Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

Hospital pre-authorisation vs quotes – what you need to know

Due to the different waves of Covid-19 and the emerging variants, a number of elective surgeries were postponed to help minimise the take up of hospital beds and to avoid unnecessary exposure to the virus. However, surgeries are now getting back on track, – even if it’s only a window during which the backlog of elective surgeries can be tackled. It is the perfect time to talk about the issue of pre-authorisation and quotes and why you should know the difference. Lee Callakoppen, Principal Officer of Bonitas Medical Aid, says pre-authorisation, ahead of any medical procedure or hospital admission, is always required. He also stresses the importance of asking for a quote to submit to your medical aid. This will ensure you know exactly what is covered and whether you should plan for any out-of-pocket expenses. Does pre-authorisation mean payment, in full, is guaranteed? Not necessarily. Let’s take you through the process and T&Cs. What is pre-authorisation? All procedures that take place in a hospital must be pre-authorised. Essentially, it’s an agreement between the medical aid and the hospital, indicating a willingness to pay for costs associated with the visit. But even if you do have pre-authorisation your medical aid is not promising to cover 100% of the costs. All pre-authorisation requests are evaluated against the different schemes’ rules and clinical funding policies however, you remain responsible for any shortfall, including any co-payments. If you are unsure how to go about the process speak to your broker or your medical aid. When do I need to pre-authorise? You must apply for a Pre-Authorisation Reference number (PAR) as soon as a visit or admission to a hospital is planned. This applies for a CT scan, MRI scan or radio-isotope study. Do this as early as possible in case you are required to submit additional documentation or a motivation from your healthcare provider. You also need pre-authorisation for: Renal clinic admissions for dialysis Procedures in doctor’s rooms or day clinics, instead of hospital Physical rehabilitation care in rehabilitation facilities Drug and alcohol rehabilitation care in specific facilities Hospice admissions Oxygen therapy at home All specialised radiology What information is needed? Name and surname of the person having the procedure Membership number and dependent code The date of admission or procedure The diagnosis All proposed surgical procedures, diagnostic procedures or specialised radiology codes available (ICD-10, CPT, NRPL codes) The name of the facility where the procedure will take place The names and practice numbers of the healthcare professionals (doctor, surgeon, specialist etc) Once your pre-authorisation has been approved you will receive a confirmation letter. Read this carefully and check that the information is correct. If you are any queries speak to your doctor or your medical scheme. What about emergency admissions? In the event of emergency treatment or admission to hospital, you – or a family member or the hospital – must contact your medial aid on the first working day after the incident to obtain authorisation. Did you know? Your doctor or the facility you are being admitted to, can do the authorisation on your behalf. Despite this, it remains your responsibility to ensure that the authorisation is completed and correct. What happens if you don’t pre-authorise? You will either be liable for a co-payment, or your procedure will not be covered. Does pre-authorising ensure payment of the procedure? No, unfortunately not. Most medical aid plans have varying hospital benefits according to the level of cover you have chosen and they also have a ‘rate’ and which they reimburse healthcare providers. This means that even if the payment is 100% of the rate, this is not necessarily what the healthcare provider will charge, they may charge 200% of your medical aid rate. This means you are responsible for any shortfall in the form of a co-payment. Co-payments differ from one medical scheme to another and are often higher than anticipated, mostly due to medical practitioners and hospitals charging higher than the medical aid rate. ‘We mitigate this as much as possible,’ says Callakoppen, ‘by negotiating with hospitals and service providers who are on our network, to place a ceiling on the costs of the procedures.’ For this reason, it is best to find a healthcare provider on your scheme’s network Quotes vs pre-authorisation for procedures Callakoppen advises private medical aid members to not only obtain pre-authorisation but to also ask for a detailed quote from the hospital and medical practitioner prior to being admitted to hospital. ‘This gives you an opportunity to negotiate and eliminates any additional ‘surprise’ payments required after the procedure. ‘The most important thing’, says Callakoppen, ‘is to find out, prior to being admitted, what your medical aid will pay and what payment you might be responsible for. The last thing you want to deal with is a surprise large co-payment and the stress related to that when you are recovering from a procedure.’

September 30, 2021

What should I do if I have symptoms of COVID-19 and I am pregnant?

