Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

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

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

March 4, 2021

New Head of Operations for Bonitas

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

February 26, 2021

The low down on Covid-19 test protocols

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

February 12, 2021

Pregnancy and Medical Aid

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

February 3, 2021

What vitamins and minerals are needed during pregnancy

As an expecting mom you’ll want to do your best to make sure that your baby is as healthy as possible. What you eat is critical during this time, as everything your baby needs comes from you. Prenatal vitamins are supplements which can be taken during pregnancy which contain needed vitamins and minerals. What vitamins and minerals are essential and why? During pregnancy your vitamin and mineral needs will change as you now have a growing baby to provide for. Your food should contain much of the vitamins and minerals needed during pregnancy, particularly if you are already following a healthy, balanced diet. Folic acid and iron are typically found in most prenatal vitamins and are essential in a healthy pregnancy. Folic acids helps to prevent neural tube defects and iron supports healthy growth, helping prevent anemia and blood (in both mom and baby) carry oxygen Vitamin D, calcium and iodine are other important nutrients that are needed during pregnancy. Vitamin D aids in the development of the bones, teeth and nervous system, calcium helps bone and teeth development and iodine is important in brain development. Getting the correct micronutrients is important. Deficiencies can lead to complications such as hypertension and a low birth weight. However, it’s also important not to exceed the healthy amount of certain vitamins and minerals – too much vitamin A, for example, can cause birth defects. What foods should I be eating? Prenatal vitamins are a good idea to cover any nutritional gaps you may have, while they may supplement your diet they don’t replace a healthy lifestyle. Therefore, eating correctly also greatly benefits you and your growing baby. Foods you should try include in your diet are dairy products, such as milk and yogurt, as they contain extra protein and calcium, as well as probiotics. Legumes, such as lentils and soybeans are another good food to include – these contain protein, fibre and folate (which is very important during pregnancy). Sweet potatoes, high in vitamin A and fibre, are another good veggie to add to the shopping list. Eggs, broccoli, lean meat and berries are other wholesome foods you should be including in your diet. A healthy pregnancy benefits both you and your baby in the long run, not only does it ensure that you deliver a healthy baby, but helps your child throughout adulthood development.

January 4, 2021

Working and pregnancy – when to stop and how much is enough

As an expecting mom with a career you may be wondering when the best time would be to stop working and how you can stay comfy and productive when you are still in the workplace. Morning sickness, back pain, frequent bathroom breaks and other pregnancy related symptoms can make working as you used to a more challenging task for you. It’s important that you calculate the risks that your job could possibly have to you and your baby. For instance if you are working with chemicals, heavy metals or radiation you’ll need to either stop working or take extra precautions. Heavy lifting or labour intensive jobs and lots of travel for work are also jobs that’ll become more difficult as your pregnancy progresses. Desk work and computer work are generally regarded as safe, whereas jobs that require lots of standing will become more difficult in later pregnancy. Dealing with work and pregnancy Working can be stressful without having a growing baby in your belly. The physical and emotional changes that you experience can make meeting your body’s and workplaces’s demands a challenging task. However, some moms with healthy pregnancies are able to work almost until they go into labour, how much you can do will depend on your pregnancy. Morning sickness is something many moms have to deal with. There are ways you can help manage nausea at work. Avoiding dining areas, packing mouthwash and a toothbrush and packing in soothing lemon and ginger are all things you can do to make yourself more comfortable. Eating and drinking little and often can also help keep the nausea at bay. Be sure to dress comfortably, and try to take frequent breaks and walks, as this’ll also help you stay more comfortable. What rights am I entitled to as an expecting mom in South Africa? As a pregnant employee, you are probably wondering what rights you’re entitled to. It is a good idea to inform your employee as soon as you can, so that your employer can manage the situation as best as they can (for both of you) – they are required by law to maintain a work environment that is safe for their employees. As an expecting mom, you will be glad to hear that you’re well protected under South African law – you may not be discriminated against or dismissed due to your pregnancy. You also have the right to four consecutive months unpaid maternity leave, anytime from four weeks before your expected birth date. Unfortunately employees are not obligated to pay you during this period, however, your job will be kept open for you until your return to work after maternity leave.

December 21, 2020

Advice from the experts

The value of sports and exercise

“Children should be playing and moving outdoors instead of sitting indoors” Says Elzanne Van Der Walt, Sports Scientist and Clamber Club Sports franchise owner. Skills learned through playing and sporting activities can contribute to the educational development of children, help children to develop physically, and can shape them to be better human beings. In this article, Elzanne gives us some valuable information and tips on the benefits of sporting for children.” “Sport can affect the development of a child’s self esteem and self-worth.” Dr Glyn Roberts What can sporting activities do for my child? Teach key values– Participating on the playground and sports field teaches values: Honesty – through fair play and sticking to the rules of the game. Teamwork – through interaction with others, kids learn to play and work together. Respect – for yourself, others and equipment used during the games. Ability to follow rules – to listen to someone other than a parent or teacher, and to abide by the rules for the good of the team. Punctuality – being early, and ready to start when the team does. Controlling emotions – sporting games and activities can often lead to strong emotions, such as disappointment, frustration, exhilaration etc. Part of sports is learning how to control your temper and other emotions so that you can participate effectively and in the spirit of good sportsmanship. Build strong healthy bodies – Sporting activities and exercise can: Immune system– getting enough exercise strengthens the immune system, which fights infections= Heart– improves oxygen supply to the heart muscles and makes the heart more effective. Posture– improves agility, flexibility and overall posture. Lungs– strengthens the muscles used for breathing, making breathing more efficient and increasing lung capacity. Bones– increases the bone density, making them stronger and less likely to break. Sleep– improves sleep and reduces anxiety. Concentration– increased oxygen to the brain helps to improve concentration. Develop gross motor skills: Body awareness Balance Eye hand and eye foot coordination Coordination of body sides and crossing the body midline Balls skills such as catching, throwing, and kicking Elzanne’s top SPORTING tips: Keep your children physically active– The more active kids are, the higher their skills level will be, the more valuable they will feel, and the more motivated they will be to develop new skills and take on bigger challenges. Learn broad sporting skills when young– A preschooler needs to be learning basic techniques and generalized sporting skills, and not those of a specialized sport. If young children have a broader spectrum of sport skills in general it is much easier for them to decide what sports they favor and to see what they are best at. Then at a later stage (when they are a bit older) they can specialize in whatever they are best at or like the most. Allow for competitionin the older child and learn to lose with grace – Learning to deal with competition is a huge advantage for a child in terms of life skills, and is learnt from participating in competitive sporting games. This is also healthy, but it must be presented and taught the right way. Learning to cope with winning and losing is important. Reduce stress and anxiety– Not all children can cope with stress. Sports is known to be one of the best de-stressors for a child. When we are physically active our body releases serotonin which directly contributes to our feelings of well-being. Develop muscle memory from a young age – Sporting activities require fast reflexes and skilled movements that have been practiced over and over in many different ways. If this muscle memory is there from a young age, the child feels stronger, more confident and relaxed. This improves their self-esteem and sporting ability. “Sports is the best medicine for any child’s body, mind and development” Elzanne Van Der Walt.

July 4, 2018

Another antibiotic winter looms unless decisive action is taken

The traditional approach to education must be revolutionised in order to ensure the best outcomes for the current generation of school children, who are increasingly being called Generation Alpha, and whose world differs materially from the world in which their Millennial parents grew up, an education expert says. “Generation Alpha represents those children who were born after 2010, who are now at the beginning stages of their school careers,” says Jenny Coetzee, career educator and founding member of the ADvTECH Group’s prestigious Crawford School La Lucia. Coetzee, currently MD of the soon to be opened Crawford International School in Kenya, has in the course of her decades-long career forged an exceptional reputation as a visionary pioneer and leader in the education space. She says each generation – whether they be Generation X, Y or Z – grew up in a world different to that of their parents and the generations before them. Just as each of these generations were exposed to unique circumstances, challenges and opportunities, so are the newest generation, whose labelling as Generation Alpha is fast gaining traction. “These children are the most connected, educated and sophisticated generation ever, so when educating, a school should provide an environment that enhances learning for these digital integrators,” she says. “These children live in an open-book environment – just a few clicks away from any information, they connect in a borderless world – across countries and cultures, and they communicate in a post-literate community where texts and tweets are brief, and where visuals and videos have the greatest impact.” She says schools should be putting special emphasis on developing critical thinking and problem-solving skills, so that students are equipped to see problems from different angles and formulate their own solutions. “Regardless of the field they choose to enter for their careers, the ability to think, be creative and act quickly is an indispensable tool for the future, particularly in view of increasing automation and the expectation of the workplace of the future, as identified by the World Economic Forum. “It goes without saying that technology must be embraced in today’s schools, but what is of crucial importance, is that it is effectively used to enhance pedagogy and improve learning. In order to achieve this, schools must be equipped with high speed internet and embrace the value of social platforms.” Students must also be exposed to new technologies, such as 3D printing, drones and robotics, and schools should articulate the possibilities these new technologies create. They must also expose students to new fields such as user experience design, and the latest schools of thinking such as design thinking modelsas a scaffold for project work. “Just like Generation Z before them, schools looking after Generation Alpha must cultivate the spirit of entrepreneurship. Entrepreneurial thinking and leadership are imperative and entrepreneurship courses must form part of the curriculum where collaboration between subject disciplines is encouraged.” Coetzee says it is imperative that schools nurture a global outlook, and that students are able to benefit from strong networks formed with international education bodies. And teachers must be trained in the latest strategies and teaching techniques. “Children come to us naturally curious about their world and wanting to explore it. Their imaginations are vast and untamed, creating endless amounts of practical and impractical things. As teachers we need to continue to nurture them to develop their curiosity and imagination, as well as teach them how to apply them creatively and purposefully using technology as a tool. “We may not know exactly what lies ahead for our students in the future, but we know what skills and tools they will need once they get there: to think critically, to work as a team, but most of all to be curious and excited about learning in this world that is so different from the world in which we were raised.”

July 3, 2018

Pregnancy: Taking care of your nutritional and financial needs

By 1Life You’ve finally taken steps to confirm the reason behind your weird cravings, unexpected emotional outbursts, the fatigue as well as all the other unusual things that have been happening to your body of late and so begins the journey towards motherhood. One moment you only had yourself to worry about, and now you’re making way for the new bundle of joy that’s growing inside of you. When you are expecting, taking care of your nutritional needs goes well beyond ‘eating for two’. Instead, there are certain nutrients that your body needs during this journey, to ensure your baby is healthy and that you keep yourself in excellent condition as well. Maryke Gallagher, a registered dietician in Cape Town and President of the Association of Diabetics in South Africa, states that from a nutritional point of view, the first 1000 days are the most important. This includes the time the baby spends in the womb, where the first 1000 days are said to set the stage for healthy brain development, growth and appropriate weight gain and building a strong immune system. Having a healthy nutritional plan is therefore vital and can also assist with protecting against chronic diseases like diabetes, heart disease and high blood pressure later in life. As a result, what you put in your body during this period is extremely important. Some crucial nutritional needs include: Energy needs: These increase in the second and third trimester, but this does not mean you should eat for two. It means increasing the energy intake by 800-200kj per day, the equivalent of a small meal snack, like yoghurt, fruit and nuts, or a slice of rye bread with nut butter and a fruit. Protein needs increase: Focus on eating more safe proteins, at least twice per week. Options that are generally considered safe include trout, salmon, herring, pilchards and mackerel. Plant proteins are mostly incomplete proteins. This means that legumes like lentils, chickpeas and butterbeans need to be combined with grains such as brown rice, quinoa or barley to form complete proteins. Soya beans and tofu are some of the only complete plant proteins. It is generally believed that it is safe to be vegetarian while you are pregnant if you plan carefully to eat sufficient proteins that meet the body’s demands. Omega 3 Fatty Acids: These essential fats are important in pregnancy for healthy brain development in the baby. Fish is one such example of a good source of Omega 3 fatty acids, which you should consider before taking supplements to ensure that you are meeting your daily requirements. These type of vitamins reduce the risk of preterm birth and play a role in the visual acuity of the baby. Later in life, they play a role in the IQ and behaviour of the child. They also play a role in regulating the mood of the mother. Total fat intake: Every cell in the body is made up of fats, and cell membranes consist of phospholipids that influence how well cells communicate with each other within the body. Plant fats are particularly valuable and include nuts, seeds, avocado, olives, olive oil, and flaxseed oil. Micronutrients: These are essential vitamins, minerals and phytochemicals. During pregnancy, the important ones are Folic Acid, Iron, Calcium, Vitamin D, B12 and Choline. Choline plays a role in the first trimester development of the baby, in particular the brain development and formation of neural pathways. Choline is found in animal-protein-rich foods such as eggs and beef. Haricot beans, soya protein, pulses and dairy products (like milk and yoghurt) are good sources of Choline. Folic acid is found in fruits and vegetables such as leafy dark green vegetables, liver, legumes and fortified cereals. The above is all important to keep in mind. However, your nutritional needs are in fact only one of very many aspects that you will need to consider as an expecting mom. As you enter this new life stage, your financial needs are also set to change and you will then need to start asking yourself questions about your financial plan. Things like, can you provide for the wellbeing and financial security of your child, the schools you want them to attend and if you are saving enough towards their future education. Safeguarding your assets is also an important consideration, which ensures that these will go to your child in your absence. These are the first of many aspects related to your financial planning that you will need to consider as you enter this new chapter. When starting your pre–birth financial planning, do a financial needs analysis to determine what your future financial plan should look like. Then ask yourself if your current long-term insurance provider can adjust your cover to cater for your growing family and financial needs. If they are unable to, look for a provider who can – and one who will become your partner in providing financial assurance as your family grows.

