Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Urban living’s impact on our wellness

South Africa is urbanising rapidly: 63% of South Africans are already living in urban areas. Stats indicate this will rise to 71% by 2030 and by 2050, eight in 10 people will be living in urban areas. While it is unavoidable that people migrate to cities for work, it does have a negative effect on people’s health. The most significant effect is the increase in non-communicable or lifestyle diseases. Dr Morgan Mkhatshwa,Head of Operations at Bonitas Medical Fund, says that the main problems associated with changes in lifestyle and behaviour, due to urbanisation, are: Increased alcohol and tobacco use Lack of exercise. Cities are often over-populated, there are too few public spaces for physical activity and many residents have to use public or private transport because of long commutes to work, schools and amenities Poor nutrition. Changes in diet include more processed and refined food, an increase in high-fat and high-sugar diets, less fruit and vegetables, less complex carbohydrates and fibre Socio-economic factors There is an increasing recognition of the importance of social, economic and physical environments as determinants of health and well-being. Unfortunately, the poorest people living in under-serviced inner city areas or informal settlements are the most exposed to unhealthy urban environments. With urbanisation, the double burden of non-communicable diseases (NCDs) will increase if no effective health systems and policies are put in place to prevent, detect and treat communicable and non-communicable diseases. ‘Our analysis of lifestyle diseases indicate that hypertension is the most prevalent non-communicable disease, followed by high cholesterol and diabetes Type 2. Obesity, high cholesterol, diabetes Type 2 and hypertension are all symptoms of metabolic syndrome, caused by poor nutrition and a sedentary lifestyle. ‘The science around nutrition has long been problematic. Published results have varying conclusions but concur that highly processed and food with high sugar and “bad fat” content should be avoided. ‘Also, in the top seven conditions are susceptibility to blood clotting, asthma, underactive thyroid and depression,’ says Dr Mkhatshwa. Asthma is a respiratory condition most often caused by pollution or other irritants in the environment and mental health conditions can also be a consequence of urban living. Oncology is also becoming more and more prevalent. The number of Bonitas members with cancer has more than doubled since 2016. Air pollution Motor vehicle, industry and domestic fuel use increases air pollution which is responsible for a range of lung and respiratory diseases, heart conditions and cancers. Chronic Obstructive Pulmonary Disease (COPD) and asthma are two of the most prevalent respiratory diseases. ‘We have the expertise to respond to these risks and lifestyle diseases by providing comprehensive, integrated care, every step of the way,’ explains Dr Mkhatshwa. ‘And, through our Managed Care programme, we help equip our members to take responsibility for their health by providing information and education, encouraging wellness, paying for preventative care and providing cover for medical costs incurred. However, more needs to be done and we advocate collaboration with public health authorities to educate and encourage South Africans to look after their health.’ Covid-19 and NCDs It is common knowledge that Covid-19 and non-communicable diseases such as hypertension and diabetes interact to create a perfect storm. The pandemic has made people more aware of having to take responsibility for their health and preventing or managing chronic disease optimally. ‘Co-morbidities have an impact on those who contract Covid-19 and there is possibly a synergistic issue with the coronavirus and these co-morbidities that exacerbates the prognosis and burden of disease.’ Managed Care ‘Achieving good patient health outcomes is the fundamental purpose of healthcare,’ says Dr Mkhatshwa. ‘Measuring, reporting and comparing outcomes is perhaps the most important step towards unlocking rapid outcome improvement and making better choices. ‘Managed Care is a critical component and improves quality of care and we know that proactive intervention and working with members to prevent or control lifestyle diseases is the only way forward. Because when ‘I’ becomes ‘we,’ illness can become wellness.’ The GP is pivotal We believe there needs to be coordination of care and that members should be encouraged to nominate a General Practitioner as the first port of call for all health care needs, who can refer to a specialist or auxiliary provider as the need arises. This eliminates inefficiencies caused by ‘doctor hopping.’ ‘To tackle the rising burden of disease, we need medical schemes to work together with public health authorities, particularly in the context of the challenges of urbanisation, lifestyle diseases and the Covid-19 pandemic.’

September 13, 2021

Performing in a pandemic: Bonitas announces healthy annual results

Bonitas Medical Fund reported its financial results for 2020, with significantly bolstered reserves of R6.1 billion. Luke Woodhouse, Chief Financial Officer of Bonitas says, ‘The Fund, which has 40 years’ experience in the medical aid industry, had 333 141 principal members and total beneficiaries of 710 157 as of 31 December 2020. This accounts for 14% of the open scheme market, representing 8.3% of total market share.’ Bonitas ended 2020 with an unprecedented surplus of R1.7 billion (2019: R186.1 million). The surplus is the largest ever reported by the Fund and is largely attributable to the suppressed utilisation of non-COVID related claims expenditure. ‘The surplus was also positively impacted by the effective implementation of our strategic pillars, proactive risk management and prudent Board decisions in a unique, but volatile year,’ says Woodhouse. ’Bonitas’s medium-term objective is to sustain solvency levels above the statutory minimum of 25% and to make meaningful, strategic decisions about current reserves in the interests of our members. This while facing significant uncertainty, especially in terms of the cost and prolonged impact of COVID-19, non-COVID-19 utilisation and roll-out of vaccines.’ 2020 performance at a glance: R3 billion gross healthcare result (2019: R1.3 billion) Reserves reaching R6.1 billion (2019: R4.3 billion) A net surplus of R1.7 billion (2019: R186.1 million) Solvency ratio of 32.7% (2019: 24.9%) R51.7 gross recoveries from Fraud, Waste and Abuse (2019: R41.2 million) Strategic purchasing yielded hospital negotiation savings of R346 million (2019: R370.4 million). This is lower than the previous year, in absolute terms, due to lower outflows as a result of COVID-19, including cancellation of elective procedures and a reduction in trauma and major medical related costs An investment income of R316.6 million (2019: R420.1 million) that exceeded CPI Net claims decreased by 4.7% to R14.3 billion (2019: increased by 8.9% to R15.0 billion) Healthcare cost savings initiatives realised savings of R221m – the most significant of these were achieved through the Scriptpharm chronic medicine capitation model 83.0 claims loss ratio (%) (2019: 92.3) The Investment Committee was particularly active given the volatility in equity markets and the market crash that occurred in March 2020. The active management and continued strategic asset allocation approach contributed to a turnaround in investment returns, growing the investment portfolio (excluding cash and cash equivalents) from R5.01 billion in December 2019 to R7.14 billion at the end of December 2020 – delivering an overall return of 4.16%. Although COVID-19 induced severe capacity constraints in the healthcare system, the hiatus in all other areas of healthcare decelerated a long-term trend towards overuse and medical cost inflation. This occurred against an economic backdrop of market volatility, record low interest rates, rising unemployment and declining incomes. The significant surplus capacity was systemic within the healthcare industry. Investments and economic growth In addition to investment volatility, South Africa’s sovereign credit rating was downgraded to sub-investment grade status with a negative outlook by the Moody’s and Fitch ratings agencies. According to the IMF, South Africa’s real GDP contracted by 8% in 2020, but is expected to show 3% growth in 2021, before slowing again. Claims’ expenditure While some categories such as in-hospital admissions experienced a major decline, with a high number of elective surgeries cancelled, there was a marked increase in medicine claims and costs. Under servicing could, however, lead to higher downstream healthcare costs over the long term. The combination of these factors led to lower claims in an environment where Bonitas actively continued to manage costs, promote Managed Care and supervise investment performance. As opposed to other years the key cost drivers were COVID-19 related, including: Hospital admissions, investment in PPE, pathology test costs, home-based care, healthcare support to members in the workplace, medication and deferred elective surgeries. Hospital negotiations This year we participated in the first collective negotiation process on hospital tariffs with five other medical schemes administered by Medscheme. This followed the finding by the HMI that collective negotiations would not contravene the Competition Act. The common tariff resulted in a 3.1% saving in 2021 terms and these savings could exceed R200 million in 2021. In addition, hospital costs and medical specialist costs reduced by 5.4% (2019: increased by 8.9%) and 5.3% (2019: increased by 10.0%) respectively on a per-member-per-month basis. Total claims per-member-per-month declined by 8.7% (2019: increased by 8.1%). Strategic purchasing Cumulative savings since the start of the strategic partnership arrangement with hospital groups in 2017 was R1.247 billion. Growth and retention To retain members under significant financial stress due to COVID-19, members received assistance in line with CMS regulations This had a negligible impact on performance but assisted in retention of members during the worst of the pandemic. COVID-19 also resulted in a marked increase in queries about joining a medical fund as people realised the need for quality healthcare. We experienced a cumulative net decline in membership of 5 610 members (1.7%) in 2020, which compares well against a significant contraction in GDP and increased unemployment. Despite the challenges experienced in 2020, Bonitas acquired 37 814 new members (2019: 50 680). Bonitas also kept increases as low as possible without jeopardising the sustainability of the Fund. There was a competitive weighted average contribution increase of 4.6% – 1.61% higher than CPI whereas, under normal circumstances, contribution increases are set at a minimum of CPI +3,5%. Day hospitals We identified day hospital use as a viable option to improve efficiency and reduce costs. There is minimal disruption to members, speedier recovery times, less risk of infection. Home-based care During COVID-19, home-based care received renewed interest and focus. Not only is it a cost saver but studies have shown that patients recover faster in their comfort of their own homes. Efficiency Discounted Options (EDOs) The four EDOS introduced have been a success – the EDOs cover over 74 000 lives and the principal members who join are around 10 years younger than the average Bonitas member. Members on these plans use network healthcare providers and pay around 15% less for the same benefits. Virtual

August 30, 2021

Caring for Baby

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Circumcision care Newborn circumcision is a surgery that removes the loose skin (foreskin) that covers the end of a baby boy’s penis. It may be done for various reasons and usually heals with 7-10 days. Follow the care instructions you were given by your baby’s doctor. Often times they will recommend that you use a small amount of petroleum jelly on the site at diaper changes to prevent irritation. Contact your baby’s doctor if you see blood or pus around the circumcision or if you smell an odour coming from the site. Myths about newborns The following are common myths about newborns: Myth: Don’t touch their “soft spots” – Truth: Known as the fontanels, these areas are a thick protective membrane, not your baby’s brain, so if you happen to touch them gently nothing bad will happen; as with all of your baby, handle that area with gentle loving care. Myth: Baby girls don’t have periods – Truth: Baby girls may have a “mini period” within the first few weeks of life which is the result of the stimulation of their uterus by Mom’s high estrogen levels. If you ever have questions about what’s happening with your baby, contact your doctor. Myth: Babies don’t get acne – Truth: Some newborns will develop acne due to circulating hormones from their mother between 2 weeks and 2 months of age; you don’t need acne creams, just cleanse the area gently. Myth: Babies have flat chests – Truth: Some babies may temporarily have swollen breasts due to their mothers circulating hormones; this can happen to boys and girls. Myth: Sneezing must mean my baby has a cold – Truth: Newborns have tiny noses and often have some congestion, so they may sneeze a lot at first; if they have thick, coloured mucus and are sneezing a lot then they may be developing a cold. Never hesitate to contact your doctor if you are worried about what’s going on with your baby. No question is ever “dumb” if you are worried. Bathing your newborn Your baby doesn’t need a full bath every day, only 3-4 times a week. When giving them a full bath make sure the water is warm, but not hot, by testing the temperature with your elbow – if it’s too hot for your elbow, it’s too hot for your baby. Use mild bath soap made specifically for babies – harsh soaps may dry and irritate their skin. Always keep one hand on the baby while they are in the bathwater. There are some parts of your baby that will need to be washed with mild soap every day, especially their face, chin, neck and bottom. Do not use soap on their belly button (navel) or on a circumcision until it’s healed. Make sure the room you are in to bathe your baby is warm and free of drafts. Every baby is different so don’t hesitate to talk with your baby’s doctor if you have any questions about caring for your newborn. Healthy skin for newborns You don’t need to use lotion or powder on your baby unless it’s been recommended by their doctor. Don’t use fabric softener or bleach on their clothes as these can irritate their skin. Use mild detergent to wash their clothes, making sure to wash new clothing before you put it on the baby. Be careful not to overdress your baby – if you are comfortable in a t-shirt and shorts, your baby will be fine in a t-shirt or short sleeved onesie and a diaper. Diaper care for your newborn Periodically check your baby’s diaper to see if it’s wet or soiled. Change their diaper whenever one becomes wet or soiled. When changing your baby’s diaper, wash their bottom with mild soap and warm water or use disposable baby wipes. Be sure to wash your hands each time you finish changing a diaper. Additional tips for care of newborn For mouth care, wipe you baby’s gums daily with a clean damp washcloth or an infant toothbrush. To prevent scratches, keep your baby’s finger and toenails cut short. Remember that newborns sleep a lot – usually between 16-18 hours a day. Make sure to schedule your baby’s first check-up as recommended by their doctor – it’s usually recommended between 2-4 weeks of age. Umbilical cord care Do not place the baby in bath water until after the umbilical cord stump has fallen off. Keep the umbilical cord stump clean and dry – if it becomes soiled you can clean it with a cotton ball, mild soap and water. Umbilical cord stumps usually fall off about 2-4 weeks after birth – contact your baby’s doctor if this doesn’t happen. If the umbilical cord stump turns red around the base, bleeds, develops coloured drainage or a bad odour contact your baby’s doctor right away since it could be a sign of an infection. Contact your baby’s doctor if you have any questions or concerns about your baby’s umbilical cord stump. Teething pain relief The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. To help soothe the pain from teething give your baby a teething ring, a wet washcloth cooled down in the refrigerator, or feed him/her cold foods such as applesauce or yogurt. You can also talk to your doctor about giving your baby acetaminophen (Tylenol) to ease the pain.