Given today’s current global COVID-19 pandemic, worrying about the potentially harmful viruses’ effect on your pregnancy and baby is a valid concern. You’re probably wondering the best ways to avoid the virus when pregnant, and what to do if you think you may have caught it. How can I protect myself and my baby from catching the corona virus? Protecting yourself from COVID-19 while pregnant, is similar to that of anyone else avoiding the virus. Minimise contact with others through social distancing, frequently wash and sanitise your hands, and avoid touching your nose, eyes and mouth. Don’t be tempted to skip important prenatal visits in lieu of avoiding the virus – chat to your doctor about the best way forward with regard to this. Although slightly disappointing, cancelling events such as baby showers is a good idea, as the risk of exposure and infection becomes bigger with larger groups. Being pregnant, it’s a good idea to be extra precautious where possible. However, the RCOG (Royal College of Obstetricians and Gynaecologists) states that pregnancy doesn’t increase your risk of becoming unwell from coronavirus, and the majority only develop mild to moderate symptoms. What should I do if I think I have COVID-19 while pregnant? If you think you may have COVID-19 or have tested positive for corona the first thing you should do is contact your doctor. However, it’s best to avoid travelling to the doctors office as you may come into contact with someone positive for COVID-19 in these spaces. As the virus is new, this means that the studies that have been conducted are limited. Because of this it’s essential to follow social distancing guidelines to try and protect yourself, however, if you do contract the virus there is no immediate need for stress, as pregnancy doesn’t increase your risk.

September 23, 2021

Redefining healthcare in 2022

As South Africa moves to Covid-19 adjusted Level 2 and vaccination numbers increase, access to quality healthcare remains a priority. Today, Bonitas Medical Fund announced its 2022 product line up offering. This includes the use of reserves to keep contribution increases lower, a Benefit Booster to stretch day-to-day benefits, a revised international travel benefit with payment for Covid tests and a contribution towards quarantine costs. There is also a renewed focus on preventative care, virtual consultations and plans that enable more South Africans to have access to affordable, quality healthcare. Lee Callakoppen, Principal Officer of Bonitas said, ‘The Scheme performed well in a volatile market, attributable to proactive risk management and prudent board decisions. A positive offshoot of the pandemic was an increased appreciation of medical aid cover that resulted in better-than-expected member retention and a 2.3% membership growth since January.’ Top line changes ’We have taken a strategic decision to utilise approximately R600m of reserves to ensure that 82% of members receive a below CPI contribution increase for the 2022 benefit year. The innovative Benefit Booster equates to an increase in day-to-day benefits for members ranging from 16% to 32%, depending on the members’ plan. We believe it is the largest increase in benefits ever seen in the medical aid industry.’ The average weighted contribution increase across all plans is 4.8% with the BonStart premium decreasing by 7.9%, which can be attributed to the low cost versus benefits ratio and the younger membership profile on the plan. The decrease in contribution is an industry first – as was the decision to offer BonFit Select at a 0% increase in 2020. New offerings include an additional virtual plan, BonStart Plus, a renewed focus on Managed Care with an oncology management programme as well as an enhanced member app, powered by AMP, which includes a personalised wellness programme to encourage healthier behaviour. Plans There will be a total of 15 plans for the year ahead comprising traditional, savings, hospital, edge (virtual), network and income-based plans, each carefully crafted with a specific mix of benefits to appeal to various target markets. Increases range from minus -7.9% to 6.5%. Bonitas has opted to increase its options which are currently in a growth phase – BonSave, BonFit and BonEssential – by only 3.6%. Sustainability and affordability The Council for Medical Schemes (CMS) recommended increases in line with CPI of 4.2% with the caveat that financial stability and sustainability of schemes must remain a priority. We feel that the use of part of our reserves to cushion members against increasing costs is an appropriate strategy. Other recommendations by the CMS include: Driving innovation from a pricing point of view; exercising caution in terms of utilising reserves to help cushion increases and adopting innovative pricing models – a directive Bonitas took to heart. Boosting benefits The Benefit Booster is the most innovative change in the healthcare industry since the advent of the savings account. It stretches value and equates to an increase in day-to-day benefits ranging from 16% to 100%, depending on the plan. This covers all out-of-hospital claims including acute medicine, GP consultations and non-surgical procedures such as wart removal. Members simply need to complete a wellness assessment (which can be done online), to tap into the Benefit Booster. Claims will pay from this benefit first – helping to preserve savings and day-to-day benefits for members. Managed Care At the launch, Dr Morgan Mkhatshwa,Head of Operations said, ‘Lifestyle diseases have reached epidemic proportions in South Africa. 80% of these Non-Communicable Diseases (NCDs) are caused by lifestyle risk factors like smoking and obesity. Managed Care is designed to help members with chronic conditions by using the best clinical and treatment protocols. This is achieved by analytics and continuous research, alignment to the latest technology, market trends and member needs and leveraging this data for enhanced treatment. Oncology Cancer prevalence is increasing alarmingly. As a result, coordination of care is critical for oncology. Bonitas is introducing a new Oncology Management Programme that utilises a partnership between Medscheme Managed Healthcare and the South African Oncology Consortium (SAOC), to improve the coordination of care of oncology patients. Back and Neck Programme ‘Our back and neck programme has seen a 93% success rate. In 2022, we introduce the eDBC app. This technology-driven channel offers digital coaching solutions and home-based care to help improve pain and mobility. It includes a self-assessment, baseline progress checks and outcomes’ evaluation.’ The GP is key ‘The Scheme believes that the GP is at the heart of the Managed Care model. Care coordination is essential in ensuring that members get the right level of care and support in managing their conditions. Our GP network has a broad national footprint and 98% of members are within a 10km radius of a network GP.’ Virtual Care BonStart, the inaugural Edge plan introduced in 2020, proved very successful – using virtual care as its base. For this reason, the Scheme is introducing an additional Edge plan, BonStart Plus for 2022, aimed at attracting a new profile of member through this diversified distribution channel and attractive pricing. Virtual care has proven a sound and reliable solution, locally and internationally, for improving access to quality healthcare and is now offered across all 15 Bonitas plans. Digital Covid-19 spurred progression of digital enhancements with innovations such as a mobile app and WhatsApp channel being swiftly created. The Member Zone is being enhanced allowing members to manage their medical aid more effectively. Amalgamations Callakoppen says, ‘Bonitas’ track record for amalgamations is excellent and we are currently awaiting approval from the Competition Commission to our proposed amalgamation with the Nedgroup Medical Aid Scheme. The amalgamation will fortify the size of Bonitas as well as decrease the average age and pensioner ratio while bolstering the reserves.’ Travel benefits ‘We wanted to ensure that our members are covered should they need to travel and noted that testing and enforced quarantine could be expensive. The Scheme is therefore offering a Covid-19 PCR test pre-