June 27, 2018

Why is my child not walking?

Many parents spend the first year of their child’s life focusing on motor milestones, and are hugely relieved when their baby starts to sit, crawl and walk. The variety of baby and toddler classes and other activities on offer lead to a lot of opportunities for comparison of their child in relation to others. This often leads to parents asking themselves “why is my child not walking yet?” “There are a few reasons why a child may not be walking at around a year,” says Paediatric Physiotherapist and Clamber Club Expert Nicole Hilburn. “The first thing to consider is when the baby started to sit, and crawl, as late sitters and crawlers will most likely walk late as well. From the start of sitting, a baby usually takes 3 – 4 months to start crawling, and another 3 months or so from crawling to walking,” adds Nicole. Babies with significant birth histories such as low birth weight, prematurity, hospital admissions or prolonged bouts of illness are more likely to be delayed due to decreased muscle strength, or imbalances between muscle groups. What factors prevent your child from walking? “An increasing number of babies are presenting with a condition called torticollis – which is where one of the muscles in the neck is tight due to position in utero, or often due to positioning postnatally in premature infants who have been in the intensive care unit for a while,” explains Nicole. Untreated, this condition leads to decreased use and stiffness of the arm and leg on the same side as the tight muscle in the neck, and may interfere with development. This condition may be present when a baby holds his head slightly to one side, and prefers looking to one side; or cannot look all the way to one side. Babies who use alternative methods of crawling such as bottom shuffling will not develop the core stability and pelvic girdle stability to support them in standing and walking, which will delay the onset of walking. These babies will also struggle to pull up to stand from the floor, due to being on their bottoms and struggling with kneeling. There are a few reasons for bum shuffling – the main reason we usually find that baby’s bum shuffle is due to resistance to tummy time – this leads to weak back muscles, weak arms, and the baby never really experimenting with pushing up off the ground. Excessive use of equipment such as seating devices, and walking rings may lead to walking delays. This is because the child is fully supported in these devices and is not using muscles or engaging postural control while in them. A baby’s temperament also contributes to how quickly he or she will start moving. A very easy-going baby may take longer than a very busy baby. A baby with sensory issues, or who is happy being stable will also take longer to walk, as gaining balance on two legs is much more difficult than being stable on all fours, and these babies may find this frightening. How can you ensure that your baby is on track to walk? Lots of floor play between the ages of 1 and 6 months – on the back and the tummy, which will strengthen the trunk muscles. If a baby looks like he/she is not going to crawl or is using an alternative method to move such as rolling or bottom shuffling, this should be corrected by a physiotherapist, in order to build up appropriate muscle strength in the trunk, shoulder girdle and pelvic girdle. Torticollis should be treated by a physiotherapist. Once a baby is pulling up to stand and cruising, the following tips can be used to promote walking: Use a wooden wagon to push around Play in the standing position at flat surfaces such as a fridge (e.g. playing with magnets) Encourage play while standing, and give your baby something in each hand, which will encourage standing without holding on Walking with your baby while holding his hands You can also use a hula-hoop if he tends to pull down on your hands a lot – you hold one side and walk backwards and your baby holds the other side – this will give less support, and encourage him to engage his muscles more.

June 20, 2018

Why play should be a priority in children’s development

Play is not just fun but also significant for a child’s development. It is fundamental for healthy brain development and is the way that children learn about their world. Play provides the opportunity to explore the world, learn cause and effect and derive meaning form experiences. There are many forms of play which fall within the structured or free play categories. There are 4 general types of play that we will explore, namely: physical, object, rules, and pretend play. Physical play uses the entire body. It develops and strengthens both gross and fine motor skills and keeps children active. This is often explored as free play. Climbing trees, running, pushing and pulling. It also offers social and emotional benefits as children learn to engage with others. Object play refers to the use of toys or any objects that can be used to engage play. This is great for the senses as well as creativity and problem solving. As a child learns to manipulate objects to cause a specific reaction. For instance tying a rope to a bucket and having to pull it. Games with rules such as, board games or team sports, help develop social skills as well as, language and communication skills. This is because they need to learn and communicate turn taking, sharing and empathy. Pretend play aids in a child’s understanding of the world around them. It gives them a chance to let their imagination run free. This could be in the form of acting out real-life situations or by making something up that is weird and wonderful. This is a necessary tool to use in regulation of emotions. This helps children to learn empathy as they get to play a different role than themselves. All these types of play work together to ensure that children learn and develop the physical, social and emotional skills needed for grown up life. Skidz includes all these types of play in each Clever Activity Box. The aim is to give parents the tools and resources needed to spend quality time with their kids. This time spent together is pivotal in teaching them how the world works. It helps their physical development as well as their social and emotional development. Everything a child learns is taught through play and this is what we focus on. Each Clever Activity Box comes with over 100 activities in to do at home. It also includes a fun filled curriculum for each day of the week. The ages range from birth up to 5 years. To get your Clever Activity Box and to spend quality time with your child is as easy as visiting our website www.skidz.co.za. For some more awesome and fun ideas you can also like our facebook page at www.facebook.com/skidzsa

June 18, 2018

Hay fever headaches

A change in season also brings a change in the pollen types that are in the air and these trigger headaches directly or cause hay-fever with headaches. Sinus congestion and pressure is a secondary condition, which has also been known to trigger headaches. Dr Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery, explains “Usually hay fever is associated with spring, when airborne pollens from grasses are at their peak. October and November are peak allergy months in Cape Town, and with the Western Cape now consistently recording pollen counts of over 30 – considered extremely high – allergic people should be sure to seek help soon because there is still a long time to go.” Hay fever headaches cause a dull, deep, throbbing pain. Some of the symptoms of hay fever headaches are pressure like pain in one specific area of your face or head (for example, behind your eyes), face is tender to the touch, pain is worse with sudden movements of the head and bending forward and worse pain in the morning (because mucus has been collecting and draining all night). They are caused by an inflammation in your sinuses (air-filled cavities around your nose, eyes, and cheeks). Headaches often begin as soon as you get up in the morning, and may be better by the afternoon. Dr Shevel suggests the following to prevent or limit hay fever headaches: When the body comes in contact with an allergen, histamine and a number of other inflammatory chemicals are released as part of the body’s allergic reaction. Antihistamines work by blocking the effects of histamines, thereby reducing the symptoms of hay fever. Regular use of antihistamines throughout the pollen season is effective especially if treatment is commenced early in the season. Steroid sprays are used in more severe cases. They deliver a low dose of steroid powder through the nasal passages to control the inflammation in your nose and to help hay fever symptoms. Decongestants when used topically for short periods (less than 7 days) are effective in reducing nasal blockage and help penetration of topical steroid nasal sprays. Cortisone injections tend to be prescribed only in more severe cases where the hay fever symptoms are not controlled with other over-the-counter medications. They can’t be repeated frequently due to the possible side effects. Take note of the pollen count forecast on television or in the newspaper. Try to stay indoors if it’s a high count or on windy days after thunderstorms. Choose plants that are pollinated by birds or insects in your garden, rather than plants that release their seeds into the air. Smear petroleum jelly (like Vaseline) inside your nose to stop the pollen from touching the lining of your nose. A simple saline (salt water) nasal douche is effective. Saline and sea water nasal sprays help flush pollen grains off the nasal mucosal and improve nasal patency. Splash your eyes often with cold water to flush out any pollen. When it is more than just a headache triggered by hay fever! If your headache persists after you have your hay fever under control, it is imperative that you undergo a multidisciplinary investigation to diagnose the specific factors behind the recurring headache. For those patients who want to have healthier alternatives to medication, there are a number of various breakthrough treatment options. These include minimally invasive arterial surgery and posture modifying technologies. In most cases it is possible to get to the bottom of the problem and resolve the pain permanently.

June 15, 2018

Help your child make sense of the world around them

The importance of sensory stimulation for babies and toddlers The world is an exciting place for children, with new sights, smells and sounds at every turn. Making sense of this sensory information is known as perception, and developing this skill is a critical part of your child’s development. Without it, we would look and never see, listen but never understand. Sense making skills The more children are exposed to different sensory inputs, the more they develop their perceptual skills. “Each sense plays an important role in the development of a child’s sensory system which unlocks the key to how they learn, think and feel,” explains Liz Senior, Occupational Therapist and Founder of Clamber Club. “The role of the senses in learning cannot be overstated,” adds Kelly Westerman, Occupational Therapist and Clamber Club Toddler Milnerton Franchisee. “Parents need to have at least some understanding of what the role of each individual sense is in order to maximise the learning potential of even the simplest everyday experiences, such as bathing, sleeping, feeding and dressing.” Touch Touch and hearing are two of the senses that develop in the womb. The sense of touch relies on receptors in the skin that tell us about heat, pressure, texture and pain. As the skin is the largest sensory organ in the body it has the greatest potential to be stimulated. These touch experiences will develop what is known as the Tactile System. Smell Receptors in the nose are responsible for receiving and perceiving smells, developing what is known as the Olfactory System. Smell is largely underrated and often ignored as it is less closely linked to physical and intellectual development. However, the sense of smell has an important role to play in our emotional stability and memory recall and should therefore not be ignored. Sight Through sight we are able to learn by visually exploring the world in which we live. We gain an understanding of the relationships between people and objects and experience light, colour and form. It is for this reason that parents should invest as much time as possible to help their children develop their visual sense. Hearing The most common cause of speech delay in children is hearing loss; a child must be able to hear in order to learn to speak. Children who are able to hear and listen well are able to learn faster, make fewer mistakes and are less easily frustrated. Taste Children taste everything that goes in to their mouths, and through these taste experiences they develop what is known as the Gustatory System. A child’s taste preferences may also be linked to their temperament. Very relaxed children who require a large amount of sensory input to stimulate them show a preference for strong flavours such as lemon and curry; while children who are easily overstimulated tend to show a preference for bland and salty food. Take your child on a sensory journey Even before a baby is born they begin to use their senses to discover and learn about their world. In the beginning, a new-born is forced to take in just about every single sensory input, but as children grow they are able to filter through the sensory stimuli they receive and refine their various perceptual skills. “As parents you should have an understanding of what senses may be involved in any particular activity and aim to give your children good quality sensory experiences from an early age,” suggests Westerman. This can be done by stimulating each of the senses individually and in combination with other senses. “These sensory experiences will lay important foundations for learning, movement, emotional security and survival,” she concludes.