August 20, 2021

Digital Covid Hub drives education and vaccinations

The 3rd wave of Covid-19, which is predominantly the Delta variant, is having a major impact on our healthcare system with reports of hospital admissions being significantly higher than during waves 1 and 2. ‘We can attest to this by the ongoing monitoring and analysis provided by our actuarial teams’, says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘In 2020 we had a total of 8 111 members hospitalised due to Covid-19 as opposed to 7 815 over the past six months.’ Covid Hub – education for everyone ‘At the outset of the pandemic, 18 months ago, we created an informative and educational Covid-19 hub to create a reliable source of information and to educate and empower our members,’ explains Callakoppen. ‘The information includes helping identify symptoms, providing guidelines on how and where to be tested and receive treatment.’ Recently, the Fund enhanced and bolstered this centralised, digital Covid-19 information hub and made it accessible to all South Africans – www.bonitas.co.za/covid. ‘As new scientific data became available, we continued to update the hub, highlighting key topics such as safety protocols, the different types of Covid-19 tests, dispelling myths around the vaccine and explaining the difference between Covid-19, the common cold and flu. One of the key elements is the comprehensive guide to recovering from Covid-19 which includes tips for caregivers, the do’s and don’ts of Covid-19 recovery, as well as post-Covid care tips.’ ‘Now, given the increased vaccination drive and it being opened to a wider group, we have further enhanced the site to assist our members with registration and help speed up the process at Bonitas vaccination sites.’ Private vaccination sites for all To support the Department of Health’s ongoing efforts to vaccinate as many South Africans as possible, Bonitas has vaccinated over 100 000 South Africans at its private vaccination sites across the country. A quarter of whom (25 245) were Bonitas members. At present, the 50+ age groups are being vaccinated, with registration and vaccinations for 35+ now open. The 10 sites adhere to all the required safety regulations and are staffed by qualified nurses, additional sites are due to come on-line in the new few weeks. ‘As of 13 July 2021, there were 2 031 Bonitas members in hospital, compared to 1 893 the week before and 1 598 at the end of June,’ says Callakoppen. ‘We have conducted a total of 338 981 PCR tests, 150 430 of these were between January and July 12th – with 28 097 members testing positive. This is a 44% increase over 6 months. ‘However, studies have shown that once people are vaccinated, they’re far less likely to fall seriously ill and that the vaccine provides protection against hospitalisation for the Delta variant, which is why the vaccine roll out is critical.’ This aligns with the recent statement from Dr Marian van Kerkhove of the World Health Organisation (WHO): ‘The Covid-19 situation globally is dangerous with high levels of transmission driven by four major factors. The first are these variants of concern, including the Delta variant. The second factor is that we have increased social mixing and social mobility, which increases the number of contacts that individuals have. The third factor is the relaxation or the inappropriate use of public health and social measures. Proven public health and social measures that we know prevent infections, reduce the spread of somebody who is infected with the virus to others and save lives. And the fourth factor is the uneven and inequitable distribution of vaccines.’ Herd immunity Vaccinating as many people as soon as possible remains a priority if we are to minimise the impact of Covid-19. To achieve herdimmunity, the South Africa’s Department of Health is aiming to vaccinate 67% of the country’s population – this equates to around 41 million people. ‘It’s heartening to learn that vaccine acceptance is growing in South Africa, with the latest Covid-19 study revealing that 76% of the population are willing to be vaccinated. The daily average number of doses administered over the past week – counting only weekdays between Monday and Friday – amounts to 150 000 – reaching a total of just over 5 million with 1,67 million South Africans having received both doses. This means 2.9% of the population is fully vaccinated. Plans are in place to ramp this up over the next few weeks, which will include sites being open over weekends and to widen the groups being vaccinated. Educate and vaccinate In collaboration with service providers and employer groups, the Fund’s private vaccination sites also promote key Covid-19 messages, with take home educational leaflets that can be shared. ‘In addition, we have begun the process of opening vaccination facilities at major scheme employer sites, such as Eskom,’ says Callakoppen. ‘We are continually engaging with corporates to improve the support we provide.’ Identified high-risk beneficiaries are also being supported through various initiatives, including disease management interventions, home-based care and medicine supplies where required. QR Code replaces forms ‘Complaints about queues and waiting times at some sites have been taken into consideration,’ says Callakoppen. ‘We have streamlined the process for members by providing access to a QR code, upon registration on the EVDS and our portal. This means that they are scanned upon arrival, eliminating any delay by having to fill in forms – allowing for a smooth and efficient process.’ Registration should still be done via the Government website on https://vaccine.enroll.health.gov.za and everyone must remember to take along their unique token, ID document or passport to the vaccinations site. If you’re on a medical aid, make sure you have your medical aid card with you. ‘We need to remain on high alert about the pandemic,’ warns Callakoppen. ‘It may be day 477 but we cannot afford to be complacent. We must all play our part to stay safe, which means following the protocols and getting vaccinated. ‘The vaccination process is a key focus area for us, along with education. We will continue to use our Hub (available at www.bonitas.co.za/covid) as a central resource for factual information. A

August 3, 2021

Generics and biosimilars – champion cost savers in the healthcare industry

It is common knowledge that healthcare costs rise exponentially and medical schemes have to find ways to reduce costs both for the medical scheme and its members. Kathy Malherbe spoke to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, about generics and biosimilars and how they contribute towards reducing healthcare costs. One of the cost drivers is medication which is why The Pharmacy Act of 1997 and the Medicines Control Amendment Act, among other things, have made it mandatory for dispensers of medicine, be they doctors or pharmacists, to offer a patient a generic substitute if one is available. However, generics are not the only cost savers. The patent expiry on many biological medicines is opening the door to more affordable, life-saving ‘biosimilars’ to be produced – another ‘champion’ in the pharmaceutical industry. Increased consolidation in the healthcare industry is also having a positive impact on medicine prices and availability. Medical aids are trying to create more competition, even among medicines that are still under patent. They are also tightening up their formularies, in part to encourage pharmaceutical manufacturers to provide better pricing. What is a generic drug? A generic is a pharmaceutical drug that contains the same chemical substance as a drug that was originally protected by chemical patents. It is an exact copy of brand-name drugs that has the same dosage, intended use, effects, risks, safety and strength as the original. In other words, their pharmacological effects are identical to those of their brand-name counterparts. But at a much more affordable price… Generic medicines cost, on average, between 30 and 80% less than the original. What guarantee is there that generics are true replicas? In South Africa, the Medicines Control Council (MCC) carries the responsibility of making sure that generic drugs are safe and effective. Generic drug manufacturers have to prove their medicine is bioequivalent to the original brand before a product is approved into the local market. What is a biosimilar? Biological drugs are large, complex proteins made from living cells through highly complex manufacturing processes. Biosimilars are a close equivalent but not exact copies of biologicals. and are manufactured after the patent for the biological/reference drug ends. To be called a biosimilar drug, it must be shown to be safe, work as well as, and work in the same way as its reference drug – the biological. It must also be used in the same way, at the same dose, and for the same condition as the reference drug. The cost of manufacturing biological medicines is more expensive than conventional chemically produced medicines and, because biosimilars are close copies, they remain expensive but are still more cost effective that the original. What are they used to treat? The most important biological medicines are used to treat conditions such as rheumatoid arthritis, Crohn’s disease, multiple sclerosis, diabetes and cancers. How are they different from generics? The reason biological copies are called biosimilars is that, unlike generic medicines, the active ingredients are not exactly the same as the original but ‘similar.’ It is impossible to make identical copies when ‘translating’ biological molecules from living cells in the laboratory. Very importantly to note though, is that even though biosimilars are not a direct copy, the therapeutic effect is the same as the original biological product. Why are generics and biosimilars less expensive? Generics Pharmaceutical companies are researching and testing new active ingredients and medicines all the time. The patent is valid for about 20 years which means that only the approved company may research, create a new formulation (the ‘recipe’ and process for creating the actual medicine) and register the medicine. This takes years and carries a huge financial burden. After about 8 to 10 years on the market the patent usually expires and other drug companies can make an exact copy of the drug without the initial clinical research costs. Biosimilars While these medicines have revolutionised treatments for many diseases, the research and development expenses, including the costs of highly skilled scientists, clinical trials and the specialised equipment needed, are the main cost drivers. Companies are required to fund these costs, often in excess of 10 years, before registration for use by patients. Biosimilars save costs because: The molecule and effects have already been discovered and identified by the originator The number of patients required in the clinical trials is reduced The original biological medicine would have been ‘manufactured’ at least 20 years ago. New manufacturing methods are more efficient. The cost-efficiencies, which generic and biosimilar medicines provide, are assuming greater importance for state and private health funders as populations age and the prevalence of cancers and other non-communicable diseases increase. SA’s already stretched healthcare budget is coming under increasing pressure to fund the high cost of pharmaceuticals, especially biological medicines. While generics and biosimilars may not be a panacea for high healthcare costs, they will go a long way towards offering a cost-effective, quality treatment for a large range of diseases. In addition, these breakthrough treatments can halt progression and sometimes even prevent recurrence by acting on proteins that affect the genome/immune system.

July 5, 2021

Toddler Milestones

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Growing children Children grow and learn at their own pace. It is normal for your child to be ahead in one area, but behind in another. Learning what is normal for each age group can help you feel comfortable with where your child is at and spot any problems early on. Milestones: age 2 Milestones for age 2 include: Walking by themselves; this usually takes place between 9-17 months with the average being 14 months Running: about 6 months after learning to walk Climbing stairs and onto furniture Kicking a ball Ability to scribble with crayons, pencils or markers Imaginative or make-believe play Communication includes using real words by 15-18 months and simple phrases by 18-24 months Milestones: age 3 Milestones for age 3 include: Improved balance: can stand on one foot for a short time, can petal a tricycle and can walk upstairs without holding the railing All baby teeth have come through Potty trained during the day 20/30 vision Communication includes increased vocabulary (hundreds of words), uses short sentences, uses plurals and pronouns and asks many questions Can dress self with exception of laces, buttons, etc. Knows their name, age and gender Learns to share Milestones: age 4 Milestones for age 4 include: Hops on one foot well Throws a ball overhand well Uses scissors to cut out a picture Communication includes increased vocabulary (thousands of words), uses longer sentences, uses past tense and asks even more questions than ever Learns simple songs Starting to understand time better Milestones: age 5 Milestones for age 5 include: 20/20 vision Increased coordination: skipping, jumping and hopping well Learning to use writing utensils well Communications includes increased vocabulary (over 2000 words), uses sentences with 5 or more words and uses all parts of speech Knows the primary colours Learning to understand math Learning to behave with more responsibility and less aggression

June 14, 2021

Advice from the experts

Does Your Child Need a Tetanus Shot or Not?

I’ve had parents often come into the emergency room after their child has taken a tumble asking for a Tetanus vaccine, which is why I felt the need to write a post explaining what Tetanus is and why we need to vaccinate our kids. WHAT IS TETANUS? Tetanus is a disease commonly known as lockjaw. It is caused by the bacteria, Clostridium tetani and can be fatal. The toxin from the bacteria affects the nervous system and causes severe painful muscle spasms, which can interfere with the ability to breathe. Currently there is no cure for Tetanus and treatment is mainly symptomatic until the effects of the toxin wear off. Complete recovery can take up to several months. WHERE IS THE BACTERIA FOUND? Clostridial spores can be found everywhere. They are found in soil, dust and animal faeces (including humans). Once the spores enter a wound they grow into mature bacteria, which produce the powerful toxin. Clostridium tetani is found worldwide. WHAT ARE THE SIGNS AND SYMPTOMS OF TETANUS? Signs and symptoms of tetanus can appear anytime from a few days to a few weeks from infection: Spasms and stiffness of jaw muscles (hence the name lockjaw); Spasms and stiffness of the neck muscles; Difficulty swallowing; Spasms and stiffness of other body muscles, commonly the abdominal muscles; Other constitutional symptoms such as fever, sweating and palpitations. TETANUS VACCINATION I won’t go into too much detail regarding the various combination vaccines as there are many and every country has its own recommendations. A copy of the latest South African immunisation schedule can be downloaded from my resources page. The WHO recommends an initial 6-dose schedule to achieve tetanus immunity. 1. Primary vaccination Three primary doses of the vaccine are recommended in childhood starting from 6 weeks. 2. Booster vaccination Three booster doses are recommended prior to adolescence. Booster vaccines are then recommended every 10 years thereafter. TETANUS-PRONE WOUND This is any wound that has been contaminated with material that could contain tetanus spores; This is any wound that is deep; This is any wound that is dirty; This is any wound that contains a foreign body. Note: any wound can be tetanus-prone – cuts, scrapes, burns, animal (including human) and insect bites. WHEN TO SEE A DOCTOR It is recommended you see a doctor if: Your child has a tetanus-prone wound and has not had a booster vaccine in the last 5 years; Your child has a minor, clean wound and has not had a booster vaccine in the last 10 years; Your child has a wound and you cannot remember when their last booster vaccine was. RESOURCES CDC (2018) Tetanus. [online]. Available from: https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html#contraindications [Accessed 30 August 2018]. WHO (2018) Tetanus vaccines: WHO position paper, February 2017 – Recommendations. Vaccine. [online] 36 (25). Available from: http://dx.doi.org/10.1016/j.vaccine.2017.02.034 [Accessed 30 August 2018]. WHO (2018) Tetanus. [online]. http://www.who.int/ith/vaccines/tetanus/en/ [Accessed 30 August 2018].

