others are: Wear a mask over your nose and mouth, try to keep about 2m away from other people, wash your hands with soap and water for at least 20 seconds and if indoors try to be in a well-ventilated room. Events like baby showers, shopping for baby items and visit of friends once baby is home, need to be rethought as to how to make it safer for you and your baby. Some baby shower ideas are online zoom parties or drive by and drop off the gifts and a note. What ever you decide to do, consider the risks and how to reduce them. My Breastpump has an online store where you can have breastfeeding items delivered to your home: https://bit.ly/3obw7vH Look after your health. Keep all your health care appointments. Talk to your health care provider about the safest way to deliver your baby. You might consider having a home birth with a Midwife or giving birth in hospital. Eat a health balanced diet and take all your vitamin and mineral supplements. Keep active so that you are strong for the delivery. Find online antenatal classes to help you prepare for your delivery. The class should include information on different delivery types, how to recover from delivery, information of how to care for your baby once you get back home and are breastfeeding. Finding out what your hospitals policies are around COVID. It is best to know what the hospital policy is regarding COVID testing before delivery, your partners ability to see your baby, what if you do have COVID and visitation during hospital stay for family members. This will help you to be prepared and to pack your maternity bag accordingly. Many hospitals are not allowing non-parents to visit in the maternity ward. This may be lonely and scary, but it does allow you and your partner to have a baby-moon, where you both can focus on getting to know your little one, gives you time to learn how to breast feed and allows you to rest and recover after your delivery. Learn as much as you can about breast feeding. Breast feeding, although it is natural, is a learnt skill that you and your baby will need to learn. It is important to know how to breastfeed, what is normal and learn as much about breastfeeding before you give birth. Include your partner so that he will be able to help you if and when you need it. There are many videos that you can watch on YouTube about breastfeeding with a deep latch. You can visit our website for more information on breastfeeding and expressing milk. It is highly recommended that you find a lactation consultant that can give you an online breastfeeding workshop while you are pregnant. This gives you the necessary information to breastfeed well and someone you know that can help you if you need the help. If you would like to book a consultation with Carey a SACLC please email [email protected] for more information on a breastfeeding workshop. Have a plan for when you get home. The first few weeks after the birth can be difficult due to sleep deprivation and learning to care for your new child. COVID-9 just makes it so much harder because we are all social distancing. Have a plan or ideas of how you are going to make life simpler for yourself. Firstly, let your family know about visitation and how you would like them to interact with your new baby. Let them know what you would like: No visit policy, Visit but you can only look though the window or you can visit but you must wear a mask and sanitise. Will you have someone in the house to help you? If so, will that person need to self-isolate before they move in? You can ask your friend s and family to support you by taking

February 10, 2021

Keep calm and keep going

Did you know that even happy and good changes cause us stress? Think of a new baby, a new house, a new job, a new year … The arrival of the COVID-19 coronavirus is a huge stressor. We have had to make big changes to working conditions, home schooling children, staying in touch with loved ones via phone or digital platforms and managing tough economic challenges among others. Even so, South Africans are doing themselves proud and adopting mask wearing, hand sanitising and social distancing. But isolation and fear of catching or passing on the virus do take their toll on our emotional, mental and relationship wellbeing. Healthy lifestyles can help us to manage this stress. Some are: Eat healthy food. Because carbohydrates raise serotonin levels, they act like a natural tranquilizer so it’s competent to dive into bread or muffins when anxiety rises. No problem there but check that you are also eating proteins in meat, chicken or eggs, as well as vegetables, fruit, seeds and nuts, as these are the building blocks of good health. Exercise two or three times a week. Exercise has been found to decrease symptoms of depression. While we do not always feel like it, just start, even if it’s a walk around the block 3 times a week. Enjoyment and motivation tend to follow once we begin. Get a good night’s sleep. Seven to eight hours is recommended as sleep is relaxing to both body and brain and has an important role in supporting our immune system. If you find yourself worrying instead of sleeping, and feeling on edge and overwhelmed during the day, there are two Nativa Complex® formulations which support emotional and mental wellbeing and a good night’s sleep. Nativa Calm Complex® can assist the body to cope with everyday emotional strain, tension and irritability. Its formulation of vitamin B, GABA and herbal actives can help the body with anxiety support, promoting calmness and enhancing focus. Oh for a good night’s restful sleep! Vitamin B, magnesium and herbal actives in Nativa Night Complex® can support the body with restful sleep, undisturbed sleeping patterns, relaxation and reducing mild anxiety. Available from Dis-Chem, Clicks, Takealot and selected pharmacies. Prices: Nativa Calm Complex® around R120 for 30; Nativa Night Complex® around R124 for 30