June 14, 2018

ADHD vs Bipolar: Know the difference

Inattention, hyperactivity, impulsivity, sleeping problems, racing thoughts and moodiness. These are all typical symptoms of Attention Deficit Hyperactivity Disorder (ADHD). They are also common symptoms of bipolar disorder – a mental illness known for severe mood swings and depression. But how do you tell the difference? Studies estimate that 20% of people with ADHD will develop bipolar disorder. Conversely, 70% of people with bipolar disorder also have ADHD. The high comorbidity rate and overlap in symptoms make these two conditions difficult to distinguish and diagnose. ADHD is ten times more common and more likely to be recognised while bipolar disorder is often misdiagnosed. It is critical to know the difference and get an independent but coordinated treatment plan for both. Untreated ADHD can be challenging but living with a misdiagnosed ADHD and bipolar combination can be dangerous. However, with an accurate diagnosis, the ADHD and bipolar combination can be treated successfully. This will help patients feel more stable in mood and in their ability to live fulfilling lives in their roles as spouses, parents and employees. One fundamental difference is that ADHD mainly affects attention and behaviour while bipolar symptoms mainly affect mood. Distinctions can be drawn between the two based on mood shift triggers, the speed and duration of mood shifts, the onset and consistency of symptoms, and the individual’s sense of reality. The importance of an accurate diagnosis can’t be overstated. With a holistic and dual treatment plan, therapy and life management, individuals with both ADHD and bipolar disorder can live healthy and fulfilling lives. If you suspect that you or a loved one might have ADHD, set the record straight with this self-assessment. If you are unsure about the symptoms or suspect that bipolar disorder might be present, speak to a medical professional. For more information around the symptoms, impact and treatment of ADHD, visit MyADHD.co.za or My ADHD on Facebook.

June 14, 2018

Healthy Eating habits

Written by: Cynthia Innes, Teacher at Junior College Preschools Sandton. A healthy lifestyle consists of various factors that contribute to healthy living, specifically eating habits, physical activity, emotional intelligence and a well-balanced activity schedule. Co-ordinating all these factors can be challenging for a child however, it is possible to achieve with guidance and a good routine. All parents face the challenge of encouraging their child to eat healthily, the trick is to create a healthy lifestyle for the entire family. Toddlers are influenced by those with whom they spend most of their time, whether it be at Preschool, at home with the nanny or parent. Children need continuous guidance to develop a healthy lifestyle, a child’s preschool years are an important time to teach children how to eat well and exercise their bodies. Parents and teachers can work together to encourage healthy eating habits and lots of physical activities. Always have healthy snacks readily available Replace fizzy drinks and processed juices with water. Have this easily available. Have freshly cut vegetables or fruit ready to eat as a snack. A whole wheat sandwich with a fruit or veg is also a good snack between meals. Snacking regularly is beneficial to children as they have smaller stomachs and they burn energy faster. Eating healthily between meals provides their little bodies with the nutrients and hydration needed for a healthy lifestyle. Educate your child Instead of force feeding undesirable healthy foods to your children, educated them as to why it is healthy and beneficial to their bodies. Forcing your child to give into something they don’t agree with teaches them that forceful behavior from others is acceptable, this could lead to falling victim to peer-pressure situations. Reasoning and explaining why eating healthily is important, not only gives your child the power to make decisions but also develops their reasoning skills. Lead by example Children learn from their surrounding experiences, they do what you do so lead by example and they will soon follow. Having healthy snacks with your children is a great way to encourage healthy eating. Children see their parents as role models and will imitate what their parents do. Create a food schedule Creating a weekly food schedule beforehand is extremely beneficial to the cook and the family. Placing a food schedule in an area where every family member can read it will allow them to prepare themselves mentally for a meal. Explaining to toddlers what’s on the menu gives them a sense of involvement and is more likely to eat the meal. Involving the entire family in scheduling meals for the week will encourage them to finish their meals. Introduce new foods gradually Young children are more likely to eat new foods if you introduce tiny amounts in an attractive manner. Do not worry if they resist the first few times, keep trying without force but encourage a taste. It is natural for all of us to detest some foods, so allow your little one to do so if a few tastes have been tried. Try again a few months later, maturity brings change. Include the children in meal preparations Allow children to help you prepare the meal. Little ones can fetch vegetables and fruit, bring you the pots and pans and help with stirring. This also develops their counting and perceptual skills. As they get older they can learn to chop, measure and mix. A child who has helped with the cooking will generally be keen to eat it Don’t be too strict As above, a taste is all you need to encourage. Serve tiny portions attractively so the child can finish and ask for more if necessary. After 20 minutes, if the child is not keen to eat, remove the food with a cheerful statement, “I see you have had enough” Do not serve alternatives or filling snacks between meals. No punishment for not eating. The more fuss you make, the more resistance you will have. Eat meals with your children, talk without TV or phones. Meals can be a family bonding time where food is celebrated and enjoyed. Physical activity for Young children Children should be actively playing, preferably outdoors on bikes, jungle gyms or just imaginative play with the toys they have. TV or tablets should be limited to a maximum of half hour daily. Lead by example and go for walks, swim, garden play ball games or take them to the gym with you. To create a healthy eating habit, the above tips need to be implemented over time and on a continuous basis for successful results.

June 8, 2018

How binge-watching TV series can wreck our immune systems

It turns out there are some surprising daily habits, such as overdosing on our favourite TV series, that can wreak havoc on the body’s ability to fight off colds and flu. Nicole Jennings, spokesperson for Pharma Dynamics – a leading provider of colds and flu medication – says the relatively new phenomenon of being able to watch an entire TV series all at once, as opposed to waiting a week, has sparked several studies that attempt to understand how binge-watching is impacting our health. She cites a paper published in the Journal of Clinical Sleep Medicine which found that people’s addiction to watching TV series can lead to chronic fatigue, which has a damaging effect on immunity. “According to the study, over half (52%) of binge-watchers viewed three to four episodes in one sitting, with an average session lasting three hours. If one considers that most of the watching occurs in the evening, that doesn’t leave much shuteye. Binge-watchers also reported more fatigue and insomnia and had 98% more chance of having poor quality sleep than those that limited their screen time. “Watching TV in a dark room for hours on end can really mess up our circadian rhythm (the cycle that regulates physiological processes) and disrupts sleep-wake cycles. The blue light emitted from TVs, PCs, laptops, smartphones and other devices can also reduce the production of melatonin (a hormone that promotes sleep). Poor sleep in general is associated with lower immune system function and a reduced number of antibodies or ‘killer cells’ that help to fight germs. Adults need between seven and nine hours of uninterrupted sleep every night in order for the immune system to function optimally. You can still enjoy watching TV, but try to avoid a binge too close to bedtime,” she recommends. Apart from lack of sleep, marathon-viewing can also exacerbate mindless eating and unhealthy snacking – both detrimental to your waistline and immunity. Research by Cornell University’s Food and Brand Lab found that action-packed shows, such as The Walking Dead for example, made participants eat twice as much (98%) than others who watched milder talk show content. Those that watched depressing shows, like the sci-fi drama, Solaris for example, also ate 55% more than participants who watched positive, upbeat programmes. According to the researchers, action and adventure shows may encourage viewers to eat more, because viewers subliminally try to keep up with the pace of the story. Stress and anxiety experienced during a show also leads to comfort-eating. Jennings points out that although it’s easier to order in pizza than pausing your show for an hour to cook a nutritious meal, junk food really upsets the immune system. “Fatty, fried foods increase bad cholesterol and can cause inflammation, leading to reduced immunity, while sugar can hinder the body’s ability to produce germ-fighting white blood cells that destroy foreign pathogens. Watching your favourite characters drink a beer or smoke a cigarette might also trigger a craving for these substances, which have been proven to lower immunity. If you’re planning to watch a TV series, rather put out cut-up fruit and vegetables or low-carb meals and healthy drinks on the table,” she suggests. Furthermore, sitting in the same position while watching hours of TV series not only contribute to deep vein thrombosis and the formation of fatal blood clots, but also increase one’s risk of respiratory tract infections (RTIs) such as a cold, sinusitis or tonsillitis, most likely as a result of lowered immune function. A study conducted by researchers in the US found that staying physically active nearly halved the odds of catching cold viruses, and even those that did fell ill, didn’t suffer too badly. Jennings suggests that instead of sitting on the couch, TV addicts should consider watching a series on their cellphone or tablet while walking on the treadmill, stationary bike or rowing machine. “There are different ways to make the occasional marathon TV session healthier, but moderation is key,” she concludes. These findings were released as part of Pharma Dynamics’ ongoing public awareness efforts to help reduce the incidence of respiratory infections, which typically spike in winter.

June 7, 2018

Beat The Holiday Food Traps

The worst part of a holiday trip isn’t the packing before the holiday or the large crowds – it is the price your diet pays. As much as we look forward to a holiday, many of us fear enjoying it too much – and piling on the kilograms. It is no coincidence that when holidays get under way, your diet takes a nosedive. But is not just stress associated with travelling or the temptation and treats that take their toll on you. There seems to be the assumption that when you travel, you can’t eat healthily, so subsequently you don’t even make an attempt to. However, the correct foods can help ward off road rage, prevent jet lag and give you the energy to deal with your family when you finally get where you are going. You will also feel healthier, more alert, and have more fun once you reach your destination. Typical freeway fare includes fast food, microwave-ready service station options, pies, bags of chips, chocolate bars and lots of fizzy drinks. These foods are almost always full of bad fats, lots of calories and not much valuable nutrition. With a little bit of effort and willpower, you can navigate your way around the junk food and maintain your healthy diet while on a long road trip. Follow this guide to help you stay on the straight and narrow. Keep on reading to help you make the right food choices on the go. Breakfast on the run Always start your day of travelling with breakfast. Tempted to hit the Wimpy? Not so fast – beware of hidden fats and kilojoules – you also want avoid excess sugar. High carbohydrate meals e.g. restaurant or coffee shop muffins may improve your mood for a short time, but lots of sugar can also make you sleepy – which isn’t good if you are the driver. Your best bet is to look for lean protein. A protein rich breakfast can help increase the feeling of fullness and reduce cravings later in the day. Seed loaf or wholewheat toast with eggs is a good choice. Health bread or wholewheat bread contains a fraction of the kilojoules found in croissants or bagels. Rather choose ham over sausage or bacon (both are very high in artery-clogging saturated fat). Breakfast wraps are a good choice, but do avoid wraps that has words like loaded, meaty or cheesy in its name on the menu or packaging description. A common mistake people make is drinking a smoothie with their breakfast instead of drinking the smoothie as their meal. Smoothies are often high in kilojoules and high in sugar. Pick a smoothie that is made with fat-free yoghurt instead of ice cream and avoid ingredients such as fruit syrups. Skip Granola and fruit mix, despite its health reputation, granola contains more than 2000kJ (476kcal) and 30g fat per cup! It is often further loaded with dried fruit that sends the sugar content further through the roof (not to mention your blood sugar). If you do have time, it is best to prepare yummy “padkos” yourself. See below for ideas. Lunch on the go Tired of hearing…… How far yet? Now you also have to start thinking about lunch. If you weren’t organised enough to pack lunch, then it means hitting the one-stop along the freeway or the restaurant at the airport. Options such as grilled chicken sandwiches or wraps are a good idea, as long as they’re not loaded with cheese or sauces such as mayonnaise. Caution with pre-prepared salads – they are often drenched in salad dressings loaded with kilojoules, saturated fat and salt. All the salt is sure to make you feel uncomfortable and bloated in an already cramped car or airline seat. Sushi is another healthy alternative that contains healthy fats as well as omega-3 fatty acids. If you choose a burger, try to give the chips on the side a skip. A typical serving of chips provides you with 2310kJ (550kcal) and 20g fat – this is half of the typical amount of energy most women need in a day. Snack on the road The petrol gauge’s needle is edging towards empty…… and so is your tummy! You stop at a petrol station to fill up and inside the shop you are confronted with mostly unhealthy food choices. Bypass the high sugar and fat items on the shelves and look out for healthier options. Fat free yoghurt (or low fat if there isn’t any other choice) is a healthier option which is also high in calcium and protein. Bananas are high in soluble fibre that won’t bloat you and contain magnesium that helps with headaches while driving. Be careful with nuts – limit your portion size to a small handful. Nuts are high in fat (yes, it is the healthy fat but is still high in calories). Also, be cautious with protein bars, unless you eat a brand you know and trust (approved by your dietitian). You could very easily end up with a protein bar that’s closer to a chocolate than a healthy snack. Some manufacturers jam their bars with sugar. Pack Light Packing your own travel bag of food? Then make smart choices such as the following: Packets of instant Oats (original flavour) – ask for some boiling water at your pit-stop. Alternatively, pack individual portions of Futurelife or Pronutro (original or wholewheat flavour) – just add water or milk. Homemade sandwiches, wraps, pita breads or provitas with a lean protein filling. Chicken strips, mini bobotie bites, mini quiches (made without the cream and buttery short crust pastry) – see ‘Snacks and treats for sustained energy’ for recipes and more ideas Biltong: this practically fat free protein source will keep your mouth busy and fuller for longer. Fresh fruit or fruit snacks e.g. Low GI Safari Fruit Break Bars or Just Fruit Bars (also available at the practice) for a fibre-filled way to satisfy a sweet craving. Nuts: pack 30g portions that can