July 31, 2019

The big four – know your numbers

‘South Africa is heading for a disaster if the number of people living with chronic lifestyle diseases does not change.’ That’s what both the Human Sciences Research Council (HSRC) and the Medical Research Council warned two years ago. The Council described the problem of these non-communicable diseases as an ‘emerging epidemic’. If you look at the exponential growth of chronic lifestyle diseases then it is not difficult to understand why former Minister of Health, Dr Aaron Motsoaledi, said chronic diseases such as hypertension and diabetes are putting a huge strain on the country’s health care system. Obesity and being overweight are major risk factors for the development of chronic diseases. Testing for lifestyle diseases such as diabetes and heart disease is essential in the face of a steadily deteriorating health status in our country. Lee Callakoppen, Principal Officer of Bonitas Medical Fund says, ‘Get tested, know your numbers and take action now!’ The Bonitas Clinical Team explain why you need to keep your finger on the pulse of your ‘big four’ wellness numbers and what they are. Cholesterol What is cholesterol? It is a soft, waxy substance – one of the blood fats made naturally in the body. It helps to form cells, hormones and bile (that helps us digest food). Cholesterol is found mostly in animal products such as meat, cream and butter. What is high cholesterol? This is when you have too much ‘bad’ cholesterol in your blood. This, in turn, can cause narrowing and blockages of the arteries – the blood vessels that carry blood to your heart muscle and to other parts of your body. In time, the narrowing of the arteries to your heart can lead to a heart attack, while blockages in the arteries of your brain can cause a stroke. The test Called a fasting lipogram it measures the exact amount of different types of cholesterol you have. Good to know If your total cholesterol is greater than 5mmol/L on your fasting lipogram this indicates raised cholesterol Your low density lipoprotein (LDL) – the ‘bad cholesterol’ – should not be greater than 3mmol/L. LDL causes the build-up of cholesterol in the arteries which means a greater chance of heart disease High density lipoprotein (HDL), if less than 1.2mmol/L, means you don’t have enough good cholesterol which prevents build up in the arteries and transports cholesterol to the liver If your triglycerides (fat stored in the body) are higher than 1.5mmol/l, this is also indicative of a possible cholesterol problem. Weight and BMI Your Body Mass Indicator (BMI) calculator checks if you’re at a healthy weight. The test You can calculate yours by: Dividing your weight in kilograms (kg) by your height in metres (m) Then dividing the answer by your height again to get your BMI. Underweight less than 18.5 Normal weight 18.5 – 24.9 Overweight 25 – 29.9 Obese 30 or greater Diabetes What is diabetes? Our bodies produce insulin all day – a hormone that creates energy by converting sugar, starches and other foods. Without insulin, cells cannot absorb sugar (glucose), which they need to produce energy. When there isn’t enough of this hormone in your body, or it’s not used as it should be, sugar (or ‘glucose’) can’t be moved to your other body cells to supply them with energy. This means that you have higher than normal blood-glucose levels, resulting in diabetes.There are two main types of diabetes: Type 1 and Type 2. They are different conditions but are both serious and need to be treated and managed properly. Type 1 diabetes occurs when the pancreas stops producing insulin. It usually starts very quickly and in younger people. If you have Type 1 diabetes you need insulin injections to survive as well as having a carefully balanced food intake and exercise programme Type 2 diabetes (formerly called adult-onset or non-insulin-dependent diabetes) occurs when the pancreas makes too little insulin or your body can’t use the insulin effectively. It usually develops in adulthood and is often caused by being overweight and not exercising. Approximately 85–90% of all people with diabetes have Type 2 and many people who have this condition are undiagnosed. This can result in serious damage to the delicate parts of the body and lead to blindness, heart attackstroke, kidney failure, impotence and amputation so it’s vital to be checked. The tests Test 1: The Fasting blood glucose test – blood glucose is taken before you eat in the morning. Normal 3.9 to 5.5 mmols/l Prediabetic or Impaired Glucose Tolerance 5.6 to 7.0 mmol/l Diabetic More than 7.0 mmol/l Test 2: HbA1c test. The HbA1c levels determine your blood sugar control over time. Normal Less than 6% Prediabetic 6 – 6.4% Diabetic 6.5% or more Blood pressure What is blood pressure? Blood pressure is the pressure of blood in your arteries – the blood vessels that carry blood away from your heart. The blood pressures numbers mean the following: The first (or top) number is your systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats. The bottom figure is your diastolic blood pressure and is the lowest pressure exerted as your heart relaxes between beats. What is high blood pressure? High blood pressure or hypertension is when blood pressure stays elevated over time. Hypertension is often known as the “silent killer”, since nearly 33% of people who have it, don’t know it. The only way to know if you have high blood pressure is to have yours measured. Range Normal 120/80 to 129/84 Upper end of Normal 130/85 to 139/89 Mild hypertension 140/90 to 159/99 Moderate hypertension 160/100 to 179/109 Severe hypertension More than 180/110 If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and if it’s not treated, hypertension can cause kidney failure, eye problems, heart disease and stroke. Callakoppen says, ‘When you consider that 1 in every 3 people in South African has high blood pressure and every 8 minutes 1 South African has

July 19, 2019

Emergency Numbers Every Parent Should Know

It occurred to me the day I went back to work after my maternity leave that I didn’t know any other emergency number besides 10111. Thankfully I have never had to use this but I couldn’t risk leaving my daughter at home with her caregiver without leaving a more comprehensive list of important numbers by the phone. The last thing you want to do in an emergency is dial the wrong number. In the US, the UK and Europe there is only one toll-free number to call from any landline or mobile phone. In South Africa, things are not as simple. Unfortunately there isn’t one single number for an emergency. I spent a really long time searching the web and making a couple of phone calls but I finally managed to put together this simple list. It is vital that you as parents and/or caregivers know what number to dial when and it is perhaps even more important that your little ones know this too. USING YOUR CELL PHONE: Any emergency nationwide – 112 (this number will still work even if you have no airtime) USING YOUR LANDLINE OR CELL PHONE: Police/Fire – 10111 Nationwide ambulance (public EMS) – 10177 Netcare 911 (private EMS) – 082 911 ER 24 (private EMS) – 084 124 Poison Information Centre – 0861 555 777 Remember, before making that emergency call, try to stay calm. You also need to have important information ready such as, the type of emergency, details of any injuries and the exact location of the emergency needing attention. A list of Emergency Numbers can be downloaded for free from my resources page. It may be a good idea to stick this on your fridge or somewhere nearby the phone.

July 18, 2019

Emotional Decisions

Irrational decisions are made when they are the result of a knee jerk reaction and when you are at your emotional peak. It is a choice you have made and decided to act upon based on your feelings and usually clouded by misinformation. Decisions made on the spur of the moment and under emotional conditions have almost always been the wrong decision, which leads to one feeling embarrassed and the need to apologise followed by the necessary mending of the relationship.

July 16, 2019

GOOD NUTRITION FOR TEENS

Garbage in – garbage out? What are we feeding them? Good nutrition is of paramount importance for teenagers. Teens who do not eat correctly are more likely to be overweight, lack energy and enthusiasm and perform poorly at school.

July 12, 2019

Is It A Cold Or Is It The Flu?

Winter is here and so are coughs, colds and flu. Common colds and flu are both caused by viruses and share many of the same symptoms however colds are usually milder and do not cause any serious complications. More than 200 viruses can cause a cold whereas the flu is caused by the Influenza virus. This is why there is no vaccine available for the common cold.

July 5, 2019

Five tips to stretch your medical benefits

Lifestyles or Non-Communicable Diseases (NCDs) – such as diabetes – have become an epidemic in South Africa which is why preventative and managed healthcare has become all important. Whether you rely on the public or private healthcare system it is critical that you manage your health and lead a healthy lifestyle, to prevent long term illness. Cardiovascular (heart attacks and stroke), cancer, chronic respiratory disease and diabetes are on the increase and responsible for the high cost burden of healthcare. For the around 20% (just under 8.9 million) South Africans who are on private medical aid schemes, managing their medical expenses correctly is important if they want to avoid unnecessary out of pocket expenses and make their medical benefits last longer. It also helps them understand the cost associated with the healthcare services they receive and the benefits associated with the plan they have elected. Here are the five tips from Lee Callakoppen, Principal Officer of Bonitas Medical Fund on how you can stretch your medical benefits. 1. Use Designated Service Providers 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 the benefits are optimised and the scheme at large is sustainable. So if you use a network hospital, doctor or pharmacy you will not be charged more than the agreed rate. This will help you avoid co-payments and make your medical aid last longer. So, to reduce co-payments and even avoid them altogether, find a healthcare professional on your schemes network. 2. Go generic Use generic medicines which have the same active ingredient, strength and dosage as the original brands and are as effective. Most pharmacists offer a generic option, especially for chronic medication. Medical schemes are more likely to pay in full for generic medicine. Pharmacists are also able to provide sound medical advice on problems such as rashes, colds or illnesses that are not severe, simply ask and buy the recommended over-the-country medicine to save on a visit to the doctor. 3. Managed Care benefits Some schemes offer programmes to help you manage severe chronic conditions such as cancer, diabetes and HIV/AIDS. 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. Know the facts If you do need to be hospitalised and it’s not an emergency ensure that it’s 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 they are 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 Checking what additional costs will apply (if any), what costs will be covered and how you can avoid these. 5. 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 and make good and less costly healthcare decisions,’ says Callakoppen. ‘Your health is important, so take time to research and understand the medical aid plan you are on. Read the information sent to you by the scheme or your broker, including the fine print and, if you don’t understand some of the terms, speak to your broker or phone the customer care line. Understand and know your rights in terms of healthcare cover, this will go a long way in helping you make the most of your benefits.’

July 3, 2019

Splitting up with your medical aid

Going through a divorce can be extremely harrowing and stressful, not just for the couple themselves but also for their children. And, given the divorce statistics released recently by StatsSA, divorce is on the increase. More than 25 390 divorce papers were filed in 2017, four in 10 divorces came from marriages that lasted less than 10 years and 55,6% involved children. Part of the anxiety is financial which can be exacerbated, depending on whether you are married in community of property have an ante nuptial agreement with or without an accrual clause. It can be very difficult going through the nitty-gritty details, especially when emotions are high. There are a lot of factors to consider, including how to divide up property and other assets, child care and support and, just as important, healthcare. Divorce can seriously impact the healthcare cover you might have previously enjoyed, especially if you are your children were on a joint medical aid, with one partner being the main member and the rest of the family listed as dependants. We put a few questions to Lee Callakoppen, Principal Officer of Bonitas Medical Fund to help you make sure have the right information and follow the correct procedures to ensure your healthcare is not compromised during divorce proceedings. What is the correct process to follow when getting divorced and taking a dependant off your medical aid? All changes in dependency must be sent through to the medical aid. You are usually required to fill in a form regarding this and provide supporting documents. In instances of a divorce, you will need to provide the divorce settlement to your medical aid together with your form. Is there a notice period required? Usually changes are effected within 30 days, which means you do need to allow time for the change to take place. What are the rights of the dependent being removed in terms of coverage while moving to a new medical aid? The main member is effectively the policyholder when it comes to medical aid and his/her dependants are beneficiaries. Unfortunately, this means the dependant has no rights once they are removed from the membership which is why it is important to obtain cover for you after a divorce with immediately effect. Does moving from one medical aid to another impact continuity of cover and/or will waiting periods apply? The usual underwriting rules apply so check with your new medical aid in terms of waiting periods and/or any exclusions. What happens if the medical aid cover was always in the ‘husbands’ name and now the ex-wife wants to apply – will she been penalised for not having a medical aid and be charged late joiner fee (if over 35)? No, however you will be required to prove that you have previously belonged to a medical aid. We advise that you request a certificate of membership showing the period that you belonged to the medical scheme as a dependant on your ex-spouse’s medical aid. What are the advantages and disadvantages of being a dependent on a partner/spouse’s medical aid? Advantages Reduced contributions, the monthly contributions for an adult dependant is cheaper than that of a main member Disadvantages The main member has to provide access and approval in order for a dependant to access online portals etc Can a divorced couple still share a medical aid scheme or does this only apply to children? Yes, if one spouse is financially dependent on the spouse. You will need to provide proof of dependency for this. If you are able to remain or your ex’s plan would this be a recommendation in terms of medical cover and continuity of healthcare? No. You will still have continuity of cover if you join a medical aid as the main member. The bottom line: Although divorce means heartbreak and emotional turmoil you do need to keep your wits about you. Seek the help of a financial adviser or broker to ensure you don’t compromise on your health or that of your children. Keep copies of your divorce papers, get any additional paperwork required, notify the existing medical aid of the changes and sign up for you own medical aid or hospital plan that kicks in immediately.

June 20, 2019

Five ways to prevent a red, chapped nose this winter

A red, chapped nose is one of the more visible side-effects of colds and flu, for children and adults. Here’s five practical ways to prevent a sore or raw nose this winter, from mom of three, Dirna Grobbelaar, Oral Hygiene Advisor at Ivohealth. A runny nose can cause dryness and chafing as frequent blowing and wiping, strips natural moisture from the skin and causes irritation. Apply some type of barrier cream, balm or ointment such as petroleum jelly or coconut oil to form a protective layer over the skin. Or ideally, use Letibalm, the only product available in South Africa specifically designed to protect and repair the delicate skin around the nose and lips. It’s made with natural and active ingredients including ancient healing herb centella asiatica with proven antioxidant, anti-inflammatory and hydrating properties; nourishing cocoa butter and antioxidant vitamin E. Whichever balm you use, it’s vital to apply it several times a day, especially before and after blowing the nose. Keep a tub or tube of Letibalm handy in your bag, child’s school bag and the car, so there is one available whenever needed. Wiping with the correct tissues will minimise irritation. Wet wipes aren’t suitable as they may contain cleansers, chemicals or other irritants; rather use a soft tissue, ideally ones infused with aloe vera or calendula. Instead of wiping the nose, gently pat or dab the skin. Blowing the nose less often will help prevent ‘tissue burn’. Rinsing the nostrils with a saline spray or homemade saline solution can help clear stuffiness. Buy a nasal spray at the pharmacy or make your own saline solution with a cup of cool, boiled water and half a teaspoon of salt. Steam helps relieve congestion and moistens the nasal passages, another good reason to enjoy hot soups and herbal teas when you’re feeling under the weather. Steaming your face over a bowl of hot water under a towel may be helpful, or sit in a sauna or steamy bathroom, probably a safer steaming method for children. Keeping the body and skin hydrated is important in preventing dry skin. Using a humidifier can add moisture to the air. Drinking plenty of fluids, especially water or herbal tea, is always recommended and especially when you have the sniffles. A clean washcloth soaked in warm water can be used to gently moisturise the face. Avoid harsh soaps, facial scrubs or anti-ageing products but do use plenty of moisturiser to keep the skin soft, in addition to a balm around the nose and lips. The best advice is to do all you can to stay well this winter. Maintain a healthy lifestyle and diet; get lots of fresh air and exercise; regularly wash your hands to avoid germs. But should the sniffles strike, these few simple steps can make it nicer and less nasty for your nose . Five tips to prevent a chapped nose this winter: Regularly apply a barrier cream, such as Letibalm nose and lip repair Use soft tissues, ideally infused with aloe vera or calendula. Gently pat rather than wipe Blow the nose as little as possible. Use a saline spray or solution to help clear stuffiness Use steam to moisturise the skin and help relieve congestion Keep the skin hydrated and mucous thin – use a humidifier and drink plenty of fluids For further practical advice from Dirna Grobbelaar read the Ivohealth blog on www.ivohealth.co.za.