September 22, 2021

Covid-19 Information for Moms-to-Be

Pregnant women do not appear to be more severely unwell if they develop Coronavirus than the general population. As this is a new virus, how it may affect you is not yet clear. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

September 16, 2021

Urban living’s impact on our wellness

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

September 13, 2021

Performing in a pandemic: Bonitas announces healthy annual results

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

August 30, 2021

Advice from the experts

Addiction – a dangerous trend gripping the nation

It is estimated that around 10 million – or 20% – of South Africans are abusing substances. This is according to the South African Society of Psychiatrists. Whether it is alcohol, codeine, dagga, heroin or other drugs it’s a very worrying statistic that costs the private and public healthcare industry millions annually in rehabilitation and recovery.

September 20, 2019

HAPPY FAMILY ORGANICS – CHANGING LIVES AND THE WORLD, ONE MEAL AT A TIME

Happy Family Organics, makers of ready-to-eat, nutritious and delicious organic meals, is not only changing the way babies and children are nourished in South Africa and around the world, but they are also changing the lives of young orphans in Tanzania through their Happy Family Children’s Village (HFCV).

September 9, 2019

Are probiotics & vitamin D beneficial for babies?

How do you know what health products and supplements are necessary or not when it comes to your little one? How do you choose and what do you look for?

September 6, 2019

Medical aid non-disclosures: What you need to know

Be honest and disclose all information. Don’t forget to read the questionnaire carefully and regardless of whether you think it’s important or not, or whether the medical condition was years previously, include it in your application

August 28, 2019

BULLYING AT SCHOOL CAN HAVE A LIFE-LONG IMPACT ON MENTAL HEALTH

Bullying has been put on the radar this July, which is recognised as National Mental Illness Awareness Month, to highlight the need for greater public awareness and responsiveness given the high level of violence experienced at SA schools.

August 22, 2019

How Sugar can Damage our DNA

While we may be familiar with the dangers of a poor diet, in particular eating too much sugar, the actual effects of this may be far more frightening than previously imagined. Certainly, science supports the idea that excess sugar consumption leads to weight gain, increasing our chances of becoming obese as well as developing diabetes and heart disease. But now, new data shows that sugar can harm us in a place we didn’t expect, by actually attacking our DNA. Majority of the world’s population will average around 13-14% of calories a day from pure added sugar. It would seem we’re destined to harm our DNA.

August 15, 2019

Combatting rising healthcare costs

Access to quality healthcare remains a priority for South Africans. However, with healthcare costs consistently outpacing inflation, the challenge for private medical schemes remains finding the right balance between providing a high level of value and care for members, while managing costs effectively.