June 1, 2018

Eye Allergies in Children

Eye allergies are surprisingly common in children in South Africa and unfortunately, this phenomenon appears to be on the increase. Some children will experience eye allergies as infants and young children but outgrow it as adults, while others will continue to battle with it right into adulthood. If one of the child’s biological parents suffers from some form of allergy, there’s a 40% to 50% chance that the child will have some sort of allergy as well. That probability jumps to 75% to 80% percent when both biological parents have allergies. An allergy describes the “over excited” way in which the body reacts to something in the environment which it sees as foreign. This foreign substance is called an allergen. Types of Allergens Outdoor allergens include pollens, diesel exhaust and petrol fumes. While indoor culprits encompass pet dander, dust mites, mould, and cigarette smoke. A child can come into contact with an allergen by touching it, breathing it in or eating it. The following image has been borrowed from Adam, Inc. which shows some of the various types of culprits that can cause allergic reactions in children whose body sees them as foreign. Allergic Eye Disease Symptoms In a child with allergies, the body mistakenly identifies the foreign object (seen in example above) as a serious threat, which in turn triggers a cascade of immune mediated enzymes and chemicals to be released into the body to fight off this intruder. This overzealous reaction can cause a range of symptoms from having mildly itchy eyes, to chronic scarring with resultant loss of vision. Symptoms may only occur during certain seasons such as spring when flowers start to blossom or may be present throughout the year due to continual exposure to something like house dust mites. Symptoms that occur commonly in allergic eye disease include: Itchy eyes with frequent rubbing. Increased tearing (watery eyes) Red or pink eyes. Mild swelling of the eyelids. Areas around the eye or just below the eye are also often involved. Darkened discoloration of the skin under the eye Watching Children’s Behaviour is key Children are not young adults; therefore, they cannot always describe to us what exactly is wrong. It is very helpful to carefully watch their behaviour, such as: Rubbing their eyes often. Blinking forcefully and repeatedly. Making rolling eye movements in response to the itchy sensation caused by the allergies. Allergies Are Not: Important to note is that eye allergies do not cause the following: A sticky, stringy, mucus discharge. A green or a yellow discharge Lids that are so swollen that they close the eyes. Pain or a fever. Should any of these symptomsoccur, medical attention should be sought immediately! Management of Allergies Once a diagnosis of allergic eye disease has been made by your eye specialist, there are a variety of management protocols that can be followed. The simplest of these is to avoid the possible triggers. Many allergens that cause eye allergies are difficult to identify, but there are a few general procedures that can be helpful: Keep windows closed during high pollen periods and stay indoors as much as possible when pollen counts are at their peak, usually during the midmorning and early evening, and on windy days. Avoid using window fans that can draw pollens and moulds into the house; use air-conditioning in your home and car if possible. In damp areas use a dehumidifier to control mould. Use “mite-proof” bedding covers to limit exposure to dust mites, and wash your bedding frequently, using hot water (above 40C). Wash your hands after petting any animal. In addition to avoiding triggers, your child’s eyes can be made more comfortable by using medication. Some symptoms can be controlled by using over-the-counter medication such as artificial tears, a decongestant drop and oral antihistamines. There are two important factors to be considered when taking these medications. OTC decongestant eye drops should not be used for more than two to three days. Prolonged use can create a “rebound effect” – increased swelling and redness that may last even after discontinuing the drops. OTC Antihistamine tablets may cause dry eyes and potentially worsen eye allergy symptoms. Prescribed drops include preparations such as anti-histamines, mast cell stabilisers, non-steroidal anti-inflammatories and corticosteroids. Your eye specialist will determine which combination of these treatments are the most appropriate for your child. Correct Diagnosis is Important Eye allergies can cause great discomfort and in rare cases, even vision loss. But with the correct diagnosis and treatment, the condition can be well controlled. It is always recommended to see an eye specialist for the best possible advice. References: Oxford Handbook of Ophthalmology, 2ndEdition, p. 170 American College of Allergy, Asthma and Immunology Allergy Foundation of South Africa Images: Borrowed from todaysparent.com; Adam, Inc.: Parenthub; Paediatric Associates of Franklin; Allergy & Ashtma Center of Atlanta; Eyecare Kids; allergyaustralia.com

May 24, 2018

Talking about periods

HOW SHOULD I APPROACH THIS? Your daughters first period is a momentous event in her life, but it can also be a little confusing and anxious too. When it arrives, it’s important she feels prepared and is aware of what’s happening to her. Discuss the science Although it sounds an obvious thing to say, its worth talking her through the basics of why we have periods, how the menstrual cycle worksand the blood loss she’ll experience. We’ve got all the information you need here to help explain these things, including a Teen Handbook. If she wants to find out herself, direct her to the teen section which includes advice on all aspects of her body Help her feel prepared One of the biggest worries many girls have is starting their period when away from home or in school. Very often, wearing a pant liner on a daily basis can build her confidence as it alleviates any fear that she will be caught unaware. Its also a good idea to give her some pads to keep in her school bag just in case. Lil-lets has a mini purple rangedesigned with petite women and younger girls in mind Is there a minimum age for using tampons? There is no minimum age for using tampons or a medical reason why a girl new to her periods should not use one. However, it is often best for them to understand their flow and monthly cycle before choosing to use this form of protection. Show her products It’s easy to forget that she probably hasn’t seen what a pad looks like. Once you’ve bought a pack, show her a pad, how she should position it and how to dispose of it afterwards. This should give her the confidence to do it herself next time. If you would both rather not have this conversation directly, our Teen Handbookhas explanations of how to use pads so she can have a look in her own time. The same applies to tampons as they can be really confusing, especially as they come in both an applicator and non-applicator formats. Anything else to add? Its perfectly normal for her period to last a couple of weeks too, so again, Its worth sharing this bit of information with her so she will know what to expect. Many thanks to Lil-Lets for their insight, you can read more atÂ https://www.lil-lets.co.za/Advice/Advice-for-parents

May 21, 2018

Veggies for vitality: Get your munchkins to gobble more greens

Diet – probably one of the most dreaded four-letter words in domestic history. The reason why nutrition often feels like a real burden is because our society’s concept of and relationship with food are quite rotten. As a result, there exists a confusing mess of contradicting information on what really constitutes a “healthy diet”. To pile on the pressure, you now have kids whom you love to bits and want to feed wholesome food and it’s most of the time a struggle, right? My own pursuit of answers to the much-debated topic of diet led me to a very simple (and I like to think obvious) conclusion: Eat. Real. Food.To clarify – the closer to nature, the more it will nurture. Conversely, if it is modified (processed or refined), it is best to stay away from it. A “real” diet is inevitably loaded with the substance of life: vegetables! “But my child is a fussy eater!” you say. Let me spill the beans on how you can help to fill your child’s tummy with nature’s best: Start smart The hard truth is: your child will most probably not be begging for broccoli if his palate is spoiled with “easy” foods, such as sweetened yoghurt, crackers and other refined edibles. A baby’s first foods should be freshly prepared vegetables, fruit, natural fats, proteins and whole grains rather than commercially processed baby food. Weaning foods lay the foundation for eating habits. If children won’t eat anything but white bread with cheese spread, we have to ask ourselves: Would that have happened without the option of this “meal”? Our babies have clean dietary slates – they learn to eat what we feed them. So, let them have veggies! What if it is too late for the right start? Detoxing your family from “fake” factory foods and replacing them with wholesome alternatives is a beautiful Plan B. However, it costs commitment! It will be challenging until the whole family, as well as your grocery shopping, cooking, and snacking habits, have adjusted. Cheat them to eat them If mealtimes are mostly synonymous with war, try dosing fussy eaters with vitamins, minerals and fibre by sneakily masking veggies or fruit in their food. Here are some ideas: Make smoothieswith added vegetables. You can even freeze this blend and offer it as popsicles or sorbet. Check out this recipe for a delicious green smoothie. Baked goods(made from healthy flour alternatives) are brilliant hideaways for wellbeing foods! Add grated or pureed veggies, such as carrots, baby marrows, cauliflower or pumpkin to muffins, biscuits, crumpets, breads, wraps and more. Sweeten with blended fruit like banana or dates. See these inspiring recipes for spicy pumpkin muffinsand cauli-wraps. (Google will gladly contribute many more ideas!) Hide veggies in meat recipes(like these fantastic meatballs) – add them to quiches, blend them into yummy soupsor puree them into flavoursome saucesas topping or filling for brown rice, quinoa, omelettes and more. Go on, become a master of disguise… The real deal should also appeal We should be cautious of always offering veggies in easily edible forms. When we do this, we are not accustoming children to their taste and texture and thereby not training them to be vegetable victors. That does not mean that you can’t make it less painful and more fun! Dangle a carrot in front of their noses like this: Build vegetable pictureson their plates. The internet is packed with creative ideas! Give them healthy dipslike hummus, cream cheese or mashed avocado to dunk veggies into. Gardeningis a great way to get kids excited about plant foods! Let them help and witness their greens grow. The key often lies in variety. If Fussy Fiona absolutely refuses mushrooms, give up and give celery. But try again next month. Home-grown habits The apple does not fall far from the tree when it comes to diet. In the end, what you cook and eat yourself is what your child will model. Yup, this means the pressure is on! But luckily it will pay off for your own wellbeing too. A final word of encouragement: Our survival instinct will eventually force us to eat what is available. Your child will not starve if you replace comfort foods with vegetables. May your efforts to fill the apple of your eye with good food bear much fruit! Hopefully, your tantrum-prone little eater will soon be as cool as a cucumber when there is salad for supper!

May 16, 2018

Ponytail May Be Leading to Some Headaches

Some headache and migraine sufferers develop sensitivity of the scalp from all the pain that they experience. This means that things that normally would not cause pain or discomfort, start to cause problems. Wearing a tight ponytail would normally cause no discomfort, but in migraine sufferers who have developed a highly sensitive scalp, wearing a tight ponytail can cause discomfort and pain. It actually has a name – ‘ponytail headache syndrome’, according to Dr Elliot Shevel, Medical Director of The Headache Clinic, and South Africa’s internationally recognized Migraine expert and pioneer in the field of Migraine Surgery. Other signs of scalp hypersensitivity may be discomfort with combing or brushing the hair, shaving, showering, or wearing glasses or earrings – things that are not normally painful. Dr Shevel says that if one does suffer from scalp hypersensitivity – the medical term is cutaneous allodynia – then treating the cause for the overload of pain signals to the brain should come first – i.e. treating the headaches. When the original source of the most significant contributor to the pain is successfully treated, the allodynia subsides along with it. At The Headache Clinic, the emphasis is upon diagnosing the original source of the pain, and then directing treatment in a focused manner at the origin of the pain. In most patients this can be achieved without the use of drugs, with their often unpleasant or harmful side-effects.