June 19, 2019

Restore, Revitalize, Revive: Vit-C Shower is here to reawaken your senses!

The provision of a constant, clean supply of municipal water is a necessity that underlies modern infrastructure – ensuring that convenience and hygiene are easily attainable, with water freely available at the turn of the tap. What is often overlooked; however, is that in order to achieve this, a cocktail of chemicals are added to the water supply. These include free chloride and chloromines, along with other heavy metal elements and VOC’s (volatile organic compounds) such as pesticides, fertilizers, petro-chemicals, dioxins, radioactive materials and micro-organisms. Ideally, these substances should be filtered out of all consumable water as evidenced by the widespread popularity of household water filters and purification systems. Less known, but as important, is that impurities such as these can also be absorbed through the respiratory systems and eyes, whilst the highly absorptive nature of the skin means that up to 60% of the chlorine that most people absorb daily is due to showering or bathing in chlorinated water. When it comes to incorporating filtered water into your showering routine though, things can get tricky as the efficiency of a carbon filter is severely compromised by high temperatures, pressure and the volume that a showerhead handles. That’s where, the latest in innovative technology ─ Vit-C Shower comes in! Delivering the benefits of Vitamin C directly to you, the Vit-C Shower combines intelligent design and the powerful effects of Vitamin C to provide users with a water supply that is dechlorinated and packed with natural benefits. As opposed to conventional filters that only remove around 20 – 50% of the chlorine in water, the Vit-C shower dechlorinates and neutralizes up to 99.8% of free chlorine and chloromines in the water. What makes this possible is the pioneering use of Vitamin C within a filter that is independent from the shower head. Exposure to Vitamin C in the form of ascorbic acid enclosed ceramic balls, not only allows for far greater dechlorination but also provides users with an array of supplementary benefits; helping in the growth and repair of all body tissues, formation of collagen, absorption of iron, wound healing, maintenance of cartilage, bones and teeth and immune system defences. This is then bolstered by a rigorous 12 stage filtration process that includes sediment filters in the form of micro-porous cotton and stainless steel mesh, along with a variety of additional elements that include calcium sulphite, malfan stone and tourmaline to ensure that the highest water quality is maintained. The negative consequences of chlorine and chloromines in our water are manifold. Amongst others, skin and hair are stripped of their natural oils thus possibly resulting in over 20% of infants and children, and 3% of adults suffering from eczema type skin conditions. What Vit-C shower offers is a chance to dramatically reduce this possibility, whilst providing gentle care for your skin in the form of water that is softer, gentler and which leaves you feeling refreshed and revitalized!

June 18, 2019

Dangerous Decibels, Noise induced hearing loss in children

It has become increasingly more common to see children using tablets, portable gaming devices and smartphones with headphones. Certainly these days our children are wired for sound, but does this increased use of headphones and the potential damage inflicted by them mean that they will be more wired for hearing aids in the near future? Loud noise and sounds can be very damaging to a child’s hearing. Both the level of noise and the length of time exposed to it can put your child at risk for noise-induced hearing loss. Sound levels are measured in decibels (dB); the higher the decibel number, the louder the sound/noise. Research has shown that sounds louder than 85 dB can cause permanent hearing loss. However, it’s not a linear relationship. Eighty decibels is twice as loud as 70 decibels, and 90 decibels is four times louder. Exposure to 100 decibels, about the volume of noise caused by a power lawn mower, is safe for just 15 minutes. Noise at 108 decibels, however, is safe for less than three minutes. Most of the hearing loss caused by exposure to loud sounds can happen very slowly and take years to be detected by the person who has it. Sound Level Length of exposure, before damage to your hearing 50 – 70 dB No damage 85 dB 8 hours 90 dB 2 hours 100 dB 15 minutes 110 dB 1 minute 120 dB and upwards Instant damage One of the most common ways young children are exposed to excessive noise is via noisy toys. Many toys are designed to be played at a distance from the body, but a young child will bring the toy close to his/her face and ears. By bringing the toy closer to his/her ears, the resulting sound is louder and therefore more damaging. Some toys can reach 100dB or more if placed close to the ear. Research has shown that there has been an increase in hearing loss in adolescents during the past three decades. What is even more frightening is that a loss of hearing may go undetected for many years after chronic exposure to high levels of noise. This means that the hearing loss caused by the noise teenagers are exposing themselves to today might not surface for many years. A recent study suggests that children who listen to headphones may be at greater risk for a noise-induced hearing loss. The study further claimed regardless of how long they wore headphones or how high they set the volume, kids who used headphones just one or two days a week were more than twice as likely to have hearing loss as children who didn’t use headphones at all. A noise-related hearing loss is classified as a hearing loss in the high frequencies (high pitched sounds). A child with a noise related hearing loss may struggle to hear soft or faint sounds, speech may sound unclear or muffled and it may be accompanied by ringing in their ears. Noise-induced hearing loss generally comes about gradually and is not painful. However, the damage caused to the inner ear is irreversible. A loss can be temporary after a loud event but it can become permanent with repeated exposure to noise. How can I tell if I’m listening to dangerous noise levels? You or your child is listening to dangerously loud sounds/noise if: You must raise your voice to be heard even when you’re 1 meter from the person. If you can clearly hear what your child is listening to through their headphones, then it is too loud If a parent is arm’s length away, then the child should be able to hear if the parent asks a question. You are listening to music or a game at more than 50 percent (half) of the maximum volume. Speech around you sounds muffled or dull after you leave the noisy area. You have pain or ringing in your ears (“tinnitus”) after exposure to noise. What can be done? You cannot limit every sound that a child hears, you can take some preventive steps to minimize potential damage The best option is to avoid the loud sounds or noise whenever possible. If that is not possible, use hearing protection like earplugs and/or earmuffs. Cotton will not protect your hearing. If you don’t have any hearing protection available, try to limit the amount of time you or your child is exposed to the loud sound. When purchasing toys for infants, look for ones with a volume control or an off/on button. Limit the amount of time that children are exposed to sound or remove the batteries from young children’s toys. Another option is to cover the loudspeaker with tape to lower the volume. Keep personal-listening devices set to no more than half volume. Don’t be afraid to ask others to turn down the sounds from speakers. Encourage children to take breaks from their headphones in order to give their inner ear hair cells time to rest Instead of the in the ear headphones, let your child use headphones that fit over their ears. Purchase sound limiting and noise cancelling headphones for your child but continue to monitor the level that they listen at Look for noise ratings on appliances, sporting equipment, power tools, and hair dryers. Purchase quieter products Life is loud so lead by example! YOU can also lose your hearing with noise exposure, so use hearing protection when needed and listen to music, the T.V., and other sounds at a softer level. Remember to test your child’s hearing on an annual basis to monitor their hearing abilities.

June 14, 2019

What you need to know about Pneumonia

Lee Callakoppen, Principal Officer of Bonitas Medical Fund talks about pneumonia: According to the World Health Organisation (WHO), a child dies from pneumonia every 30 seconds. Which means that around 1.1 million children, under the age of five, die each year. This is more than malaria, AIDS and tuberculosis combined. What is pneumonia? Pneumonia is a lung inflammation caused by a bacterial or viral infection, it’s when the air sacs in the lung fill up with pus and can affect or one or both lungs. The flu shot and pneumonia Having a flu vaccine is the first line of defence when it comes to protecting yourself, with studies showing it reduces the risk by about 50 to 60%. The vaccine trains your body to recognise flu and fight it. Pneumonia is a relatively common and serious complication of flu.Supporting evidence from randomised clinical trials indicates that fluvaccines are effective in preventing influenza-associated pneumonia. Signs and symptoms of pneumonia may include: Chest pain when you breathe or cough Confusion or changes in mental awareness (in adults aged 65 and older) A cough, which may produce phlegm Fatigue Fever, sweating and shaking chills Lower than normal body temperature (in adults older than age 65 and people with weak immune systems) Nausea, vomiting or diarrhoea Shortness of breath How are flu and pneumonia different? Bonitas explains that pneumonia symptoms are similar to flu but last longer. The severity of the pneumonia depends on your age and overall health. In the case of newborns and infants, sometimes they show little or no infection and other times they may vomit, have a fever and cough, have difficulty breathing and eating. Pneumococcal vaccine There are a total of 80% Community Acquired Pneumonias (CPAs). These streptococcal bacteria can spread from the nose, throat and ears to cause pneumonia – a severe infection of the lungs. The vaccine protects you against: Infection that can result in Pneumonia, infection of the blood (bacteremia/sepsis), middle-ear infection (otitis media), or bacterial meningitis. Pneumonia is by the most common of these infections. Is it an annual vaccination? The pneumococcal vaccination is suitable for those over 65 years of age or immune compromised members a pneumococcal vaccination once every five years. Who should have the pneumonia vaccination? It is recommended for all individuals aged 65 years or older plus individuals aged 2-64 years with certain long-term health conditions, such as a serious heart or kidney condition. In fact for anyone with an increased risk, from a chronic disease, immune-suppressed people particularly those who are HIV positive, cancer sufferers and smokers who are more prone to respiratory illnesses. The cost of pneumonia In severe cases of Pneumonia, the estimated cost of spending a night in intensive care is R15 000 whereas a Pneumococcal vaccine costs around R1000. Most medical aids do cover the cost. Bonitas offers a free flu vaccine annually to members as well as a once off pneumococcal vaccine for people over 65 years of age. According to the New England Journal of Medicine (NEJM), ‘In addition to reducing the risk of hospitalisation for an influenza infection itself, the flu vaccinations appear to reduce the likelihood of hospitalisation for influenza-associated complications such as pneumonia. When to see a doctor? See your doctor if you have difficulty breathing, chest pain, persistent fever of (39 C) or higher or a persistent cough, especially if you’re coughing up phlegm.

June 12, 2019

Five facts about ‘flu

Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund gives five facts about flu: Flu strains, like fashion, change every year The latest flu strain South Africa can expect is nick-named ‘Aussie Flu’. This particular strain – H3N2 – is a subtype of influenza A. The virus has, in fact, been around for a whilebut unfortunately the flu strains have a built in survival mechanism, they mutate or change so they outwit the body’s immune response. Which is why each year flu vaccinations are updated, meaning last year’s won’t necessarily protect you this year. The symptoms of flu? These include high temperatures, body pain, sore throat, tiredness, loss of appetite and are the same year in and year out. However, some flu strains may cause the symptoms to last for a longer time and be more severe. The flu can also bring on headaches, muscle pain, vomiting and diarrhoea. In people with weaker immune systems, the flu is even more serious. The flu shot doesn’t gives you flu According to the Centre for Disease Control, ‘A flu shot cannot cause flu and serious allergic reactions to the flu vaccine are rare. However, if you are allergic to eggs you need to notify your doctor. Flu vaccines are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious or with no flu viruses at all. The most common side-effects from the shot are small amounts of soreness, redness, tenderness or swelling around the injection site. Protecting yourself and your family The flu vaccine reduces your chances of getting flu and, if you do get it, it will be milder.The vaccine trains your body to recognise flu and fight it. More importantly, if you are vaccinated you will protect others, via what is called ’herd immunity’. This includes vulnerable members of the family such as such as small babies and the elderly as well as those who are immune-compromised. Some of the reasons people don’t vaccinate Every year there is a debate about flu injections yet up to 11 000 people die from flu in South Africa every year, despite the flu vaccination being readily available and paid for by most medical aid schemes. There are a number of reasons, including the notion that: ‘I don’t get flu’, ‘the vaccine doesn’t work’, ‘it will hurt my arm’ or ‘the vaccine will give me flu’. However, according to Bonitas, there are very good clinical reasons why you should. Bonitas covers one flu vaccine for all members. Members can go Clicks, Dischem or Pick n Pay pharmacies for the vaccine at no cost, or attend a Bonitas Wellness Day.