August 12, 2019

Uncomfortable in your own skin? How to manage eczema

What is eczema? Atopic eczema is a common chronic skin condition that causes dry, red and itchy skin. It may affect up to 20% of infants, and 3% of adults. It is commonly associated with other allergic disease such as asthma and hay fever. Atopic eczema usually begins in infancy, at around 3 months, and it may persist into adulthood. Its’ course may vary over a period of time with bouts of red, angry flares interspersed with relatively normal-looking skin. The good news is that in most cases eczema improves by age 3 to 5 years, and has often completely resolved by teenage-hood. What causes eczema? Importantly, eczema is not a contagious disorder. It is due to the interplay of genetics, environmental factors, and a defective skin barrier in an individual. Due to this abnormal layer of skin, there may be water loss, and allergens and irritants may enter the skin resulting in itchiness and dryness. The skin may be vulnerable to bacterial infections during the flares. What are the common sites of eczema? In young children, eczema is usually seen on the face and outer legs and arms. It appears wet and oozing. As a child gets older, the rash usually changes to a dry scaly itchy rash, and the position moves to the inner creases of the elbows and knees. Is eczema a serious condition? Though not associated with serious illness, eczema has definitely been proven to affect one’s quality of life. This may be due to the intractable itch, often subconscious, leading to sleep problems for example. Lack of sleep may, in turn, result in both behavioural and learning problems during school. There is often an associated issue of low self-esteem as individuals feel embarrassed by their skin, and absenteeism is common. What causes eczema to flare-up? Heat, woollen or synthetic clothing, fragranced soaps, washing detergents, and bubble baths have all been associated with eczema flare-ups. What are the steps to manage eczema? Reduce trigger factors prevent over-heating wear cottons rather than wool or synthetic clothing keep nails short to reduce damage to the skin from scratching emollients should replace soaps fabric softeners should be avoided avoid bubble baths bath water should be lukewarm not hot, and once out pat yourself dry, don’t rub the skin wash hair in the basin to avoid shampoo making contact with the skin before swimming, use a layer of emollient from top to toe after swimming, have a shower to remove the chlorine, followed by using an emollient again Moisturizing emollients These are the cornerstone of eczema treatment. They create an oily layer on top of the skin, which stops water from leaving the skin and therefore becoming dry. They should be applied in large quantities and frequently, as much as 8 times a day. Aqueous cream should not be used as a moisturizer as if it is left on the skin it is likely to irritate it however it may be used as a substitute for soap. Steroid creams These are effective in stopping skin inflammation. They work rapidly to settle down eczema flare- ups, and should be used during flare-ups to prevent skin damage. Steroids come in different strengths, from very mild to very strong. Very strong steroid ointments should be used sparingly as they have side effects such as thinning of the skin. Mild steroids have far fewer side effects, and will not affect a child’s growth and development. In a flare-up, a potent steroid cream can be used, but once controlled a lower strength ointment should replace it. This should be slowly reduced until the steroid cream can be stopped completely, and then only the emollient continued. Emollients should be used during flares too, and applied directly onto the steroid ointment. Cortisone tablets, syrups or injections are not recommended. While they may provide short term improvement, they may also cause worsening of eczema and are associated negative side effects. Antibiotics Your doctor may prescribe antibiotics in severe cases where areas of infection are noted around the eczematous lesions. Is eczema due to a food allergy? There is a lot of concern that eczema is a result of a food allergy. In fact, a very small minority of children with atopic dermatitis will have food allergy. This is far more common in severe atopic dermatitis. It is more likely that eczema causes food allergies, than the other way around, as allergens may enter the skin through the defective skin barrier. Food should not be removed from diet for the treatment of atopic dermatitis without the guidance of an allergy doctor. A baby with widespread eczema not responding to the correct eczema treatment may need to be worked-up for a possible food allergy. Can I prevent my baby from developing eczema? Babies at high risk are those whose parents or siblings have any type of allergies. There is a lower risk of eczema if babies are not exposed to cigarette smoking. Breastfeeding is beneficial in the first 4 months, if possible. Probiotics during pregnancy may provide a beneficial role in eczema prevention. And lastly, regular use of emollients in high risk babies, even if no eczema is present, has been shown to be protective against developing eczema.

August 5, 2019

Pregnant and too busy to eat healthily?

Life doesn’t stop when you are pregnant. Most of us are still busy with a full day’s work plus the usual cleaning, washing, shopping and cooking chores while sometimes caring for older children as well.

August 1, 2019

Does Your Child Need a Tetanus Shot or Not?

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

July 31, 2019

The big four – know your numbers

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

July 19, 2019

Emergency Numbers Every Parent Should Know

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

July 18, 2019

Emotional Decisions

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

July 16, 2019

GOOD NUTRITION FOR TEENS

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

July 12, 2019

Is It A Cold Or Is It The Flu?