May 9, 2018

Bedwetting: When to consult a doctor

Bedwetting is an issue that millions of families face every night. This can be very stressful for the whole family, and often the children feel embarrassed or guilty about wetting the bed. Bedwetting can also cause anxiety when spending the night at a friend’s house or going away to a school camp. In most cases, children will grow out of bedwetting, but there are certain cases that will need medical attention. There can be numerous reasons for bedwetting. This is a problem experienced by an estimated 10% of South African children aged between 4-15 years old. In most cases, it’s linked to delays in physiological development. Children are unique, and each child develops at a different pace. It could also stem from being in a very deep sleep or a bowel issue like constipation. Bedwetting could also be caused by psychological problems that have resulted from issues at school or a change in family dynamics. Whatever the circumstances, the question remains: When should I start being concerned about bedwetting? Dr Michael Mol, Brand Ambassador for DryNites® Pyjama Pants, sheds some light on when parents should consult a healthcare professional when it comes to bedwetting and which specialist would suit the situation: “The signs that parents need to look out for when their child is bedwetting include: Signs of bladder or Kidney infection. These signs will be evident when your child cries or complains when urinating, when there is pink urine or bloodstains or when your child visits the toilet more frequently than usual If your child is over the age of 5 and cannot control their bladder When your child who in the past was able to control their bladder has begun to wet the bed and this is happening more frequently There are several healthcare professionals who can help deal with bedwetting. These specialists can also provide you with the relevant advice you need to assist both you and your child,” says Dr Michael Mol. A General Practitioner If your child is five years old or over but is still wetting the bed at night, you should consult your GP on the subject, especially if the bedwetting persists beyond seven years of age. It is also advised to consult your GP in the case of secondary enuresis (when a child starts to wet the bed again after a period of at least six consecutive months of nighttime dryness). A Pediatrician Your GP can recommend you to a pediatrician if the initial treatments are unsuccessful. A Pediatrician Urologist This specialist may be consulted only by referral from your GP or Pediatrician. Referrals will be made in the case of daytime bladder leakage which may be caused by a recurrent urinary tract infection. A Psychologist If your child is suffering because of regular bedwetting in terms of a loss of confidence, feelings of guilt or embarrassment, a tendency to isolate themselves, etc. you are advised to see a psychologist. Visible symptoms in children include depression, anxiety, hyperactivity, behavioral issues and lack of concentration. A psychologist may also be referred by your GP in cases of secondary enuresis. An appointment with a psychologist can be arranged by your GP or pediatrician. You cannot stop your child from wetting the bed. You can however help to manage their bedwetting by making them feel more comfortable. One way of doing this is to introduce them to DryNites® Pyjama Pants. DryNites® Pyjama Pants are available for boys and girls and come in two different sizes; 4-7 years and 8-15 years. These age appropriate disposable pyjama pants are super absorbent and comfortable like real underwear. They are thin enough so that children can discreetly wear them underneath their pyjamas, helping them to feel more confident and independent. For more information on DryNites® Pyjama Pants, or to ask Dr Mol a personal question or to request a free sample, visit www.drynites.co.za. DryNites® Pyjama Pants are currently available at selected retailers nationwide.

May 4, 2018

Quality Nutritional Supplements: A Benefit for pregnant moms

Expectant moms want the best for their babies but often feel overwhelmed by the information they receive on what is and isn’t good for them and their baby, which is often contradictory. Getting the right nutrients during pregnancy, and while breastfeeding, can help to ensure the best health outcomes for you and your baby, so it is important to be able to differentiate between facts and myths. Diet1 and appropriate nutritional supplementation2 play an important role in a healthy outcome for both mom and baby. Research has shown that conditions like excessive weight gain1,3,undernutrition caused by nutrient deficiencies2, and gestational diabetes4 during pregnancy can have a negative and lifelong impact on mom and baby.3,4 Abby Courtenay, a registered consulting dietician from Nutritional Solutions, provides tips below on how nutritional supplementation can help you have a happy and healthy pregnancy: When should you supplement your diet? If you suffer from loss of appetite, nausea or vomiting, supplementing your diet will help you reach your calorie and/ or nutrients goals. If you are not consuming enough calories, not gaining any or enough weight or carrying a high-risk pregnancy, a nutritional supplement may help to bridge any nutritional gaps.5 Nutritional supplements which are formulated to contain a variety of nutrients, can be used as a great on-the-go option for busy moms who don’t have the time to prepare healthy snacks. These nutrients include a combination of carbohydrates, proteins and fats which will assist to lower your glycaemic response6, ensuring that you have sustained energy throughout the day; as well as a host of micronutrients to support a healthy pregnancy. It is important for you to look after yourself during pregnancy and whilst breastfeeding your baby – a happy, healthy mom ensures a happy, healthy baby Similac® Mom provides an easy and convenient nutritional solution for expectant moms as well as for breastfeeding moms. Similac®Mom is available at all major pharmacy groups and selected retail outlets and via online shopping. References and notes: Source: https://nutrition.abbott/za Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD007145. DOI: 10.1002/14651858.CD007145.pub3. Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD004905. DOI: 10.1002/14651858.CD004905.pub5. Nutrition Working Group, O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, et al. Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can. 2016 Jun;38(6):508-54.e18. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/27368135 De-Regil LM, Fernandez-Gaxiola AC, Dowswell T, Pena-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev. 2010 Oct 6;(10): CD007950. Abstract available from: http://www.ncbi.nlm.nih.gov/pubmed/20927767 Nutrition Working Group, O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, et al. Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can. 2016 Jun;38(6):508-54.e18. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/27368135 Augustin LS, Franceschi S, Jenkins DJ, Kendall CW, La Vecchia C. Glycemic index in chronic disease: a review. Eur J Clin Nutr. 2002 Nov [cited 2013 Jul 6];56(11):1049-71. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/12428171

May 1, 2018

Is decision making an art or a science? Is it crafted or learnt?

By Jenny Platford Crawford College La Lucia School Counsellor “You’re on your own. And you know what you know. And YOU are the one who’ll decide where to go…” (Dr Seuss) As Dr. Seuss so clearly emphasizes, much of how we go about making our decisions is based on a personal sense of self, shaped by our personality, life experiences, knowledge, sense of self- awareness and confidence, values both personal and societal. He implies that we have a sense of purpose and control over our decisions irrespective of the external factors impacting on us. There are definite steps that can be followed when making an informed decision-these include identifying and clarifying the decision that is to be made, seeking information to provide adequate knowledge and understanding, weighing up pros and cons and then making a decision based on all known entities. This may be the science of decision-making- a clear process, a plan of action. There can, however, be no definite known outcome, no matter the preparation that goes beforehand. Rather all decisions inherently offer more than one outcome and hence many involve an element of risk. In the society in which we live, this perceived potential for risk and uncertainty, can add stress and anxiety to the larger life decisions we face. Added to this, our society is in a constant state of flux – Politically (as populist movements increase), economically (challenges from crypto currencies) and socially (with the advent of social media platforms- challenging the essence of our relationships with one another). Many young people face uncertain futures as they watch the challenge to our tertiary system. Online courses are on the increase and careers are constantly evolving. Uncertainty can foster a sense of indecision and self-doubt. The media constantly floods our cognitive space, setting definitive guidelines as to what would be construed as socially acceptable and cyber communication brings an immediate communication of all world events clouded by the advent of fake news. There is an overwhelming amount of information available to us and often, young people feel incapable of making sense of it all. How then do young people learn to take control over their lives through effective decision-making? Those students who appear adept in this skill are those who often have a clear sense of self, which has been developed as a result of authentic life experiences, rather than those based on contrived digital experiences. They are familiar with the wonderful potential of both their intellectual and their physical capacity and have developed a sense of resilience, having faced failure in a supportive environment. Parents who allow their children to celebrate the learning that occurs when mistake are made, teach resilience. Thereby overcoming the fear of failure that often paralyses young people when they face life decisions. Young people who are allowed to be curious and independent in their thinking, find decision making another opportunity to explore the unknown, chart a different course, flex themselves. This becomes the art of decision-making. Those who travel, read, explore their faith, live in the physical, and not the digital world, get to build a wealth of insight into their capabilities, and their limitations. They have authentic knowledge as to challenges they have faced, skills they have relied on and support that they can draw on. This frees them, to try new things, trust their judgment and act out their choices. Interaction with a variety of people, exposure to diversity in terms of ideas, faith and culture is empowering and builds understanding, insight, compassion and empathy – all necessary when making informed decisions as very rarely does a decision just impact one person -inevitably, ethical considerations are often required and so a true sense of one’s personal values is of paramount importance. The world we live in requires that individuals are innovative, creative and solutions driven. All these factors require young people to be able to make decisions, act on them and then reflect on the decision made and the outcomes presented. Parents, who make all the decisions for their children, stunt their curiosity and buffer the learning process thereby preventing independence of thought and the development of self-confidence. Decision-making therefore in my mind is crafted over time, built alongside character and identity and bolstered by lessons learnt through life experiences and teachable moments.14324

April 24, 2018

Medical aid payments

It’s a lament often heard. There are, however, two sides to every story and the problem doesn’t always lie with the medical scheme. There are a variety of reasons for non-payment ranging from members not following the correct claiming procedures or rules, benefits not being depleted or even providers not billing correctly. Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund gives some tips on what may have gone wrong and how to fix it. The important thing to remember is that medical aid scheme options differ, which means some options cover procedures that others might not, but there are certain rules everyone needs to adhere to. Your medical scheme will usually tell you the reason for non-payment. If you are unhappy you can take it up with them, however, the best advice is to first check that the fault doesn’t lie with you or the medical practitioner. Your membership number This may sound simple but it is surprising how often an incorrect membership number or dependant code is submitted with a claim. In some instances, this information is omitted or incomplete. A medical scheme cannot pay without proof that you had the treatment. Remember to update your details if you have changed your medical aid option or medical scheme. ICD-10 codes ICD-10 codes are used by medical schemes and healthcare providers, including doctors and specialists to identify specific conditions. These must be correct as they are a diagnosis for specific conditions. If there is no ICD-10 code or, for some reasons that condition is not covered by your medical aid, the account won’t be paid. Schemes also have sub-limits, for example they agree to pay for rehabilitation and the amount they will cover is finite, so check prior to the treatment. Certain dental procedures have definite sub-limits so it is important to read the fine print and check your policy for what is covered and what isn’t. Your contributions are not up to date It sounds simple but check that your debit order has gone through or that your employer has paid your contribution, non-payment of premiums could result in your bill not being paid – especially if your membership is suspended. The claim has expired Be aware that there is a cut-off date for submitting a claim. It is usually four months from the date of treatment. Ensure that the correct date is on the top of the account. Your benefits are depleted If you do not manage your medical aid benefits carefully you can run out of benefits before the end of the year. This means that you may have to pay the bill yourself. Different options have different limits for various procedures so, once again, make sure you understand what your option covers. Medical schemes are required to pay for Prescribed Minimum Benefits in full but you may have to use a specific provider. Waiting periods may apply When you join a new scheme there is a waiting period of three months and sometimes, based on your medical history, a twelve month exclusion could be enforced for certain conditions. If you claim before the waiting period is up, the bill will not be paid. Your hospital/doctor is not on the network Most schemes have hospital and doctors networks who agree on certain rates for their members. If you choose to go to another hospital or a private doctor you could end up paying a large portion of the bill. You didn’t use a Designated Service Providers A Designated Service Provider is a specific provider that has been appointed by a medical scheme for a specific service. If you choose not to use a Designated Service Provider, you may have to pay a co-payment or not be covered – depending on the Scheme Rules or your specific plan limits. Pre-authorisation was not obtained If you are going to undergo a procedure you need to get authorisation from your medical aid ahead of going to hospital and, once again, make sure you have the right information and ICD-10 Codes for this. You’re using medicine that’s not on the formulary Every scheme has a formulary, which lists chronic medication approved by your medical aid. These are often generics which are copies of the original medication but more affordable. Ask your pharmacist for a generic as a matter of course as it will ensure your benefits last longer. The procedure or treatment may be an exclusion All medical schemes have a list of exclusions which are not covered. This often includes cosmetic surgeries and non-medical expenses. Van Emmenis says, ‘If you read the small print and know exactly what the rules are for your medical aid and the plan you are on, you will be able to ensure that your benefits last as long as possible and that the bills are paid.’