June 5, 2019

How To Make The Medicine Go Down

It’s stressful when your kids are sick and even more stressful when they refuse to take their medicines. Not to mention the icky stickiness that is almost impossible to wash off your skin. In this blog I will share with you some tips I have learnt over the years to help make the medicine go down. 1. Disguise the taste Many over the counter liquid medications available for kids are flavoured. Look on the bottle to see which flavour you are buying. Some brands have different options for the same drug such as Panado’s strawberry and peppermint flavours. Some brands may have the same flavours but taste different. My daughter prefers the strawberry flavour of Calpol than that of Panado. If the medication needs to be made up by a pharmacist, ask them to flavour the medication if possible. Unfortunately, some meds just taste awful and not all pharmacies stock flavourings. You’ll need to get creative here. You can mix the liquid with fresh fruit or vegetable juice and even honey (if your child is over one year). You can also try mixing meds with milk or yoghurt but the calcium may interfere with the effects of some medications, particularly with certain antibiotics. Acidic foods may also inactivate some antibiotics. It’s important to ask your pharmacist and read the patient information leaflet before you decide to try this method. If you are hiding the medication in a food or drink, keep the volume small so that the entire dose can be taken. Don’t mix with a full bottle or cup of juice if your child will not finish this. 2. Equipment I always use a syringe and squirt the medicine along the inside of the cheeks and not onto the tongue. This way you can bypass the taste buds a little. You can also use a medicine dropper the same way. Slide the syringe or dropper along the cheek towards the back of the mouth and squirt the medicine slowly. Do not aim for the throat as your child will gag and cough and if you aim too far in front of the mouth the medicine will simply be spat out. Using a syringe also allows you to give correct dosages. In kids it’s vital you give the correct dosage of medication. You can wash and reuse the syringes but after a while you should replace them. 3. Keep it chilled You can also numb the taste buds beforehand. Your child can suck on a block of ice if he or she is older or you could try an ice-lolly for a younger child. Some medications can also be stored in the fridge, which can make them taste better. 4. Wash it down Whilst Mary Poppins recommended a spoonful of sugar, I’m not sure many of us moms will be too happy with the after effects of this sugar rush before bedtime. Have a glass of water or your child’s favourite drink on standby to drink as soon as they swallow just so they can wash their taste buds. 5. Coat the taste buds You can try giving your child a spoonful of something thick and sweet such as maple syrup or honey to coat the tongue before giving the medicine. 6. Try a tablet instead Some liquid medicines are available as chewables. If your child is old enough you can try these. Whilst there are some tablets that can be crushed and mixed with food. Speak to your doctor or pharmacist before you do this. You may also find dissolvable tablets. Dissolve the tablet in a small glass of water and add some fruit juice to hide the taste as these can be extremely bitter. 7. Give your child some control You will find that your kids will be more willing to take their medicine if they are in control or at least think they are. Allow them to choose when to take their medicine, for example, before or after the bath. They can also choose what flavour medicine they would like when you are buying it for them. IF IT WORKS, STICK TO IT You might find that more than one trick is necessary. If you have found a technique that works, stick to it. A while back I tried using one of those fancy medicine syringes I got at my baby shower instead of a simple syringe (I had actually forgotten to replace the ones I had thrown out). These syringe type medicine feeders are quite big and I couldn’t get it far enough to the back of the mouth to bypass the taste buds. My daughter did not like this at all and I ended up wearing most of the medicine! Do you have any other tricks or tips to get your kids to take medicine? Please share in the comments section below! If your little one requires medicine on a regular basis, here is a medicine chart to help you organise the days and quantities: https://www.oneaid.co.za/resources/

May 23, 2019

Parenting tips for ADHD

At least one in 20 children in South Africa suffer from attention deficit hyperactivity disorder (ADHD). This is according to research by Cape Town-based psychiatrist Dr Renata Schoeman. ADHD is characterised by three main sets of symptoms – poor concentration, hyperactivity and impulsivity – and, when left untreated, can be among the most debilitating disorders to live with. The risks include academic, social, and emotional problems in childhood, which may impact on job performance, relationships and mental health in adulthood. It is understandable why parents dread an ADHD diagnosis; not because the disorder is untreatable, but because they are unsure of how to help their child. Fortunately, all is not lost. There are many ways to help your ADHD child. Take a look at five parenting tips for ADHD below, but keep in mind that what works for one child may not work for another. Five parenting tips for ADHD Limit distractions In the 21st century, it is easy for anyone (especially children with ADHD) to get distracted if there is a smartphone, a television, video game or computer close by. Access to electronics should be monitored and limited. Establish a routine Having a set routine in place can provide essential structure for children with ADHD. Have meals at the same time every day and have rituals in place before bedtime like taking a bath, brushing their teeth, and reading a bedtime story. Encourage exercise Exercise is the perfect outlet for built-up energy. According to an article in Healthline, exercise may help to improve concentration and stimulate the brain in healthy ways. Try to find an exercise that your child enjoys and make sure to join them, as you will benefit too. Understand your child’s thought process Children with ADHD often speak and act before thinking. Encourage your child to verbalise their thoughts and reasoning, as this can help you understand their thought process and hopefully help curb impulsive behaviours. Ask for help You don’t always have to have all the answers. It is okay to ask for help. Consult a psychologist who specialises in ADHD or consider attending an ADHD Parenting Course. And, remember that it is not only your child that can benefit from professional help – A therapist can help you manage stress and anxiety. Finding a support group in your area can also be beneficial. Home education can provide a nurturing learning environment for children with individual needs. Impaq Educationprovides all the necessary products, services and tools to enable your child to complete Grade R to 12 at home.

May 16, 2019

Deciphering Medical Aid Speak

It can be rather daunting trying to understand the terms in your medical aid plan and all the detailed information about your benefits. Medical Schemes and the Council for Medical Schemes (CMS) use certain terms in reference to benefits. They can be tricky to fathom. Here are some of the most frequently asked questions, as highlighted by the Bonitas Medical Fund call centre. Prescribed Minimum Benefits (PMBs) PMBs are confusing even to those in the medical industry but simply put, it is a list of 26 chronic diseases and 270 treatments which have to be covered by all medical aid schemes as outlined in the Medical Schemes Act. PMBs are in place to make sure all members have access to certain minimum health services, regardless of their benefit option. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable. Above Threshold Benefit Medical Schemes set an annual limit for day-to-day claims. Once you have reached this limit – or threshold – then your claims are paid from the ‘Above Threshold Benefit’. The amount available depends on the plan you are on as well as the number of dependants. Day-to-day limits Members and their dependants are given a pre-determined maximum amount of money for out-of-hospital expenses during a year. There is a limit to what you can spend after which you move onto the above threshold benefit. Pre-authorisation Unless there is a medical emergency, members are required to obtain pre-authorisation from their schemes before being admitted to a hospital for a procedure. If you do not organise pre-authorisation, the scheme can refuse to pay. Quotes for procedures Bonitas advises members to not only obtain pre-authorisation but to also ask for a detailed quote from the hospital and medical practitioner prior to being admitted to hospital (if it’s not an emergency). It means you can submit it to your medical aid ahead of the procedure to find out if co-payments will be required and if so, how much they are. Co-payment Medical practitioners and hospital often charge more than medical aid rates. This means medical schemes seldom cover the entire bill. A co-payment refers to the outstanding portion of the account, for which you will be responsible. A co-payment varies from one medical aid scheme to another and is sometimes not necessary if you use a designated service provider or network hospital. The medical aid can pay from 100% – 300% of the medical aid tariffs, depending on the plan you are on. ICD codes This is a coding system developed by the World Health Organisation (WHO) that translates the written description of medical and health information into standard codes. It means every medical treatment and diagnosis has a specific code – called an ICD 10 code. These are important as it allows the scheme to identify the code of the healthcare service you require and to make sure payment is made. The correct ICD Code must be included on every claim to ensure you are paid for the correct benefit and t the healthcare practitioners are paid for their service. Claim After you have seen a doctor or been in hospital, you can either pay the bill directly and claim the amount back from your scheme or your doctor can submit the claim on your behalf. Remember to ensure that all the correct information is on your claim, including your membership number and the ICD 10 Code. Chronic Medication Is medicine prescribed by a medical practitioner for an uninterrupted period of at least three months. This medicine is used for a medical condition that appears on your scheme’s list of approved chronic conditions. Payment of chronic medication is usually a separate allowance on your medical aid plan. Formulary Medical Aids have a list of medicines on what they call their formulary – or list – that are recommended to treat different diseases. If you opt for medication not on the formulary there might be a co-payment. Generic medicine There are a number of generic medicines on the market that are cheaper than the original, patented brands however they contain the same active ingredients and are just as effective. Most medical schemes encourage the use of generic medicines to save costs and help you stretch your benefits. Check with your pharmacist. Private healthcare in South Africa is not cheap and the best way to make the most of your medical aid or hospital plan is to understand what is and isn’t covered as well as the terms and conditions. Make sure you get to grips with the various terms used by your Scheme and Dr and if you are unsure … ask!

May 10, 2019

What to do if you’re child is the bully

Bullying at school is common and the source of much misery and discomfort for many students and their parents in turn. The effects can be long lasting for the victim’s health and wellbeing, sometimes even having fatal consequences. Teachers are trained to help combat this anti-social behaviour and parents as well as students have access to many outside support structures that give guidance on how to overcome the effects of bullying. Parents, often, only see their child as a possible victim and therefore, guide their child on how to avoid being bullied. It is rare for parents to consider that their child might be the bully. This is understandable; after all, acknowledging that your child is a bully, is possibly an indictment on you as a parent. Sadly, we are well aware that bullying at schools is rife; someone is doing it. Frighteningly, it could very well be your child. One should recognise and acknowledge this possibility and remedy such behaviour patterns immediately. Your child could see denying the occurrence or ignoring the problem as acceptance of this anti-social behaviour. The long-term consequences of being a bully are scary. Bullies are prone to mental illness later in life. They continue to be aggressive and even violent. According to stopbullying.govbullying is a risk factor for depression and thinking about suicide. Children who bully others, are bullied, or both bully and are bullied are more likely to think about or attempt suicide than those who are not involved in bullying at all. Therefore, if you notice some of the following signs, it is time to step in and get help for your child as mentioned by Sheeri Gordon on Tips for addressing bullying by your child(2019): Your child is often in the company of other bullies Your child is constantly criticising and insulting other children to the extent that they feel belittled and offended Your child is regularly violating the school’s code of conduct and in trouble at school Your child actively invites kids over but turns down a couple that used to be included Your child is obsessed with being popular Your child is aggressive physically and/or verbally Your child is uncompassionate and has no concern for those that suffer Your child avoids you and spends too much time alone at home Address the bullying without delay; don’t hope that it will stop. Your child must know that you explicitly disapprove of the behaviour and that they will be disciplined. It must be clearly understood that bullying is inexcusable. However, the appropriate disciplinary measures can only be taken if you know why your child is bullying someone else. Identify the reasons, for example, your child may be bullying others because they want to be part of a popular group. You should address the importance of keeping the right company and not succumbing to peer pressure. Remember to let the punishment fit the crime. A knee jerk reaction is likely to make matters worse. Taking away privileges is a tried and tested form of discipline for teens and is very effective. For example, you can take away electronics, watching TV and the privilege of attending parties or special events. The list is endless. Ensure that that you don’t give in at any point and stick to the length of time that the privilege will be revoked. Collaborate with the school and show full support for the school’s code of conduct. Don’t attempt to rescue them from the consequences of their actions. Once this is done, your child will expect that you will always do so and will not take responsibility for their actions. Determine the details of your child’s bullying behaviour. Are there skills your child is lacking that may prevent future bullying incidents like anger management and impulse control? Seek professional assistance if required. Don’t dispel the value of a session or two with a psychologist if need be. Avoid humiliating or shaming your child, especially not in front of anyone else. Letting family members and friends know about what is going on, will not help. In fact, it could prove only to worsen the behaviour. Keep it private and the solution will be more easily achieved. Remember, praise may be public; but punishment, always private. Talk about the consequences of bullying; be sure your child takes the time to really think about how he would feel if he was on the receiving end. When children learn to see things from a different viewpoint, they are less likely to bully again. Raising your child’s emotional intelligence and instilling empathy will go a long way in preventing bullying. So consider carefully, your own actions and utterances as a parent; children most often, unwittingly emulate their parents. When bullying is identified early and addressed appropriately, it usually won’t happen again. However, don’t automatically assume that this is the case. Instead, monitor your child’s conduct and continue to discipline him if necessary. If given the right skill set, most children who bully others can change. Stopping your child from bullying others can take some time, it’s not an overnight solution. Written by: Sedhoorajan Padayachee, Principal at Abbotts College Northcliff

May 2, 2019

How To Get Your Kids To Go To The Dentist

We’ve all been there as a child—apprehensive, maybe even afraid of the dentist. Now as a parent, you face the other side, helping your child beat their fear of the dentist. The good news is, there are many things you can do to make the experience more enjoyable for them so that the next time they need a checkup, they go with a lot less fuss. Here are some of the things you can do to get your kids to go to the dentist. Start Dental Visits Early Many kids fear the things they don’t know. If you take them to the dentist early enough, they will be used to it long before many of their friends are. As soon as they get their first teeth, you can introduce them to the fact that there is nothing to worry about. Let Them Talk to a Dentist There is nothing wrong with calling your dentist and informing them of your child’s apprehensions. A lot of the time, they will welcome a visit so they can discuss the process with your child. Even if they don’t end up being treated that day, it can go a long way towards helping future visits. Use a Family-Friendly Dentist. Some Dentists will be friendlier than others. Given this, you want to make sure you find one that specializes in family treatments, so you know your kids are in good hands. In terms of being family friendly, North Pointe dental options are abundant. Enquire before you visit your office of choice and see how they can make your child more comfortable. Do Not Use Bribery It can be tempting to offer a reward for visiting the dentist. This can add to the tension they are feeling. If you tell them that if they don’t cry, they can have X, then they will think about why they might cry just as much as the reward. Also, any offer of a sugary reward isn’t a great idea, for obvious reasons. Give the Dentist Space There is nothing wrong with holding your child’s hand if they ask, or even if you feel like you want to. What you shouldn’t be doing is interfere if they make a fuss about the situation. The dentist will be well versed in how to help your child feel more relaxed. It will be easier for them to do so if they are given the room to. Encourage Good Oral Hygiene If you encourage your child to develop good teeth care habits, then they will better understand why a trip to the dentist is necessary. Help your child to see that a dentist will work to keep their teeth healthy. Although it can be a stressful time for both parent and child, a few simple steps can go a long way. Your future trips to the dentist will run a lot smoother when you know how to help.