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

July 5, 2019

Five tips to stretch your medical benefits

Lifestyles or Non-Communicable Diseases (NCDs) – such as diabetes – have become an epidemic in South Africa which is why preventative and managed healthcare has become all important. Whether you rely on the public or private healthcare system it is critical that you manage your health and lead a healthy lifestyle, to prevent long term illness. Cardiovascular (heart attacks and stroke), cancer, chronic respiratory disease and diabetes are on the increase and responsible for the high cost burden of healthcare. For the around 20% (just under 8.9 million) South Africans who are on private medical aid schemes, managing their medical expenses correctly is important if they want to avoid unnecessary out of pocket expenses and make their medical benefits last longer. It also helps them understand the cost associated with the healthcare services they receive and the benefits associated with the plan they have elected. Here are the five tips from Lee Callakoppen, Principal Officer of Bonitas Medical Fund on how you can stretch your medical benefits. 1. Use Designated Service Providers or networks Medical schemes negotiate preferential rates with providers – known as Dedicated Service Providers (DSPs) – who have partnered with them. This allows schemes to ensure that members get the best quality services at the most cost-effective rate so that the benefits are optimised and the scheme at large is sustainable. So if you use a network hospital, doctor or pharmacy you will not be charged more than the agreed rate. This will help you avoid co-payments and make your medical aid last longer. So, to reduce co-payments and even avoid them altogether, find a healthcare professional on your schemes network. 2. Go generic Use generic medicines which have the same active ingredient, strength and dosage as the original brands and are as effective. Most pharmacists offer a generic option, especially for chronic medication. Medical schemes are more likely to pay in full for generic medicine. Pharmacists are also able to provide sound medical advice on problems such as rashes, colds or illnesses that are not severe, simply ask and buy the recommended over-the-country medicine to save on a visit to the doctor. 3. Managed Care benefits Some schemes offer programmes to help you manage severe chronic conditions such as cancer, diabetes and HIV/AIDS. These programmes are usually covered from the risk portion of your medical contribution and are not funded from your savings account. They help you use your benefits to maximum advantage while ensuring you receive quality care by using specific providers. Other benefits – such as maternity consultations, wellness benefits, preventative care and dentistry – are also paid from risk by some schemes. Again giving you more value for money and are in addition to your savings and day-to-day benefits. Carefully read through what your plan offers and choose wisely to make sure you find the right plan to suit your specific healthcare needs 4. Know the facts If you do need to be hospitalised and it’s not an emergency ensure that it’s on your medical aid’s DSP list. Talk to your doctor or specialist to find out all the facts in terms of what they will be charging and compare this to what your scheme will cover. If the difference is substantial, negotiate. Approach your doctor and ask if they are prepared to adjust their fee. Alternatively, you can also check if there are other healthcare providers on your scheme’s network that will charge you a better rate. You can also avoid the unwelcome surprise of a co-payment or sub-limits by: Making sure you obtain pre-authorisation Making sure the medical practitioner uses the correct ICD-10 codes Checking what additional costs will apply (if any), what costs will be covered and how you can avoid these. 5. Keep moving One of the best ways to manage your health and the associated costs, is to live a healthy lifestyle and this includes getting enough exercise. Try different exercise routines and find one that works for you. Whether it is a regular short power walk, playing tennis or soccer, riding a bike or attending a yoga or pilates class, it will be beneficial to your mental and physical wellbeing. ‘Be informed and make good and less costly healthcare decisions,’ says Callakoppen. ‘Your health is important, so take time to research and understand the medical aid plan you are on. Read the information sent to you by the scheme or your broker, including the fine print and, if you don’t understand some of the terms, speak to your broker or phone the customer care line. Understand and know your rights in terms of healthcare cover, this will go a long way in helping you make the most of your benefits.’

July 3, 2019

Splitting up with your medical aid

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

June 20, 2019

Five ways to prevent a red, chapped nose this winter

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

June 19, 2019

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

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

June 18, 2019

Dangerous Decibels, Noise induced hearing loss in children

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

June 14, 2019

What you need to know about Pneumonia

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

June 12, 2019

Five facts about ‘flu

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

June 5, 2019

How To Make The Medicine Go Down

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

May 23, 2019

Parenting tips for ADHD

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

May 16, 2019

Deciphering Medical Aid Speak

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

May 10, 2019

What to do if you’re child is the bully

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

May 2, 2019

How To Get Your Kids To Go To The Dentist

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

April 18, 2019

Listening to Learn

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

April 17, 2019

First Aid Tips Every Mom Should Know

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

April 15, 2019

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

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

April 10, 2019

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