April 24, 2018

Help ! My child’s being bullied

Unfortunately bullying, especially cyber-bullying is a major problem facing children. Sadly it isn’t ‘just an inevitable part of growing up’. Research shows that whether your child is being bullied, being the bully, or watching their friend being bullied, they need help. It affects everyone (even you as parents) and often has a major impact on children’s developing sense of self, school performance and self-esteem (even into adulthood). Often it’s emotionally terrifying – silently imprisoning kids in shame, feeling worthless and desperate. Some warning signs in children: depression and anxiety – often seen as a nervousness and loss of interest in usually enjoyable activities strong feelings of sadness, loneliness, worry and fear disturbances in sleep and eating patterns health complaints – poor appetite, headaches, abdominal pain, tiredness school refusal – skipping class, or dropping out performance deteriorates From shoving, hitting, mocking, threats, name-calling, shunning, spreading rumours or exclusion tactics to forcing victims to do or give them things, bullying is any ongoing/repetitive intentional tormenting. Cyber-bullying –via electronic messaging, online chatrooms, the internet and social media – is even more complex and has become a major problem worldwide. Warning signs in cases of cyber-bulling : loss of/obsessive interest in the computer and cell phone won’t talk about what’s going on gets stressed when receiving e-mail, texts or instant messages withdrawing from family and friends Bullying is all about power, with those with the lowest self-esteem (i.e. the least power) becoming the victims. Bullies have unfortunately learnt to feel powerful in destructive ways, and are often doing so from their own previous emotional hurt. Although children may respond differently, they will rarely admit that they’re being bullied (even if you have a close relationship.) This makes it vital to learn more about bullying and seek help for your child. Become involved – check whether your child’s school runs anti-bullying awareness campaigns and has a policy of how to deal with bullying. The best antidote is to help build their self-esteem. (see the author’s revolutionary children’s self-esteem game : www.raisingkidspositively.com/game)

April 20, 2018

HOW DOES PLAY PROMOTE HEALTHY SOCIAL AND EMOTIONAL DEVELOPMENT

Play is a child’s language, his work, his relaxation and the way he builds relationships. Forming a healthy relationship with parents help children to feel secure. This sets the stage for a child’s social and emotional development for the rest of his life. Social development is how we interact with others, the ability to form secure relationships. Emotional development is the ability to regulate and express our emotions. Strong social-emotional development is the basis for all later social, emotional and academic success. According to the National Academy of Sciences there are three qualities children need to have to be ready for school. Intellectual skills, motivation to learn and strong social and emotional capacity. How do we as parents create the opportunities needed to develop these skills? It is simple, children need to play. Children use play to release emotions, work through feelings and understand their world better by play-acting in situations they can control. The give and take patterns of play allow children the opportunity to practice the skills necessary for healthy emotional development. Here are some practical ways to help: Suggest ways for children to interact and play together. If you see a child struggling to build a tower, suggest that one helps by holding it while other one builds. Help children learn to take turns, or share what they have. “Ethan wants to play too but he has no play-dough. Let’s give him some of ours so we can all play together.” Help your child build empathy and sympathy for others. If someone got hurt let him give a hug or a special toy to help him feel better. Teach him to help someone up if they fell. Build your child’s vocabulary regarding feelings. Being able to express his feelings adequately will result in less frustration and aggression. For example, disappointment, nervous, frustrated, curious, amazed and astonished. Acknowledge your child’s feelings. Help him to talk about how he is feeling. Comfort and hold him and speak to him softly and calmly. Love your child and show affection towards him. Give him lots of hugs and cuddles. Tell him that you are proud of him. Role play and pretend play are lovely ways to teach children about feelings. Tell a story about how the bear got hurt, or how someone said something ugly to him. Explain how he is feeling and give your child a chance to explain what feelings the bear could be having because of what has happened. Let him help the bear with suggestions of how he can make him feel better.

April 19, 2018

Should I be taking aspirin while pregnant?

When you are pregnant everything that you take in your baby takes in too. This relates to the food that you eat, the drinks that you consume and of course any medications that you take. This means that you need to be very careful with the medications you take, even when it seems that they are seemingly harmless medications that you normally wouldn’t worry about at all. What Is Aspirin? Aspirin is a common, over the counter western medication that is used to treat fever, inflammation and/ or pain. It is quite the norm for most people to take aspirin to treat colds and flu, as well as many other common illnesses. Due to the fact that aspirin is such a common medication to take it can be easy to assume that it is perfectly safe to take while pregnant, however it is important to always check any medications that you want to take while you are pregnant with your doctor first. While taking a few low doses of aspirin during pregnancy may possibly have no negative, taking regular adult doses of aspiring while you are pregnant can causes problems for your baby, as well as for you. For this reason it is probably best to avoid taking aspirin altogether while pregnant unless prescribed by your doctor. It is also not recommended to take aspirin while breastfeeding. Taking aspirin during pregnancy can cause the following problems: Increase of miscarriage if aspirin is consumed around the time of conception and during early pregnancy. You are at higher risk of placental abruption (which is when part of the placenta separates from womb) if you take aspirin throughout your pregnancy. Your baby’s growth could be affected by taking aspirin regularly during pregnancy. Taking aspirin late in your pregnancy means that there is a chance that your labor could be delayed and it could increase the risk of your baby developing heart and lung problems after birth. Taking aspirin could also cause problems with bleeding complications for your baby and for you. A number of studies have shown possible links between birth defects and taking aspirin during early pregnancy, however none of these studies are conclusive – most of your baby’s development takes place in the first 12 weeks of pregnancy so it is best to avoid aspirin during this time. If you take standard doses of aspirin after 30 weeks pregnant it can result in the ductus arteriosus closing while your baby is still in the womb. The ductus arteriosus is a blood vessel that needs to stay open to supply the baby in the womb with oxygen and nutrients from the mother. If there is premature closure of the ductus arteriosus then your baby may need to be delivered early. Use of NSAID’s (Nonsteroidal anti-inflammatory drugs, including aspirin) during pregnancy after 30 weeks can cause oligohydramnios which is when there is not enough amniotic fluid around the baby in the sac. How To Use Aspirin Safely While Pregnant There is no evidence to suggest that low dose aspirin has any negative effects on mother or baby during pregnancy, as long as both mommy to be and baby are healthy and not taking any other medications that may be affected by aspirin. Low dose aspirin is a total of 75 to 300 milligrams per day. In fact low dose aspirin is sometimes prescribed in these scenarios when pregnant: If you have Hughes Syndrome (antiphospholipid syndrome or APS), which means you are more prone to blood clots developing which in turn can lead to miscarriage. Taking low doses of aspiring along with the medication heparin will help to prevent blood clots from forming and reduce the chances of miscarriage occurring. If you have a high chance of developing pre-eclampsia due to having diabetes, having had pre-eclampsia before or if you have high blood pressure. If you have taken standard dose aspirin (325mg up to 4g per day) after you are 30 weeks pregnant you should inform your doctor immediately so that your doctor can assess your baby’s well being and you may need extra scans as well as monitoring. Check all the medications you take while you are pregnant, lots of over the counter medications such as Med-Lemon has aspirin listed in its ingredients. If you are pregnant the best is always to look for natural remedies for colds and flu, or alternatively ask your doctor to recommend medication that is safe for you and your baby.

April 19, 2018

Help! My child is being bullied at school

Navigating a world of people can be more challenging that climbing the most treacherous of mountains! Cindy Glass, Director and Co-founder of Step Up Education Centres says “As people, we are governed by emotions, and, unless kept in check, negative emotions can lead to negative behaviours that are detrimental to others as well as to ourselves. Bullying is a national epidemic and the harmful effects on a bullied child can last a lifetime. If you can remember that we can only give to others how we feel about ourselves, we will understand that someone who has a need to hurt another is hurting himself!” Cindy goes onto say “As people, we are also like magnets. We unconsciously attract into our lives, people who reinforce how we feel about ourselves! Bullies, who have low self-esteem, tend to target children who have low self-esteem! Both parties deal with a lack of self-esteem or self-worth in their own way and both need assistance in changing this! And, herein, lies the first and most important key to stamping out bullying- improving confidence and self- value!” Cindy’s top tips for dealing with bullying: Help your child by becoming his safe-place. Ensure that you always have a non-judgemental ear to listen and a supportive shoulder to lean on! Help your child to reclaim his/her power. Within each of us is the power to make positive choices. We can choose to internalise the words or actions of a bully or we can choose to stay detached and not allow these negative behaviours to determine who we are! Teach your child that it is not ok to be treated badly by others. Do not ignore incidents of bullying in the hope that it will just go away. The lower your child’s sense of self becomes, the more intensely he/she is likely to be bullied! Remember that we cannot control the behavioural choices of others but we can control how we react to them. Consider enrolling your child into activities which build confidence. A confident child is less likely to be preyed upon by a bully. Try drama, sports, scouts, dancing, art, debating etc. If your child shows signs of being physically hurt by bullies, you will need to ask the teacher or even principal for help. Do not confront the bully yourself. This will most likely fuel the bully into expanding his attack on your child. Confronting the parents of the bully can lead to negative outcomes because of the intense emotions that both parties are likely to feel. Schools need to focus on teaching children emotional intelligence skills. Remember, it is the bullied child as well as the bully who need support in developing positive self-worth. Cindy concludes by stating “Bullying is never ok. There are no one-stop-shop solutions to the problem. We cannot ignore these destructive behaviours. Building self-worth is the key to long-term success!”

April 16, 2018

Medical Aid and VAT

Since the announcement of the 1% Value Added Tax (VAT) increase by the Minister of Finance last month, there has been much debate around its impact on consumers and just how this will affect the money left in their pockets at the end of the month. With the revised general fuel levy, it’s clear that consumers will have to tighten their belts and adhere to stricter budgets. The rising costs of healthcare One area of concern is the cost of private medical aid and VAT. For years increasing healthcare inflation and economic pressures have been a challenge for the healthcare industry. ‘The reality is that when consumers are struggling, medical aid, which is essentially a grudge purchase, is often viewed as unaffordable,’ says Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund. ‘In addition healthcare costs are not regulated which is why it is crucial for medical aid schemes to continue to explore ways to contain costs without compromising the level of health care offered to members.’ Members’ contributions However he says there is some good news regarding VAT and medical aid because the 1% increase will not impact monthly contributions or annual benefits. ‘Many members are confused as to whether VAT is payable on medical aid contributions but let me reassure you it is not,’ says Van Emmenis. ‘The VAT increase will have no effect on members directly and what they pay every month. Medical aid contributions for 2018 are already set and Bonitas will not increase contributions mid-year to accommodate the change in VAT. So, while the increase in VAT may influence the price of services, it will not impact benefits.’ Van Emmenis says: ‘If your plan covers you at 100% of a Scheme’s Rate, you are still covered at 100% of that rate, no matter what the cost to the Scheme because the Scheme will absorb the VAT when paying for member’s benefits. The only impact is when it comes to savings and day-to-day benefits with members having a 1% lower buying power.’ The Council for Medical Schemes In fact changing contributions in the middle of the year can only be done with the permission of the Council for Medical Schemes following a request from the Trustees of the medical scheme. This is a rare occurrence and most schemes generally put through contribution increases in January each year. The law He adds that VAT is never the property of any private entity but belongs to the Government. ‘We are therefore only vendors that collect the monies on their behalf. From April 1, Bonitas will increase the VAT to all providers of the Scheme by 1%. However, although this will have a direct impact on the budget of the Scheme for 2018 it will be absorbed by operational surpluses and not passed on to members.’ Tax credits One positive announcement out of the budget speech regarding medical aid was around tax credits. ‘Medical tax credits are effectively used as an ‘expense’ when calculating tax and reduces the amount of tax payable by a household belonging to a medical aid,’ says Van Emmenis. ‘There are eight million people who rely on these credits to make medical aid more affordable. Speculation was rife that the tax credit would be removed but it is a relief that private medical aid members have some reprieve.’ Conclusion The bottom line: The 1% VAT increase and the additional 52 cents general fuel levy will have a knock-on effect for South African consumers, things will cost more. However, it will not affect monthly medical aid premiums or member benefits although it will have an indirect impact in terms of healthcare services being more expensive, which will reduce buying power.