April 18, 2019

Listening to Learn

Even though we use the words hearing and listening interchangeably, the difference in meaning is significant. Hearing is a sense. Listening is a learned skill. Hearing is the process, function, or power of perceiving sound. Listening is paying attention to a message in order to hear it, understand it, and physically or verbally respond to it. SEVERAL THINGS MUST HAPPEN FOR US TO LISTEN EFFECTIVELY: Sound waves carry spoken words to our ears. Sound travels through the outer ear canals (without obstruction) and then through the eardrum and middle ear without being distorted by fluid from colds, infection, or allergies. Sound then travels from the middle ear through the inner ear (which must be functioning properly as well) along the auditory nerve to the brain. Finally, the brain compares what it hears to previously stored sounds and words in order to make sense of the message and respond accordingly. “Listening is a crucial skill for young children to acquire. Listening is one of the basic building blocks of language and communication and particularly in the early years of education, one of the main vehicles for a child’s learning.” Eleanor Johnson Auditory processing disorder (also known as central auditory processing disorder or CAPD) is a condition that makes it hard for kids to recognize subtle differences between sounds in words. It affects their ability to process what other people are saying. DEFINING AN AUDITORY PROCESSING DISORDER: Your child passes a hearing test but is diagnosed with an auditory processing disorder. Children with auditory processing disorders typically have normal hearing. But they struggle to process and make meaning of sounds. This is especially true when there are background noises. Researchers don’t fully understand where things break down between what the ear hears and what the brain processes. But the result is clear: children with auditory processing disorder can have trouble making sense of what other people say. Typically, the brain processes sounds seamlessly and almost instantly. Most people can quickly interpret what they hear. But with an auditory processing disorder, a glitch delays or “scrambles” that process. To a child with CAPD, “Tell me how the chair and the couch are alike” might sound like “Tell me how a cow and hair are like.” The problem lies with understanding the sounds of spoken language, not the meaning of what’s being said. Some educators and other professionals’ question or doubt a diagnosis of CAPD. Not all professionals see it as a specific disorder. The medical profession didn’t start seriously studying CAPD in children until 1977. Four decades later, there’s still confusion about CAPD. The number of children with CAPD is estimated to be between 2 – 7 percent. Some experts estimate that boys are twice as likely as girls to have auditory processing disorder, but there’s no solid research to prove that. WHAT ARE SYMPTOMS OF AN AUDITORY PROCESSING DISORDER? “The kids we see are having difficulty following directions,” explains Rachel Cortese, a speech-language pathologist at the Child Mind Institute. “They ask for repetition a lot. They seem to just kind of miss things in conversations. From testing we know that their ear is hearing the signal. It’s attending to the auditory information. But they have glitches when the brain is not assigning meaning—or the right meaning—to that signal.” The term auditory processing refers to how the brain perceives and interprets sound information. Several skills determine auditory processing ability—or listening success. They develop in a general four step hierarchy, but all work together and are essential for daily listening. Although researchers do not agree on the exact hierarchy of skills, they generally agree on what skills are essential for auditory processing success (Cochlear Americas, 2009; Johnson et al., 1997; Nevins & Garber, 2006; Roeser & Downs, 2004; Stredler-Brown & Johnson, 2004). Children with CAPD can have weaknesses in one, some or all of these areas: AUDITORY AWARENESS • Auditory Awareness – the ability to detect sound • Sound Localization – the ability to locate the sound source • Auditory Attention / Auditory Figure-Ground – the ability to attend to important auditory information including attending amid competing background noise. It would be like sitting at a party and not being able to hear the person next to you because there’s so much background chatter AUDITORY DISCRIMINATION • Auditory Discrimination of Segmentals – the ability to detect differences between specific speech sounds. The words seventy and seventeen may sound alike, for instance • Auditory Discrimination of Environmental Sounds – the ability to detect differences between sounds in the environment • Auditory Discrimination of Suprasegmentals – the ability to detect differences in non-phoneme (sound) aspects of speech including rate, intensity, duration, pitch, and overall prosody AUDITORY IDENTIFICATION • Auditory Identification (Auditory Association) – the ability to attach meaning to sounds and speech • Auditory Feedback/Self-Monitoring – the ability to change speech production based on information you get from hearing yourself speak • Auditory Discrimination of Segmentals – the ability to detect differences between specific speech sounds. The words seventy and seventeen may sound alike, for instance • Phonological Awareness (Auditory Analysis) – the ability to identify, blend, segment, and manipulate oral language structure AUDITORY COMPREHENSION • Auditory Comprehension – the ability to understand longer auditory messages, including engaging in conversation, following directions, and understanding stories • Auditory Closure – the ability to make sense of auditory messages when a piece of auditory information is missing; filling in the blanks • Auditory Memory – the ability to retain auditory information both immediately and after a delay • Linguistic Auditory Processing – the ability to interpret, retain, organize, and manipulate spoken language for higher level learning and communication CHILDREN WITH APD USUALLY HAVE AT LEAST SOME OF THE FOLLOWING SYMPTOMS: Find it hard to follow spoken directions, especially multi-step instructions Ask speakers to repeat what they’ve said, or saying, “huh?” or “what?” Be easily distracted, especially by background noise or loud and sudden noises Have trouble with reading and spelling, which require the ability to process and interpret sounds Struggle with oral (word) math problems Find it hard to follow

April 17, 2019

First Aid Tips Every Mom Should Know

I was recently asked by All4Women to put together my top 10 first aid tips for moms. I wanted to share these with all of you in this blog post. You can find more tips in my MiniKit Pocket Guide (https://www.oneaid.co.za/product/minikit/). Keep emergency numbers on speed dial: Every parent should know who to call in an emergency. You should also teach this to your children. Write the numbers down and stick them on your fridge or somewhere near the phone. Cuts and scrapes: Stop any bleeding by pressing firmly on the wound with a gauze or cloth. Then rinse the wound under cool running water before applying a dressing such as a plaster. Tap water is perfectly fine, you don’t need fancy antiseptic solutions. Burns: Rinse burns under cool running water for up to 20 minutes. This will prevent any further damage and reduce pain. Do not use freezing cold water or ice Bee stings: Remove the stinger if still attached and apply an ice pack to reduce swelling. Don’t use tweezers as this may squeeze out more poison. Rather scrape the stinger off with a flat-edged object such as a bankcard. Nosebleed: Lean your child forward so they don’t swallow any blood and pinch the nose closed just below the bony part. Blood can irritate the stomach and cause nausea and vomiting. Broken bones: If you suspect a broken bone don’t move the limb or apply any weight. Splint the injured limb to prevent any movement before going to the emergency room. Seizures: Never put anything into the mouth of a child who is having a seizure. This includes medicines for fever if your child is having a febrile convulsion. Roll your child onto his or her side and wait for the seizure to stop. Heat exhaustion: Get your child out of the heat and elevate his or her legs. Prevention is key so make sure your child drinks plenty of fluids before and during any activity in hot weather. Poisoning: If you suspect your child has swallowed a potentially harmful substance do not make them vomit or give them anything to eat or drink unless told to do so by emergency services. Here are 10 essential tips to prevent poisoning in your home (https://www.oneaid.co.za/10-essential-tips-to-prevent-poisoning-inyour-home/). Be prepared: Always have a well stocked first aid kit on hand so you can manage minor injuries without delay and reduce the risk of infection or severity of injury. Be sure to follow me on Instagram @oneaidsa

April 15, 2019

Autism: What is it, what are the signs and who can help?

Autism Spectrum Disorder (ASD) is a group of conditions that affect a person’s social communication, sensory processing, thinking and emotional regulation. It is a lifelong condition that has a spectrum of difficulties. Savannah Senior, Clamber Club Expert and Speech-Language therapist, sheds some light on Autism, the signs and how you can help your little one. This means that a child with ASD will have small to significant difficulties in each area of the spectrum. Although many people describe a spectrum as a line, a circle can also be used. This can sometimes give one a better idea that a child may function better in one area and less so in another. Sensory Processing: The ability to process and integrate all your senses and use them in a functional way. For example, to hear the teacher’s voice, seeing her writing on the board, feeling the pen in your hand = processing this information and understanding that you need to copy the teacher’s writing = motor movements of you writing. Children with ASD frequently struggle to process and integrate the sensory information that they receive from their environment. Social Communication: Communicating with others and sharing joy in social relationships. Children with ASD are impacted in this area of communication as they struggle to understand others facial expressions and body language; are more literal than figurative; struggle to make eye contact; find it difficult to share attention together with someone else etc. Thinking: Children with ASD may think in a rigid manner meaning that they cannot understand or accept alternatives when they were not expected. Thinking ahead may be difficult and new unexpected situations may be difficult. Routines often help with this. They frequently have fixed interests. Emotional Regulation: This is being able to monitor and modify emotional reactions to situations that may distress you. If one cannot emotionally regulate, behavioural difficulties can often be observed. When you are well regulated, you can recognise when you need to implement a regulation strategy such as talking to our friends, taking a break when you need it, sleeping enough, exercising etc. Children with ASD find regulating their emotions difficult and this can often result in self-harm, physical aggression, or inconsolable children. Behavioural difficulties are frequently associated with children who have ASD. It is important to remember that every behaviour is a communication. The cause of ASD is unknown but it is thought that it is a combination of genetic and environmental components. At one point it was thought that MMR vaccinations caused ASD, but this has been extensively researched and has shown that there are no links between ASD and MMR vaccinations. What to look for: ASD comes in all shapes and sizes, in other words, every child is different! Not every child will present with the same signs. Here are a few signs to look out for, but remember that a child usually has a few or many of these signs and may have ones that are not mentioned here: Struggling with non-verbal communication including: eye-contact (receiving and using); understanding and using facial expressions and body language Delayed understanding and use of language. Difficulties understanding figurative language. Children with ASD will frequently take phrases literally i.e. It’s raining cats and dogs. A child with ASD will look up to see where the cats and dogs are. Lack of interest in other children. They frequently prefer to play alone or alongside children. Difficulty understanding their own and other people’s emotions and feeling. Echolalia: repeating words, phrases or sentences (immediately or later) without fully understanding their meaning. Oversensitive to touch, light, textures or sounds. Lack of imaginative or pretend play. Children on the spectrum will frequently play with toys in an unusual way such as lining them up, spinning or opening/closing a toy instead of playing with it as a whole. Enjoying routine and structure. Difficulty moving from one activity to the next or difficulty getting them to engage in an activity (seems as if they have poor attention). Preference for repetitive activities and games such as lining things up, opening and closing doors, turning lights on and off, putting things in something and taking them out etc. Arm flapping, self-harm, uncontrollable temper tantrums and other behavioural difficulties. What to do? If you are concerned that your child is presenting with signs of Autism, seek help. It is best to contact your child’s Paediatrician who will be able complete a developmental assessment and either diagnose your child or refer your child for further assessments. Autism South Africa can also help you on your quest of answers! They can be contacted through their website: http://aut2know.co.za/. Some General Tips: Make things visual! Children on the spectrum are usually visual learners. Use pictures to help improve your child’s understanding of up-coming events and situations. This can include photographs, line drawing, visual schedules, showing your child an object/action while speaking etc. When communicating, break things into smaller phrases i.e. instead of saying, ‘Put your coat on and go to the car,’ rather say, ‘Put your coat on’ child puts coat on ‘Go to the car.’ Remember that all behaviour is a communication. You can try deciphering what your child is saying by keeping a log of: the behaviour that occurred, what happened before this and how you helped your child become regulated again. Look through them to try find patterns. Avoid figurative language. Copy your child’s actions and play routines to enter their world.