February 9, 2021

Why it’s important to care for your skin during and after pregnancy

The skin is our largest organ and it serves a number of essential functions. During and after pregnancy a woman may experience changes in her skin. In order to protect herself and her baby, certain skincare ingredients need to be avoided during these periods while others need to be introduced to nourish and care for the skin’s new needs. When selecting skincare products for yourself during pregnancy, and for your baby after birth, it’s important to understand that our skin serves a vital function in our relationship with our babies. What role does the skin play when it comes to mom’s relationship with baby? Skin-to-skin contact is usually referred to as the practice where a baby is dried and laid directly on their mother’s bare chest after birth, both of them covered in a warm blanket and left for at least an hour or until after their first feed. Skin-to-skin contact provides an appropriate and affordable, yet high quality alternative to technology. There is a growing body of evidence that indicates skin-to-skin contact after the birth helps babies and their mothers in many ways: It calms and relaxes both mother and baby. It regulates the baby’s heart rate and breathing, helping them to better adapt to life outside the womb. It stimulates digestion and an interest in feeding. It regulates temperature. It enables colonisation of the baby’s skin with the mother’s friendly bacteria, thus providing protection against infection and boosting baby’s immunity. It plays an important role to help prevent postpartum depression. It stimulates the release of hormones to support breastfeeding and mothering. It stimulates the release of the oxytocin hormone (“cuddle” and pleasure hormone) in both mother and baby. What makes human skin so special? Human skin is a complex living material but in biomechanical tests it reveals its homogeneous nature. Our environment can directly influence who we are: the skin reacts immediately and directly to the outside environment. The skin is colonised by a diverse milieu of microorganisms, most of which are harmless and some very beneficial to their host. The primary role of the skin is to serve as a physical barrier, protecting our bodies from potential assault by foreign organisms or toxic substances. The skin is also an interface with the outside environment and as such, is colonised by a diverse collection of microorganisms. Symbiotic microorganisms occupy a wide range of skin functions and protect against invasion by more pathogenic or harmful organisms and may play a role in educating T cells in the skin, priming them to respond to pathogenic counterparts. In utero, foetal skin is sterile, but colonisation occurs immediately after birth. Microbial communities of the skin and other sites are established and stabilised during the first years of life especially with skin-to-skin contact with mommy or daddy as a newborn explores its environment and matures its immune system. During puberty, changes in sebum production parallel the levels of lipophilic bacteria on the skin. Physiological and anatomical differences between male and female cutaneous environments – such as sweat, sebum and hormone production – partially account for the microbial differences seen between the sexes. Environmental factors specific to the individual, including occupation, clothing, skincare regime and antibiotic usage may regulate colonisation by the skin microbiota. The importance of using specific products on both mother and baby to sustain the effect of skin-to-skin contact Mommy and baby care, hygiene and skincare products are potential factors contributing to the variation of skin microbiota. For example, the use of products that are not pH balanced will alter the conditions of the skin barrier and may either encourage healthy skin flora growth rates or cause it to deteriorate. Understanding the ingredients in skincare products that may affect skin health Particular compounds and molecules need to be applied to skin in order to assist and supplement a homeostatic balance at all times, even when the skin is exposed to the atmosphere with social and environmental stressors. A product with measurable quality, safety and efficacy standards should be considered. Bottom line: don’t settle for just anything when choosing a skincare brand and product, as not all products are created equally. Do your research and choose a product that proves its efficacy by using scientific evidence. Do some research on ingredients, and ensure the products you are using contain ingredients that are safe and effective. Look for a product that understands this scientific rationale and will optimise your skin-to-skin contact with your baby Offering a wide range of skincare solutions for the entire human race, with no exception to mommies-to-be and babies, Biomedical Emporium understands that skincare has to work both on a cellular and a molecular level. Their latest skincare range is the Maternology series for pre-conception and pregnancy, and the Biosimilar BioBaby series for baby. During the process of trying to fall pregnant, IVF treatments and pregnancy itself it is important for a woman to change her skincare regime. The Maternology range helps prepare the mother’s skin for the skin-to-skin contact after baby is born. Many biochemical changes take place during pregnancy. Some women get a beautiful glow during pregnancy due to the elevated hydration and skin moisture retention levels along with the amplified exposure to vitamins and minerals via placental fluid transport. Unfortunately, for other expecting mothers, the increased and fluctuating hormonal activity during the first trimester can have the opposite effect, and may result in an increase in sebum production that may lead to acne and the expression of pigmentation. Skincare during pregnancy should be simple and easy due to the skin being much more sensitive and reactive. The following product ingredients should also be avoided during pregnancy: Retinoic acids. Beta Hydroxy Acids. Any peroxide-containing ingredients. Artificial colour-stained products and products containing fragrances. Skin-staining products (refrain from using self-tanning products during pregnancy). Avoid skin lightening or bleaching ingredients such as hydroquinone-containing products. Avoid mechanical exfoliation as this may deteriorate the skin’s barrier function. The Biomedical Emporium Maternology range is simplistic, easy, and safe to use. The ingredients are rich in vitamins and