April 12, 2018

11 Things to expect postpartum

Pregnancy is an amazing journey and towards the end moms to be start preparing for their labor and birth, as well as the exciting prospect of meeting their new baby. The baby nursery will be prepared and hospital bags packed and ready. Then once baby has arrived the new mommy will be spending her days caring for her new baby, breastfeeding and bonding. Another important thing to remember and focus on is that the first six weeks after birth is considered a recovery period. Some moms will recover faster and other moms may take longer. How you give birth will also play a role in your recovery period, your symptoms and how you will need to look after yourself. Here are some tips for recovering after birth: Postpartum Bleeding Postpartum bleeding is known as lochia. You can expect to bleed anywhere from 4 weeks to 6 weeks after birth. Postpartum bleeding is heavier than a normal period. Your bleeding will be heaviest for the first 3 to 10 days after birth and then it should get lighter. Postpartum bleeding is made up of blood, mucus and uterus tissue. Your bleeding will turn from red to pink to brown and finally to yellow-ish white. You will need to stock up on maternity pads which are much more heavy duty than normal sanitary pads. Keep in mind that you should not use tampons for the first 6 weeks after birth – tampons could lead to bacteria in your uterus during this time. Consider buying some disposable maternity panties for use in the hospital and while you are bleeding heavily at home. You will undoubtedly leak through your maternity pads at some stage and ruin your panties. Having these stretchy disposable panties means firstly that you are comfortable but also that you needn’t worry about stains and extra washing during this time. If you get large blood clots in your bleeding or your bleeding is excessively heavy so that you are bleeding through a pad in an hour or less contact your doctor immediately as this could postpartum hemorrhage. After Your C-section When you have a c-section you won’t be mobile on the day of the birth. You will receive a epidural which means your lower body is numb and you will have a catheter which will be removed the morning after your c-section. While you won’t be able to move around fast or far in the beginning it is important that you start moving around as soon as possible after your catheter has been removed. This will help your body functions to start working (especially your bowels). It will also help to lower the chances of any post-operation complications like blood clots in your legs. Many women experience gas and bloating after their c-section which may be uncomfortable and even painful. You will need to keep your c-section wound clean and dry for the first 10 days – you will probably have a waterproof bandage on it so you can shower. When you go for a checkup after birth your doctor will remove the bandage and check your scar to see if it is healing properly. Once the bandage is off clean your scar daily and pat it dry afterwards. Check with your doctor whether he advises you leave your scar open or keep it covered. Your c-section scar will be incredibly sore the first few days and stay tender for a long time after the operation. Your doctor will prescribe you anti-inflammatory medication as well as pain medication to help you manage the pain. Using a postpartum girdle after a c-section (or even after natural birth too) comes with many benefits, including providing your stomach with support which will help with easing the pain. You can read more about postpartum girdles here. It is important not to do any lifting after your c-section other than when you need to pick up your baby of course. Refrain from lifting anything other than your baby for the first 6 weeks to give yourself a chance to heal. After Natural Birth Giving birth naturally usually means a quicker and easier recovery than giving birth via c-section, however parts of your body will have taken a bashing. Make sure to look after your perineum (the area between your anus and vagina) properly. For the first 24 hours after birth ice your perineum. Keep a spray bottle handy and fill it with warm water when you need to urinate. Give your vaginal area and perineum a squirt of warm water before and after urinating. This will keep the urine from irritating any torn skin. Your perineum may have torn during birth requiring stitches or your doctor may have performed an episiotomy (a surgical cut to the perineum) to widen you vagina during an assisted birth, if your baby is in distress or to prevent your perineum from tearing. Your body may also be achy and sore from pushing. Your doctor may prescribe pain medication and you can also take a hot shower or use heating pads to ease the aching. Your Uterus and Tummy Your stomach will take a while to get back to its normal size, so don’t expect a flat stomach after birth. You may even still look pregnant for a while. It will take some time for your uterus to contract back to its normal size. You can also expect some cramping as your uterus contracts. Breastfeeding your baby will help your uterus to contract so you can expect to feel cramps when you breastfeed. It may take a few weeks to a couple of months for your tummy to start looking normal again. You can expect to have some stretch marks and if you have had a c-section you will have a scar. You can look into ways to reduce your stretch marks, but also remember that your stretch marks are a sign that you have brought life into this world. Caring For Your Breasts Whether you are breastfeeding or

April 11, 2018

How The Way You Feel About Yourself is Interpreted to How Your Child Feels About Themselves 

(attend one of our free EQ talks – click here for details) Emotions are energy and movements within our bodies based on how we interpret life and events. When we fall in love, our bodies feel wonderful, warm, tingly, cosy and excited as endorphins are released by the brain into our bodies. However, when we feel scared or threatened, our bodies feel constricted and tight which comes from the adrenalin and cortisol released to activate the fight or flight response. We experience hundreds of different feelings but interestingly enough all of these feelings are produced from two core feelings; love and fear which all starts with whether we feel accepted or not. Acceptance is a Primal Need Acceptance is our most primal human need. Every one of us strives for acceptance; who we are, what we stand for, what we believe and what we look like. ALL of this combined is what creates the way we feel about ourselves and how we respond and express ourselves. When we accept and love ourselves, we feel emotionally safe and are able to express ourselves from a place of love. But when we believe that we are unacceptable, we become defensive and express ourselves from a place of fear, which can come across as anger, frustration, irritation, impatience, judgement or by being dismissive. Rose-Tinted Glasses I’m sure you have heard the saying ‘seeing life through rose tinted glasses’. Well here’s the thing, we all have our own pair of tinted glasses that we view life through. When someone close to you – a partner, child or friend expresses their feelings of discontent to you, we immediately tend to assume it’s about us. We ‘view’ their words through our ‘glasses of non-acceptance’ and fear kicks in. We interpret whatever they are saying as criticism or believe that we did something wrong and feel responsible for their feelings and in the process become defensive. Putting our Parents On Pedestals So where does all this non-acceptance or acceptance of ourselves start? It starts in childhood and with our parents. If our parents like themselves and they feel good about themselves, those feelings are transmitted to us verbally and non-verbally. But if our parents are not okay with who they are, then this too gets transmitted to us verbally and non-verbally. Children tend to make everything about themselves, they put their parents on pedestals, and whenever something doesn’t feel right, they think that it’s because of them. My mom loved to turn simple events into adventures. She always tried to look on the bright side. I recall one evening sitting at the kitchen table watching her make pancakes. I adored my mother, we were extremely close and as I watched her, I picked up her distress. I realised that her act of excitedly making pancakes was to mask the fact that all we had in the form of groceries was milk, water, eggs and sugar; the very same ingredients needed to make pancakes. I felt my mother’s distress of not knowing where the next meal was going to come from and in my ‘adoration for my mother,’ I came to the conclusion that if I wasn’t there, then her burden would be less. From that moment on, I grew up not wanting to be a burden to anyone and took on a stance of ‘I can do without’ and therefore I did go without so much for so many years until I uncovered this crazy belief and got rid of it. As you can see from that example, I made my mother’s feelings all about me, it changed me as a person, it changed the way I felt about myself and it changed the way I expressed myself. Not for one instance did my mother tell me I was a burden, I concluded that all on my own. You see, the only way you can change the tint on your glasses is by changing your internal view, which basically means to change the way you view yourself. How Acceptance helps your child Acceptance is a choice, to accept yourself, means being totally open and honest about who you are, and then giving yourself permission to be that person. The minute you do this, you change the tint of your glasses and not only are you able to see all the good stuff about you and your life, but you are able to do the same with others. Your defensiveness of yourself and your judgement of others disappears. Once you accept yourself, you are able to accept others for who they are too. And, more importantly you will role-model this to your children, they too will feel acceptable just as they are. I am not saying that this includes accepting bad behaviour. what I am saying is that your children need to know that who they are is acceptable, that they are enough and worthy of your love and respect, that it’s not dependant on their good behaviour. Click here to attend one of our free EQ talks in April and May

April 10, 2018

How to teach your child to overcome their fear of water

Before your child can begin learning how to swim, it’s critical to build their water confidence and remove any mental barriers they may have developed. If your child exhibits fear of the swimming pool, you’re not alone. Many children experience water anxiety that can impede progress during swimming lessons. Fortunately, this mental block can be overcome. In this article, I’ll discuss how best to deal with children who are nervous around water to help your child on the path toward proficient swimming. For new parents, I’ll also cover some common mistakes to avoid that can help prevent problems when it’s time to teach your child how to swim. Born to Swim You might be surprised to learn that babies are natural born swimmers. Just like adults, children’s bodies are naturally resistant to water. The same reflex that prevents infants from inhaling milk while breastfeeding protects them from choking on water while swimming or in the bath. If you’ve ever blown sharply in your baby’s face, you may have observed a natural mammalian diving response; a baby will automatically close their eyes and hold their breath. This is known as the bradycardic reflex and is present in infants up to one year old. Also remember that your child spent the first nine months of their lives in a veritable lap pool. They understand buoyancy and most infants don’t fuss at all about being taken into the water as long as it’s not too cold. Since fear of the water is a learned behavior, children who are apprehensive about swimming have typically had a childhood experience that caused that apprehension. Many of my swim students who started class with an existing fear of the pool had doubts simply because a parent instilled those doubts in their child, or the parents were overly cautious about getting water on their baby’s head and face when bathing. Most of these parents are well-meaning and did what they thought was best for the child at the time. Unfortunately, this teaches the child to be nervous around water and can lead to resistance when it’s time to start swimming. Take It Slow If your child has already started showing signs of water aversion, such as resistance, crying or refusing to go in or near the pool, it’s important to take it slow and proceed with caution. Don’t try to force the issue before she is ready to tackle the challenge on her own terms. Otherwise, you could end up facing an uphill battle with strong emotions like panic, crying, and sometimes, deepened fear. Start With Bath Time As the adult, you have the divine knowledge that water is completely harmless for your child. When it’s bath time, your job is to be a calm and confident parent. Use a cup to scoop water from the tub and pour it over baby’s body and head. Don’t be hesitant or express worry. Don’t make a big deal out of it by telling your child to hold her breath and count to three. And, most importantly, don’t shield your child’s eyes and face from the water. If you’re concerned about soap getting into her eyes, do an initial rinse with her head tilted back and a second and third rinse straight over the head. Let the water flow over her eyes, nose, mouth and ears. Remember that children learn to react like their parents and peers do. The same way that we inadvertently teach children to scream at the sight of a cockroach, we often teach them to be afraid of water too, sometimes just by showing outward nervousness when our children’s faces get wet. Capitalize on Interpersonal Relationships I’ve found that a role model can be tremendously encouraging for a child. If your kid has an older sibling, cousin or friend who can swim, take everyone to the pool together so your younger kid can see how exciting it is to swim independently. Often, this is enough to stimulate a non-swimmer to want to start lessons. In fact, I often teach dual-level lessons to allow for a more advanced child and a beginner to share pool-time. When the novice student sees their older brother or best friend excelling, they’re more likely to try skills they wouldn’t have attempted had they been on their own. Or, if you have two children at the same level, you can try them in a class together as well. Though some siblings have a harder time concentrating when their counterpart is around, others are encouraged by natural sibling rivalry. Make Pool Time Play Time If you have your own pool or you take regular trips to a community aquatics facility, you’re already on your way to helping your child overcome their water anxiety. If you plan to sign up for lessons, there’s no need to work on any specific skills in advance. Just allow your child to get used to the water’s feel and buoyancy. Bring some pool toys along to make the experience a positive one. When shopping for pool toys, let your kids help you decide. After all, they’ll be using them more than you and you want them to be excited about a new game before they get to play it. There’s really no wrong toys. Any toy that floats can be tossed out into the water and “rescued” with your help; anything that sinks can be placed on a step and reached down to while you encourage them to blow bubbles into the water. Even toys that aren’t meant for the pool will often work as long as they don’t have holes that water can get trapped inside and grow mold. Among the odder things in my toy bag, I have a water-tight baby doll, ping-pong balls and artificial flowers with fishing weights attached to them so kids can “pick the flowers” off the bottom. It’s important to keep pool toys separate from the regular stash so that kids don’t lose interest in them before you make it into