April 10, 2019

Keeping Your Children Safe During Bath time

I’m sure many of you will agree that bath time is loads of fun for our kids. Whilst the bathroom is a fun place, it can also be a scary place with a number of dangerous hazards such as the drowning, burns and poisoning. It’s important that you are always in the bathroom with your children before, during and after bath time. Drowning is a major cause of death in children under five years. According to the Consumer Products Safety Commision in the United States, 80% of the 87 children, under five years who drown at home each year, have drowned in the bathtub. Young children are top heavy and can slip suddenly and drown in very little water. Infants and toddlers also don’t have the upper body and core strength to lift themselves up if that slip under the water. HOW TO RUN A BATH Keep your child away from the bath until the water is the right temperature. The safe temperature of bath water should be between 37oC and 38oC (36OC for a newborn). Children have thinner skin than adults so they can burn much more quickly. Even if the bath feels warm to you it may be hot to your little one. Your plumber can also set the thermostat of your geyser to a maximum of 50oC. Always fill your bath with cold water first. Your child could put his hand or foot in the water before the bath is ready and get burnt. If you have a mixer tap, run hot and cold together but start with the cold and slowly increase the amount of hot. Run cold water through the tap before your child gets into the bath to cool the tap and prevent them from getting burnt if they touch it. If you have a mixer tap, point the lever on the cold setting when you are finished running the bath to ensure the hot water does not get accidentally turned on in the bath. Do not overfill the bath. Fill the bath water to just over your little one’s knees. HOW TO HAVE A S-A-F-E BATH S: Supervision is key! Always supervise babies, toddlers and children less than six years in the bath and when you run the water. Never leave an older child to supervise. A: Arrange everything you will need for bath time in advance for e.g. towel, soap, shampoo, nappy, clean clothes and any medications.F: Feel the water with your elbow first. It should feel warm but not hot. You can also use a water thermometer. Remember to swirl the water around to ensure an even temperature with no hot pockets. E: Empty the bath as soon as bath time is over. SLIPS, TRIPS & FALLS Slips, trips and falls in the bathtub and shower are a common cause of injury in young children and according to statistics more common than tub drownings. Use a non-slip mat in the bath. If you are using a bath seat or ring, your child will still need to be supervised. A bath seat is not a safety device. These seats are actually associated with an increasing number of reported drownings. This is because the device gives parents a false sense of security and they are therefore more likely to leave their baby alone in the bath. Infants should be bathed in the bathroom basin or a smaller infant bathtub. This way they can’t roll over or ever be completely covered by the water. Wipe up any splashes before your kids get out the bath so that nobody, including you, can slip and hit their head. As your kids get older you should also teach them to remain seated in the bath and not to stand up and jump. Be sure to keep a MiniKit in your bathroom for peace of mind. Each kit contains a range of thoughtfully selected first aid items geared towards common childhood injuries. You can purchase one here: https://www.oneaid.co.za/product/minikit/ WHEN CAN YOU STOP SUPERVISING YOUR CHILD IN THE BATH? This is a difficult question to answer as children mature at different ages. Since most children who drown in bathtubs are under the age of five, the general consensus is children under the age of six should never be allowed to bath alone and even those over six should be closely monitored. Even if your child knows how to swim you should never be too far away. OTHER BATHROOM HAZARDS Toilet: luckily my daughter has never been interested in exploring the toilet bowl but I have had moms tell me how their child likes to play with the water in the toilet. Keep the toilet lids closed at all times and if your little one is particularly curious install a toilet-lid lock. Appliances: make sure any electrical appliances in the bathroom are unplugged and out of reach when your child is having a bath. Regular plug sockets may actually not be fitted in bathrooms for safety reasons so rather keep extension cords out. Medicines: many of us keep medication in the bathroom. Make sure they are all locked away, out of sight and out of reach. Dangerous items: make sure you keep cosmetics, razor blades, nail scissors, cleaning products and other dangerous items away. Don’t get distracted during bath time. Keep your phone on silent or rather keep it out of the bathroom and join in on the fun. You could also try having a shower with your child instead for some extra fun. My daughter loves this and the best part is that I manage to get cleaned up as well freeing up some time later in the evening for something else. Just make sure you get a slip-proof mat for the shower first. RESOURCES https://www.aappublications.org/news/2015/11/11/PPBath111115 https://medlineplus.gov/ency/patientinstructions/000154.htm http://www.ncbi.nlm.nih.gov/pubmed/19596735 https://pediatrics.aappublications.org/content/124/2/541.long https://pediatrics.aappublications.org/content/100/4/e1.long?utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=Pediatrics_TrendMD_0

April 9, 2019

Helping your teen to have a positive body image

A happy home environment can help your child to develop an internal sense of control and a positive sense of self that will equip them to avoid eating disorders. Teen body image refers to how adolescents perceive their bodies. It includes their feelings about their body and how they take care of it, and is an essential part of adolescent development. Teen body image is also closely linked to self-esteem, largely because society and the media place so much importance on the way we look. This focus on appearance contributes to teenage body image issues and teen eating disorders. “An important challenge faced by teenagers is internal versus external locus of control,” says Linda Swanepoel, therapeutic manager and occupational therapist at Akeso Montrose Manor. “This means the extent to which a person believes they have the power over events in their lives. A person with an internal locus of control believes that they can influence events and their outcomes, while someone with an external locus of control blames outside forces for everything and seeks external approval and validation to feel good about themselves.” A healthy, confident child will learn to have an internal locus of control, but if the child is raised in a household where there is instability and chaos, and at times a lack of safety, they may learn an external locus of control. “When a child is too young to have the resources to cope they soon learn that ‘if I can help mommy and daddy to feel better, I will feel better’. As they grow older, face more stress and carry the weight of expectations, their focus turns to pleasing or impressing others, rather than developing a sense of self.” Teenagers experience increased school and societal pressures at a time when significant changes are taking place in their bodies. Thus, if they have not learned to believe in their own resources to cope with life, their focus will be on what other people expect or think of them, rather than on how they feel about themselves. “Eventually, everything they choose to do in their lives is dependent on assumptions they make about how they will be perceived by others,” Swanepoel adds. “Body image plays an important role in this too.” Why body positivity is important “Teenagers tend to see the concept of a ’middle path’ as average and boring, and Western society reinforces this all or nothing thinking. This leads to beliefs like you must have the perfect body, you must go to university and you must make money,” Swanepoel says. “This is why body positivity is important,” Swanepoel explains. “If we can get our society to be more middle path thinkers, teenagers with an external locus of control may be able to be more realistic and accepting of themselves. With less stress and pressure, it is easier to listen to your own voice and develop your own sense of self.” Body image and weight risk factors Maintaining a weight lower than your natural set point, or trying to lose weight, immediately activates “all or nothing” thinking. It takes motivation, discipline and determination to restrict food intake, so teens develop strict rules and often the rewards are external (for example, praise from others). “If you break a rule you’ve set for yourself, you feel weak and like a failure, and believe you are a greedy person,” says Swanepoel. “Greed, indulgence and selfishness are bad words in Western society, and can lead to guilt. Once the rules are broken, at risk teens tend to go off the rails and binge on forbidden foods. This may lead to secret eating rituals, comfort eating and avoidance of life, which may in turn lead to obesity.” According to Maslow’s Hierarchy of Needs, people need to meet basic needs like food, sleep, water, health and safety before they can strive for self-esteem and self-actualisation. “People who diet are depriving themselves of these needs in a drive for self-actualisation,” Swanepoel says. “They compromise their health, their relationships and their goals and aspirations as they become preoccupied by food, exercise and weight, becoming prisoners to their own habits. They end up lonely, exhausted and feeling like a failure – and they hate their bodies no matter what size they are as perfection is unattainable. This is where depression, self-harm and suicide become possibilities.” Look out for these warning signs Loss or gain of weight or fluctuating weight – often from bulimia – are the most common symptoms of eating disorder among teenagers Increased exercise and keeping busy all the time, as fear of boredom may lead to binge urges Avoiding social situations, as they have too many secrets to keep and need to stay in control Rigid thinking and ‘all or nothing’ thinking – judgemental, critical and catastrophising Isolation Spending many hours on social media Spending time preparing food and baking for others, but not eating themselves Making excuses at meal times (I’m going to work in the library, I’ll get a take away lunch) Many demands at restaurants – food rules become important (I’m gluten/lactose intolerant, I’m a vegetarian/vegan. I’m banting. No carbs, no sauce and no salad dressing) Becoming angry and defensive when help is offered Wearing baggy clothes, usually in neutral colours – black, white, grey Spending time with people who are not matched to the teenager’s personality Depression, anxiety and obsessive compulsive disorder (OCD) symptoms. How can you help? Children need to feel safe so that they can focus on self rather than feeling responsible for others. Swanepoel points out that it’s important to avoid the ‘drama triangle’ – perpetrator, victim and rescuer. “This is when one parent complains to the child about the other parent. The child will feel the need to take sides and rescue, immediately starting the external locus of control cycle. This leads to low self-esteem, which can lead to body image problems, such as restricting (trying to be perfect) or binging (as a result of avoidance). Parents need to work as a team

April 5, 2019

Pre-authorisation and payment: Do you know the difference?

Medical aid members know that pre-authorisation ahead of a medical procedure is always required but does pre-authorisation mean it’s an agreement to pay in full? No, not necessarily. This is the cause of a great deal of confusion and unhappiness from medical aid members as well as doctors and hospitals. Gerhard Van Emmenis, Principal Officer of Bonitas Medical Funds says, ‘Pre-authorisation is required for all hospital admissions, including emergencies. However, it is not an agreement to pay all the costs and expenses in full.’ Why not? Let’s take you through the Ts and Cs. Why do they differ? Most medical aid plans have varying hospital benefits according the level of cover you have chosen. Van Emmenis says, ‘All of our plans provide hospital cover for major medical events when you or your dependant is admitted to hospital. But, each plan has different hospital benefits available. We encourage you to use the healthcare providers on our network and to get pre-authorisation for your hospital stay so the providers of your treatment or procedure are paid to the full extent of what your plan offers.’ Understanding your medical aid rate of payment‘ For example’, says Van Emmenis, ‘The Bonitas Rate is the rate at which we reimburse healthcare providers. Where we pay 100% of the Bonitas Rate, this is NOT necessarily what the healthcare provider charges. They may charge 200% of your medical aid rate which means you are responsible for half the payment. Each plan has a different rate according to the premium you pay. If you visit a healthcare provider that charges the Bonitas Rate, we will pay the bill in full (provided that you have benefits available). For this reason it is important to use designated service providers with whom Bonitas has negotiated rates.’ How much will your plan cover? If it is not an emergency the best way to find out how much your medical aid will cover is by asking the hospital and medical practitioners for a detailed quote. Submit this to your medical aid to check what they will cover and how much the shortfall, if there is one, will be. Co-payments The shortfall will be in the form of a co-payment. These co-payments differ from one medical aid scheme to another, and are often higher than anticipated, mostly due to medical practitioners and hospital charging higher than the medical aid rate. Minding the gap When there is this shortfall between what the medical scheme pays and what the hospital or specialist charges, it helps if you have taken out gap cover. Even if you have a top of the range medical aid plan, it doesn’t mean there will not be ‘gaps’ between the tariffs your scheme is prepared to pay and the amount your specialist charges. GAP cover is not a medical aid product but an insurance policy taken out to reduce or eliminate co-payments. Again the amount you receive depends on your GAP policy It is important to note that Gap Cover is an insurance ‘policy’ and is regulated under the Long and Short Term Insurance Act (1998). Medical schemes, on the other hand, are overseen by the Council for Medical Schemes Act (1998) and are not for profit. Ensuring you are covered 1. Make sure you get a quote. Medical aid members are advised to not only obtain pre-authorisation but a quote from the hospital and medical practitioners prior to being admitted to hospital (if it’s not an emergency). Submit this to your medical aid to find out if there are any co-payments and if so, how much they are. 2. Find a hospital on your medical fund’s preferred network in order to ensure maximum payment 3. Make sure you fill in provide all information required for pre-authorisation correctly: Have your correct membership number and the details of the member who the request is for The date you are going into hospital and the date of the treatment or procedure The name of the doctor who will be treating the member, their telephone number and practice number The name of the hospital where you will receive treatment, their telephone number and practice number The relevant procedure and diagnosis (ICD-10) codes for the treatment (ask your doctor for these) If your request for authorisation does not include all the information listed above, your request will not be approved. If your pre-authorisation is declined the reasons for doing so will be listed on the correspondence. If it is approved, you will receive a pre-authorisation number and this will also outline the approved length of your hospital stay and the status of all codes. However remember the pre-authorisation is not a commitment to pay the full amount. 4. Gap cover If you have Gap Cover, notify them of the co-payment required prior to being admitted to hospital as there are limits to the amount they will pay. What about emergencies? Emergencies must be pre-authorised within 48 hours of going into hospital or on the first working day after a weekend or public holiday. If you don’t get pre-authorisation, your account won’t be paid by the Scheme. ‘The most important thing’, says Van Emmenis, ‘is to find out, prior to being admitted, what your medical aid will pay and what payment you are responsible for. It will save a great deal of stress when you are recovering from surgery.’

April 5, 2019

Top Choking Hazards For Babies and Toddlers

We recently went to a very popular restaurant for lunch and to my astonishment there were vending machines with gumballs and other small toys, right next to the jungle gym. This is a disaster waiting to happen! Children under 3 are at the highest risk of choking because their airways are so small. Plus, chewing and swallowing is a lot more difficult for them. They also love to put foreign objects in their mouths. There is a cylindrical tool in the US used to measure toy parts that is the same size as a young child’s throat. If a toy part fits into this cylinder it’s a choking hazard and a warning label has to appear on the toy packaging. Therefore any object smaller than 3 cm wide is a choking hazard for small children. WHAT IS A CHOKING HAZARD? Any object that can get caught in a child’s throat and block the airway is a choking hazard. TOP 10 HOUSEHOLD CHOKING HAZARDS Once your baby starts to crawl and explore, choking hazards are all of a sudden everywhere. Coins Small caps of bottles e.g. juice and water bottles Small round batteries Jewellery Buttons Toys and toy parts Balloons (uninflated or popped) Garden pebbles Nails and screws Stationary e.g. staples, paper clips and pen lids If you have older kids too, you should keep their toys separate and make sure they learn to pack their toys away. There are countless more choking hazards. You should probably get down on your knees and have a look at your child’s eye level. How many more choking hazards can you find? TOP 10 FOOD CHOKING HAZARDS Hotdogs, grapes and popcorn are the top 3 causes of choking in children under the age of 3. Young children have a hard time chewing their food since they lack the proper dentition (canines for tearing and molars for grinding). They are still trying to coordinate chewing, and as a result, often just swallow their food whole. This makes smooth, slippery, round and hard foods especially dangerous. The foods in the list below are not recommended for children under 4 years of age. The American Academy of Pediatrics (AAP) goes even further and recommends that hotdogs, grapes and popcorn not be given to children until they are at least 5 years old. If you do however want to give your children some of these foods, then cut them in such a way that you change their round shape. Hotdogs should be cut lengthwise before slicing and skins of other sausages removed. Grapes and other round fruit should be cut into quarters. Whole grapes, cherry tomatoes and other round balls of fruit (blueberries are ok for toddlers as they are soft to chew) Hot dogs and other sausages Popcorn Tough, large pieces of meat Fruit pips and stones Nuts and seeds Hard round sweets and caramels Raw vegetables, especially carrots Marshmallows Chewing gum BE CAREFUL Children can trip and choke more easily if playing and eating at the same time. Your child should not walk, run or lie down while eating. Children should not be distracted whilst eating. They must sit upright and concentrate on what they are doing. It is also not advisable to have your young child eat in their car seat whilst you’re driving. You might not even notice if they’re choking. You should always supervise your child when they are eating. It’s important that all parents and caregivers learn first aid for choking and CPR. There are many training academies that offer such courses around the country that are usually done over one day and will make you feel more confident when dealing with childhood emergencies. RESOURCES Altkorn, R. et al. (2008) Fatal and non-fatal food injuries among children (aged 0–14 years). International Journal of Pediatric Otorhinolaryngology, [online] 72 pp. 1041—1046. Available from: https://www.sciencedirect.com/science/article/pii/S0165587608001298[Accessed 24 October 2018]. CDC (2018) Choking Hazards [online]. Available from: https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html [Accessed 24 October 2018].