February 5, 2021

What to eat during pregnancy

A healthy diet is important for everyone, but now you are pregnant, choosing the right food is more important than ever before, as your baby is relying on you to provide all the nutrients they need to grow and develop.

February 4, 2021

Nutrition for growing bodies has never been easier

The Harvest Table launches its Kids Range Say goodbye to the mealtime battle zone with The Harvest Table’s new kids range of products which promises to provide the right nutrients for growing bodies. Catherine Clark, Owner and Founder of The Harvest Table, says that she understands first-hand what it’s like to try and get children to eat healthily. “I have two kids, Joshua (12) and Emma (9), and I understand this daily struggle all too well. What’s worse, when I don’t get it right, I’m left feeling guilty that they are not getting the right nutrition for their growing bodies. These products have allowed me to provide them with a meal replacement option that is not only nutritious but tasty and convenient too,” she says. Catherine adds that not unlike most kids, her children are drawn to fun packaging, and so, she and her team made an effort to create a vibrant range that is not only earth-consciously packaged but appealing to children too. The range features a variety of eight shakes for kids aged 3-6 and tweens aged 7-12. “We’re proud to launch a range that features different packaging for girls, boys and different age groups. We did not want to produce one-size-fits-all packaging, but rather, products that were inviting and appealed to the child’s imagination, all while making the parent’s job easier,” she adds. Each shake contains prebiotics, probiotics, protein, magnesium, barley grass juice, and lion’s mane mushrooms. The shakes are flavoured with chocolate or blueberry, so they are guaranteed to be a firm favourite in your home. Catherine explains the benefits of the ingredients below: Collagen: Collagen consists of protein building blocks, otherwise known as amino acids, which are essentially structural components found in the bones. Collagen is surrounded by calcium and phosphate, which help form mineralised (hard) bone. Children need to include it in their diet as they go through peak bone-building years at around age 10. The more collagen they have in their bodies, the more readily available it is for their bones. Bone broth: Bone broth contains gelatine which is essential for restoring the gut. It seals up holes in your stomach, heals the lining, and nourishes the gut with essential nutrients. It contributes to a well-functioning digestive system and thus helps the body absorb nutrients easily. Lion Mane mushroom: Lion Mane mushroom contributes to the production of nerve tissue growth and brain cells, which can suffer damage over time. It works throughout the body, and not just in the brain by repairing damaged nerve tissue, regenerating nerve fibres, and also improving the communication between neurons and axons. It also supports cognitive functioning, boosts mental focus, and improves memory. Probiotic: Probiotics are essentially bacteria that is found naturally in our gut. It coexists with harmful bacteria, which can set off the balance in your gut, leading to irregular bowel movements, constipation and diarrhoea. Probiotics help counter the negative effects of the bad bacteria and thus, improve gut health and function. Prebiotic: Prebiotics stimulate the growth of beneficial bacteria and balance in the gut. By promoting changes in the gut bacteria, prebiotics directly affect the mucosal immune system, which is the bodies defense mechanism against toxins. This results in decreased susceptibility to inflammatory diseases. “Parents no longer have to worry about their children getting enough nutrients. This meal replacement can be prepared with three tablespoons of the shake, 250ml of water and three ice cubes, all blended and ready to be enjoyed in a matter of seconds. This range combines great taste, good nutrition and, of course, convenience,” Catherine concludes.