April 9, 2018

Vitamin B12 deficiency: A silent epidemic with serious consequences

Vitamin B12 deficiency isn’t a bizarre, mysterious disease. It’s written about in every medical textbook and its causes and effects are well-established in the scientific literature. However, B12 deficiency is far more common than most health care practitioners and the general public realise. Research suggests that 40 percent of people between the ages of 26 and 83 years have vitamin B12 levels in the low normal range – a range at which many individuals experience neurological symptoms. Symptoms of a vitamin B12 deficiency are easily mistaken for signs of other ailments. If you’re feeling more anxious, tired, or worn out than usual, a B12 deficiency may be to blame. Vitamin B12 deficiency can be sneaky and harmful, so keep reading for some insight. WHAT DOES VITAMIN B12 DO? Vitamin B12 is a water-soluble vitamin and is also the only B vitamin that is almost exclusively found in animal foods. The human body needs vitamin B12 (together with folate) to make red blood cells, DNA and help promote healthy function of nerves. In addition, B12 is one of the vitamins responsible for a well-functioning metabolism and robust energy levels. Like most vitamins, B12 can’t be made by the body. Instead, it must be gotten from food or supplements. And therein lies the problem: Some people don’t consume enough vitamin B12 to meet their needs, while others can’t absorb enough, no matter how much they take in. The absorption of B12 is also complex and involves several steps – each of which can go wrong. As a result, vitamin B12 deficiency is relatively common. WHO IS AT RISK FOR B12 DEFICIENCY? There are many causes for vitamin B12 deficiency. In general, the following groups are at greatest risk for a deficiency: Vegetarians and vegans Because B12 is not generally found in plant-based foods, vegetarians are at risk for B12 deficiencies. This explains why studies consistently demonstrate that up to 50% of long-term vegetarians and 80% of vegans are deficient in B12. People aged 60 or over The condition is more likely to occur in older people due to the cutback in stomach acid production that often occurs with ageing, making it harder to absorb this vitamin. It has been estimated to affect about 40% of people over 60 years of age. It’s entirely possible that at least some of the symptoms we attribute to “normal” ageing – such as memory loss, cognitive decline, decreased mobility, etc. – are at least in part caused by a vitamin B12 deficiency. People who regularly use PPIs or acid suppressing drugs If you take proton pump inhibitors (PPIs) e.g. omeprazole (antacid or heartburn drugs) you may be at risk for B12 deficiency. These drugs reduce acid production in the stomach and acid is needed to absorb vitamin B12. Medical conditions Conditions that interfere with food absorption, such Coeliac or Crohn’s disease, Ulcerative colitis, irritable bowel syndrome (IBS), bacterial overgrowth (intestinal dysbiosis), atrophic gastritis (thinning of stomach lining) or gut inflammation, pernicious anaemia (an autoimmune condition where the body destroys intrinsic factor, a protein necessary for the absorption of B12) can cause B12 trouble. Certain medications Use of some commonly prescribed drugs such as metformin (insulin resistance and diabetes), or anti-seizure medications such as phenytoin may cause a B12 deficiency. Heavy drinkers or alcoholism Drinking alcohol, even in moderation (more than one alcoholic drink a day), can have profound effects on the way your body absorbs vitamin B-12. Genetic variations Common genetic variations may interfere with the absorption of vitamin B12, and subsequently levels of the vitamin in the blood. Weight loss surgery People who have stomach stapling or other forms of weight-loss surgery are also more likely to be low in vitamin B12 because the operation interferes with the body’s ability to extract vitamin B12 from food. SYMPTOMS OF VITAMIN B12 DEFICIENCY Vitamin B12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time. It can also come on relatively quickly. A vitamin B12 deficiency occurs in four stages. Stage 1 – beginning with declining blood levels of the vitamin Stage 2 – progressing to low B12 levels within the body’s cells Stage 3 – increased blood level of homocysteine and reduced ability to repair and produce DNA Stage 4 – finally, macrocytic anaemia Anemia A vitamin B12 deficiency can cause anaemia (low red blood cell production). Red blood cells carry oxygen all over the body. When the body does not produce enough red blood cells, the amount of available oxygen in the body, decreases as well. B12-related anaemia can cause many other issues, including: Extreme Fatigue: It’s normal to get tired during the day if you didn’t sleep well the night before, just ate a large meal, or completed strenuous exercise. But it isn’t normal to experience an overwhelming fatigue that doesn’t go away with rest. Muscle Weakness: You might experience soreness after a hard workout for a day or two, but if your muscles feel like you just ran a marathon after a simple activity like brushing your hair, you may be anaemic. Heart Palpitations: Feel a flutter in your chest? You could be experiencing heart palpitations due to decreased oxygen circulation. Breathlessness: Breathlessness is normal after activity, but if you find yourself short of breath during rest, it’s an indicator that something’s not right. Just like heart palpitations, anaemia can cause breathlessness due to a lack of oxygen in the blood. Pale Skin: Red blood cells are responsible for the rosy colour in our cheeks. When red blood cell production decreases—as it does in anaemic individuals—the skin becomes pale and colourless. Pins-and-Needles Sensation You know the pins-and-needles sensation you often get when your foot falls asleep? This sensation is called peripheral neuropathy and can be linked to nerve damage caused by a B12 deficiency. According to the Foundation for Peripheral Neuropathy, a B12 deficiency damages the sheath that surrounds and protects nerves, resulting in an unpleasant and sometimes painful tingling sensation. Other diseases such as diabetes can

April 5, 2018

Children with ADHD: Bullied or bully?

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) are unlikely to go unnoticed in a school environment. It can quickly earn your child the “different”, “difficult” or “disruptive” label and attract the attention of bullies. ADHD can inhibit your child’s understanding of social cues, which can have a negative impact on everyday conversations and social interactions. The exclusion from social circles only leads to heightened feelings of isolation and depression. Bullying in schools can have a serious impact on your child’s participation and academic performance. Over 3.2 million South African students are bullied yearly but more than 67% don’t speak up due to fear, shame, and doubt that parents or teachers can change their situation. Bullying is often directed at insecure and passive children who display physical weakness and poor social skills. Bullied or bully? Whether brought on by ADHD tendencies or low self-esteem caused by the condition, research suggests that ADHD children are nearly 10 times more likely to attract the attention of bullies. They tend to avoid confrontation but when taunted by bullies, ADHD children often overreact emotionally. Unfortunately, the display of tears and anger or an impulsive retort to provocation usually adds fuel to the flame for a bully. That said, recent research found that children with ADHD are almost four times more likely to bully other children without the condition. Likewise, this can be due to low self-esteem or could be in response to victimisation or feelings of depression. The destructive impact of bullying Bullying can be linked to lasting emotional, mental and physical health issues for both the bullied and the bully. If your child is bullied at school, he or she is likely to experience heightened levels of insecurity, anxiety, depression, loneliness, poor sleeping and eating patterns, and decreased academic achievement – over and above ADHD symptoms. On the other hand, if your ADHD child has become the playground bully, he or she is more likely to get into fights or partake in risky activities. Keep a close eye on school attendance as both the bullied and the bully are more likely to bunk school. Fortunately, there are many other ways to deal with bullying at opposite ends of this spectrum. In addition to a holistic treatment plan and an active support group, the impact of ADHD in the school environment can be successfully managed. That means less attention from bullies and a memorable and carefree childhood. For more information around the symptoms, impact and treatment of ADHD, visit MyADHD.co.za or My ADHD on Facebook.

March 29, 2018

Making your medical benefits last

As each new year begins medical aid members start with a clean slate, with new benefits and replenished savings available. ‘If you manage your medical expenses correctly you can avoid out-of-pocket expenses and limit the possibility of running out of benefits,’ says Gerhard Van Emmenis, Principal Officer of Bonitas Medical Fund. Van Emmenis, gives some tips on managing your medical expenses to make them last. Find a GP on your medical aid’s network Using network doctors is an invaluable tool to make your medical aid last longer as it means you won’t be charged more than a specific amount. At present, Bonitas Medical Fund has the largest network of GPs in South Africa – with over 6 000 doctors. Always use partner networks Medical schemes negotiate preferential rates with providers who have partnered with them. This means if you use a network hospital, doctor or pharmacy you will not be charged more than the rate agreed with the scheme. This will also help you to avoid co-payments, deductibles and additional out-of-pocket expenses. Ask your pharmacist Buy over-the-counter medicine to treat less serious ailments and consider using generic medicine which is cheaper but effective. Pharmacists are able to provide sound medical advice on problems such as rashes, colds or illnesses that are not severe, simply ask! Going to hospital – get the facts Talk to your doctor or specialist before being admitted to hospital. Check what they are going to be charging and what your scheme will cover. If there is a large difference, don’t be afraid to approach your doctor to see if they are prepared to adjust their fee. Alternatively, you can also check if there are other healthcare providers who are on your scheme’s network that will charge you a better rate. Remember to pre-authorise Pre-authorisation is required for all hospital admissions to ensure your stay will be covered. Always ask if there are any co-payments or sub-limits that will apply and what you can do to avoid these. For planned procedures, it’s also worth checking with your scheme if you will obtain better cover by using contracted providers or having the procedure performed in the doctor’s rooms or a day clinic. ICD-10 codes If you need to undergo an operation, ask your surgeon for the codes that will be charged. This will include the procedure codes and those for any other products that will be needed, this all helps with pre-authorisation and ensuring the costs will be covered. Look for schemes that offer benefits paid from risk These benefits give you more value for money and are in addition to your savings and day-to-day benefits. Bonitas pays for maternity consultations, wellness benefits, preventative care and dentistry from risk on most plans. 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. Be aware of consulting after hours In an emergency one has no choice, but after hours consultations are very expensive. As a general rule, try to avoid using an ER facility where possible. A bona fide medical emergency usually results in admission into hospital. Manage your chronic medicine correctly The golden rule for chronic illness benefits is to try to use the medication on your scheme’s formulary and to obtain this from a specified pharmacy, either on the network or a designated service provider. Bonitas offers a home delivery service for chronic medicine, to make things even more convenient for members. PMBs If you suffer from a Prescribed Minimum Benefit (PMB) condition, understand what benefits are provided as part of a PMB condition and utilise the service of the designated service provider to ensure that your claims are paid from risk rather than from your medical savings account. ‘Don’t be uninformed,’ says Van Emmenis. ‘Your health is important, so take the time to research and understand the medical aid plan you’ve chosen. Read the information sent to you by the Scheme or your broker. Ensure you read the fine print and understand the Scheme Rules. This will go a long way in helping you know your rights and making the most of your benefits.’

March 29, 2018

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