April 4, 2019

Are headphones damaging your hearing

If it’s too loud, you’re too old? No, more like too sensible… Headphones and earphones are the accessory of our times. They are affixed to our ears to deliver music or podcasts, to conduct telephone calls, to accompany a workout routine, or to drown out the conversation of colleagues in open-plan offices. But is all this in-ear noise safe? The answer, unfortunately, is “not really”, but you can take steps to prevent or reduce the harm of being plugged in all day. According to the World Health Organisation (WHO), up to 1.1 billion teenagers worldwide are at risk of hearing loss from unsafe use of personal audio devices, including smartphones, and exposure to damaging levels of sound at noisy entertainment venues. Of course, it’s not just teenagers who are at risk – anyone who is exposed to harmful noise levels can suffer the same hearing damage. The WHO points out that hearing loss has potentially devastating consequences for physical and mental health, education and employment. How headphones damage your hearing Sound waves travel into your ears and cause the eardrum to vibrate. This vibration is then transmitted to the inner ear via several small bones. In the inner ear, the vibrations reach the cochlea, a fluid-filled chamber that has thousands of small hairs that are moved by the vibrations. It is the movement of these hairs that enables us to hear sound. If you listen to loud sounds, the hairs move more, and if you listen to loud sounds for too long, the hairs can lose their sensitivity to vibration, or become damaged. While it is possible for the hairs to recover over time from a single instance of loud noise, repeatedly listening to sounds that are too loud and for too long can result in permanent damage and hearing loss. Preventing damage To avoid headphone-related hearing damage, the WHO strongly recommends the following: Restrict the daily use of personal audio devices to less than one hour. Limit the time spent on noisy activities by taking short listening breaks (a time when you listen to nothing). Audiologists also recommend: Turn down the volume. If you are listening through headphones and you can’t hear any of the noise around you, then your volume is too loud and is damaging your ears. Use over-the-ear headphones rather than in-ear earphones, as they increase the distance between the source of the noise and your eardrums, reducing the chance of damage. Even better, if you are listening at home or in the car, play your music or other media over a speaker, at moderate volume. If you are planning to be in a loud-noise environment, take a headphone break for most of the day so that your ears haven’t already been damaged by sound. How do I know if there’s hearing damage? If you experience any of the warning signs of hearing loss, visit a doctor or audiologist immediately, and get regular hearing check-ups so that if hearing is being lost, action can be taken. The signs of hearing loss include: the muffling of some sounds, difficulty understanding words especially when there is background noise, trouble hearing consonants, increasingly asking people to repeat themselves, needing to turn up the volume on the television, radio or device, withdrawing from conversations, or avoiding social situations. Safeguard your hearing While listening to music at loud volumes may be cool and fun and being permanently plugged into a set of phones is just the way life is, a permanent loss of hearing can affect your quality of life forever. Rather take the steps to prevent hearing damage and enjoy existing in a hearing world for as long as possible. How long to listen It’s not just volume but time spent listening to sound that is damaging to your ears. Here is a useful guide to how long you can listen to noises at certain volumes: By 1Life

April 3, 2019

SPECIAL NEEDS OR NEEDING SOMETHING SPECIAL

My children simply did not fit into the mainstream schooling system. They’re both very bright and along with that come some eccentricities that often get labelled as problems within a very structured environment where children are expected to be alike, fit within the system and not stand out or cause waves. My ten year old once explained it like this: “I’m like a puzzle piece that’s been put in the wrong box… I don’t fit anywhere. There’s no place for me.” That’s quite a tough feeling for a small child to bear. And it isn’t that there’s something wrong with her, although within that system that was exactly the message she was getting. There are many children struggling in school who don’t need to be placed in remedial classes. They need something special, but they’re not exactly special needs. They would thrive in a different environment but not that one. I have nothing against remedial education. It is fantastic in the right circumstances. But a child who is simply in the wrong place and is then moved to a remedial class where there are really special needs kids can look around and label themselves. They end up thinking there is something wrong with them. These kids will generally fly if homeschooled or placed in a good cottage school or Montessori or within the Cambridge system where they have the freedom to work at their own pace and fill in the gaps they missed by being in the wrong environment. For some, the box is simply too small to contain them. For others, it’s the noise levels. Some children are visual or kinesthetic learners and don’t respond to lectures. Most children don’t learn at the predetermined pace of the SA education system. Every child is unique – the exact reason that standardized education is failing. Nobody is standard. The trouble is if kids keep being pushed to move onto the next thing without mastering the previous stage then they end up with huge gaps in their foundational knowledge which will cause the whole structure to come crashing down at some point. That’s the point they pick up the label. Or if they learn faster than the system they get bored and restless and get labelled as ADHD or ODD (Oppositional Defiant that is, not odd – although they can be labelled as odd too!) If there is a problem with learning don’t necessarily assume that the problem is with your child. It might be. But it might not. And you are their advocate until they can stand up for themselves. You need to question and explore alternatives and not necessarily take the word of those in educational authority as fact. Only a few children really thrive within the schooling system. Most do not. Your child may genuinely be a special needs child – with Autism or dyslexia or serious processing difficulties and for these children the special needs schools and classrooms can make a huge difference to their ability to learn and develop with the appropriate assistance. But if your child is simply in need of something special – a smaller class, a more nurturing environment, a faster or slower pace, or a different style of teaching – then you need to look beyond the special needs class to any of the amazing alternatives that exist. Every child deserves to feel that there is a puzzle that they will fit in to!

March 28, 2019

MIGHT MY CHILD HAVE ADHD?

If you are wondering about the answer to this question, then it’s most likely that your child is in preschool and not primary school because by the time children are in a more formal school setting with all the demands of sitting at a desk, having a school structure etc., issues of ADHD have already started to present themselves or been diagnosed. Nearly all preschool-aged children display the core behaviours or symptoms of ADHD – inattention, distractibility, impulsivity and hyperactivity – as part of their normal development. However, as other children gradually begin to grow out of such behaviours, children with ADHD do not and this difference becomes clearer the older the child gets. So, when looking at the preschool child (three/four-year-olds), it’s easy for parents to feel confused about whether their child’s pattern of activity and behaviour is typical or whether it’s atypical. The signs and symptoms of ADHD are the same for preschoolers as they are for older children with ADHD – struggling to pay attention, getting bored and distracted quickly, being fidgety, restless or very active, having difficulty waiting and taking their turn, and engaging in risk-taking behaviour. The difference for ADHD is the degree of the symptoms. The key is to discover whether the child’s behaviour is developmentally age appropriate or not. For instance, one parent observed her child in free play at the end of the school day. She noted that her son ran around wildly and didn’t listen to the teacher’s instructions to “play safe”; when the other children were settling down after activities her son couldn’t and seemed to get more hyped up; when other children were listening to a story being read, her son was rolling around and playing with toys. Although diagnostically children with ADHD may be diagnosed as young as four years old, usually from teacher reports, assessment on the Conners Comprehensive Behavior Rating Scales™, and collateral evidence from parents, the following questions may help a parent to develop some answers. Is the behaviour I observe in my child similar to that of other children he encounters; is the behaviour I expect of my child developmentally appropriate for his/her age, do I see a pattern of behaviour when my child engages in various activities, do I see a pattern of behaviour in various settings? To be diagnosed with ADHD, a child must have a specified number of symptoms for at least six months that occur in more than one area of life, e.g. at home AND at school. However, diagnosed or not, until the age of five, medication cannot be prescribed. The best treatment plan is behavioural therapy/play therapy for the child as well as parent training to help parents understand ADHD and best manage the ADHD child so that they can function optimally at home and at school. Lorian Phillips is a clinical psychologist and has been in private practice for the last 21 years. She also parents two ADD/ADHD sons and due to her challenges with her boys, she was motivated to find more constructive ways of dealing with them. This led to her parenting her boys differently and when she saw the results of her alternative parenting style, she developed a parenting course for parents of ADD/ADHD children. The successful course has been running for the past six years. In addition, Lorian also consults with parents in her private practice to offer guidance and support in working with ADHD children. She has spoken at various schools to help teachers manage the ADHD child in the classroom and has given many talks on parenting the ADHD child including an appearance on 5FM’s Weekend Play Date where she spoke about ADHD management. You can read her parenting blog called ADHD Parenting on her Facebook page. Lorian Phillipa writes for Impaq. Impaq provides innovative and accessible education solutions.

March 27, 2019

LETTING GO OF THE PURSUIT OF HAPPINESS

Behind most things that we want, at the core of what we think we are looking for, is this one elusive word, “happiness”. We want to be happy, we want our kids to be happy, we want to be happy in our careers, we want to have happy families. Have we ever stopped to ask ourselves what happiness actually is? Do we even know what we’re asking for? And if we did, would we still want it? In order to understand happiness, we have to start by looking at the raw experience of emotion. The next time you feel any emotion, close your eyes and observe it. Imagine that you could remove the label from it and just see it in its raw state as a baby might experience it. What you’ll notice when you close your eyes is that you are instantly transported into a never-ending internal space and emotion is something that arises within this space. All that emotion is, is a movement of energy in this vast space. It may feel fast or slow, smooth or prickly, quiet or loud, distant or in-your-face. It may move upwards or downwards, be constricting or expansive, it may even have a shape or a colour. When you begin to observe your internal world, you’ll see that all emotions are simply movements of energy in this inner space, each one with a different movement, frequency or intensity. There is nothing in this movement that tells you that this is happiness or anger or sadness or boredom or excitement or anxiety or peace. There is nothing in the movement of energy that tells you that this is a ‘bad’ or a ‘good’ emotion. Each one is simply a different movement of energy once you view it without the label that you have applied to it. In fact, if you watch carefully you’ll see that without the label, it is very difficult to distinguish between boredom and peace, or between excitement and anxiety. The difference between a ‘bad’ and a ‘good’ emotion lies in the label and in the story that our minds attach to the experience. So, knowing this, then what is happiness? It is simply one movement of energy in inner space. We may experience it as smooth, quiet energy, but there is nothing in that movement that makes it better energy than one that is loud and spiky or one that is fast and expansive. What we’re saying when we say we want to always be happy is that we only want to experience one movement of energy for the rest of our lives. Like only watching one movie for the rest of your life, or listening to one song, or eating one type of food, or hanging out with only one friend. Is that really what you want? We have a variety of emotions to make life interesting, diverse, fun. There is a richness to our experience as humans because of our range of emotional energies, not in spite of them. What most people call happiness I call flatlining. What I believe we are all really looking for is fulfilment – that state of pursuing something so meaningful to you that you enjoy both the ups and downs, the highs and lows; the full range of emotional expression. That is a life worth living, that is a career worth pursuing, that is a family goal worth having, and that is what we need to be teaching our kids. Let go of the pursuit of happiness. Pursue your dreams and enjoy the roller coaster of an experience that comes with that pursuit!

March 26, 2019

Don’t Be Scared, Be Prepared

Oneaid focuses on preventing and reducing the risk of childhood injuries. Through blog posts and social media Oneaid offers you, as parents and caregivers, useful information and helpful tips on how to keep your little ones healthy and safe. OneAid by Dr Carmen Becoming a parent is one of the most challenging and liberating experiences anyone can go through. There is no amount of research, childcare books or magazines that will prepare you for parenthood. For most parents keeping their little ones safe and making sure they have few accidents as possible can be extremely stressful. It was, for this reason, Dr Carmen – mother and Doctor – created OneAid. Dr Carmen is a medical doctor with over 10 years experience in accident and emergency medicine, and is also a mom to a beautiful, baby girl. She has a Masters degree in Public Health and is passionate about disease prevention and health education. Social Media In Healthcare Almost 90% of adults have used social media to look for and share health information. Dr Carmen believes that healthcare needs to go digital and more healthcare professionals should be taking advantage of its broad reach. Social media can be an effective tool to get information to the public and promote health and safety. OneAid creates engaging fun content on social media to provide information and tips relating to various public health issues in an effort to spark up conversations to drive behaviour change and education. For a little daily advice on childhood safety issues readers can also subscribe to the OneAid newsletter. The MiniKit by Dr Carmen Cuts, scrapes and burns are common injuries to expect as our little ones gain more confidence in this world. Having a first aid kit on hand can help reduce the risk of infection or the severity of the injury. It also teaches our kids the right thing to do when they hurt themselves. Dr Carmen has designed and developed the MiniKit, a mini first aid kit geared towards common childhood injuries. This is available in two colours – red and yellow and includes first aid essentials such as plasters, burn gels, dressings and more. Plus, the MiniKit’s small size makes it fit perfectly into any nappy or handbag, so parents are always prepared, even on the go. Through its fun and colourful design, Dr Carmen hopes to get little ones engaged and involved in the first aid experience. But that’s not all. Inside each MiniKit you will find a detailed first aid pocket guide that features simple, easy to follow steps on what to do when your child has had a minor accident or fall. By following the guide’s steps, parents can take the necessary action when dealing with broken bones or burns for example, and will now know which medical materials to use. Ordering Your MiniKit Whether you are buying the MiniKit for yourself or as a baby shower gift, it’s really easy to order. All you need to do is visit the OneAid website on www.oneaid.co.za and browse through the products page. Add your products to your cart and checkout when you are done. There is no need to open up any accounts. You can also purchase the pocket guide, which can be downloaded straight onto your phone. If you buy the MiniKit this download will be available to you for free. “Accidents are just that, they happen unintentionally and unexpectedly. With the right information, we can try and reduce the incidence of these accidents.” – Dr Carmen

March 22, 2019

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