February 4, 2021

Pregnancy and Medical Aid

Motherhood and pregnancy are times of great anticipation and joy. Each experience is unique but what is probably high on the agenda is that you have a trouble free pregnancy, a healthy baby and then know and anticipate the cost involved for pre-natal check-ups and the birth. ‘Choosing the right medical aid is critical in ensuring the healthcare needs of you and your loved ones are taken care of. More so, when you’re looking at expanding your family. For those who are on a medical scheme or wish to join one, here are some important points to consider when you fall pregnant,’ says Lee Callakopen, Principal Officer of Bonitas Medical Fund. When you are already a member of a medical aid scheme When should you advise your medical aid of your pregnancy? If you are already a member, you can access the out-of-hospital maternity benefits without advising your medical aid that you are pregnant. However, please ensure that your doctor uses the correct ICD-10 codes on your claim to ensure that it is processed correctly. Bonitas pays for maternity benefits in addition to savings and day-to-day benefits, which help members get the care they need during pregnancy while limiting out-of-pocket expenses. Remember that pre-authorisation is needed for the delivery of the baby, which can usually, be done from 20 weeks onwards. Pre-authorisation will help you understand the benefits you have available on your plan and ensure that you are aware of what is covered. Bonitas members can also register for the Bonitas baby bag once pre-authorisation is obtained. The baby bag is packed with of useful goodies for the baby to make parenthood a little easier. When do you advise the medical aid that your baby has been born and needs to be added onto your medical aid? For our members, the baby needs to be registered within 30 days from the date of birth to ensure there is no break in cover and that your child will be covered from the first day of life. Are there Designated Service Providers (DSPs) in terms of gynaes and hospitals for childbirth? We strongly advise members to use DSPs to get maximum value and avoid co-payments. We agree special rates with these providers, which are covered within a member’s benefits so that they can focus on taking care of their health and wellbeing during pregnancy. What is normally covered in the maternity benefit? This differs from scheme to scheme and according to the plan you are on. Bonitas pays for up to 12 maternity consultations (paid for from a separate benefit), an amniocentesis, antenatal classes, 2x 2D ultrasounds and the delivery. In addition, there are additional benefit for newborn hearing screening tests and childhood vaccination. Does Bonitas cover the cost of a Caesarian birth? Yes, medically necessary Caesarians are covered on all plans. Some expectant mothers do prefer home births – is this covered? Yes the cost for a home delivery is covered. Are all the childhood vaccinations covered by Bonitas and if so, are there any conditions attached ie where the vaccinations should be done? Vaccines are covered as per the EPI schedule on immunisation. Please note this benefit is available on specific plans. The vaccines can be done at any clinic or pharmacy. If an administration fee is charged by these providers, it will be paid from your savings or day-to-day benefits. The vaccines covered are as follows: The Bonitas Babyline – a dedicated children’s health advice line In 2016, Bonitas introduced Babyline – a 24-hour children’s health advice line manned by paediatric trained registered nurses. They are on the other side of the phone to assist with any parental concerns, vaccination schedules and health related issues, 24/7, 365 days of the year. How does Babyline work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to speak to paediatric trained nurse. Through a series of questions asked regarding the health issue, parents will be provided with professional advice on what to do next. Depending on the symptoms, the advice might be to head straight to the ER or to see a doctor or specialist. The nurse will advise which healthcare provider is the most appropriate, given the health issue. The services offered by the Babyline include: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the ER The Babyline service is available to members across all the Bonitas plans, for children under 3 years. Joining a medical scheme when you are already pregnant It is very common for women to apply to join a medical aid scheme when they fall pregnant. But according to the Medical Schemes Act 131 of 1998, medical aid schemes are entitled to impose a 12-month condition specific waiting period for any pre-existing medical condition, such as pregnancy. These waiting periods must be imposed for specific pre-existing conditions to protect the interests of current members of the scheme. When a waiting period is applied to pregnancy, then the pregnancy and birth will not be covered but your baby will be covered from the first day of life – if you register them on your medical aid within 30 days. This will allow you to ensure the needs of your child and the healthcare will be covered. Bonitas has different plans and expectant mothers will be able to select the one most suitable for their needs. Informing the medical aid of your pregnancy Prospective members need to inform their medical aid upon application or within 30 days after you complete the application. What is the policy regarding a member joining Bonitas when they are pregnant? What sort of cover can they expect, if any? The pregnancy would be considered pre-existing and therefore not covered. The baby will be covered if registered within 30 days post-delivery. What happens if someone signs up for medical aid not realising they are already pregnant? At what point is

February 3, 2021

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