Health - Parenting Hub

Expert Advice from Bonitas Medical Fund

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

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

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

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

Advice from the experts

Why Playgrounds are so Important

Slip, slide, bump, bash, climb, wibble and wobble! Who knew so much fun could be so valuable?! Having access to a safe, clean and developmentally appropriate playground can have far reaching benefits for the leaders of tomorrow! In an age where there is a tendency for little ones to be involved in more sedentary play, it is becoming increasingly important for caregivers to make opportunities available for climbing, swinging, sliding and balancing. This kind of invaluable play can help to strengthen your child’s core muscles needed for sitting endurance and task completion. Our children are becoming accustomed to getting what they want easily and quickly, and thus “practice makes perfect” is not always inherently part of growing up. In the past, when children spent many hours entertaining themselves, often outdoors, skills such as endurance, frustration tolerance, creative problem solving, perseverance and the ability to apply initiative were part of growing up. While our faster-paced world has provided amazing new opportunities to connect our children and expand their life space globally, technology has led to more time spent indoors, often sitting or lying down in front of a screen! Playgrounds provide opportunities to move in many different planes and ways. Our movement sense sends information to our brain which provides our muscles with the information needed to stretch and contract appropriately in order to negotiate obstacles and balance on unstable surfaces. The way in which this movement is completed (successfully or unsuccessfully), in turn, feeds back into our brain to help plan and refine our next set of movements. The brain tells the muscles what to do, but the senses enable the brain to do the telling. The ability to come up with an idea for movement, plan and then execute that movement smoothly and efficiently is called motor planning. Motor planning is essential for a child to learn any new tasks. It affects how efficiently a child tackles this new task, and thus will impact how quickly he can master and complete it. A child who struggles with motor planning may often stand on the side lines and watch other children play before feeling confident enough to join in. He may also be hesitant to try new movements and prefer to stick to what he knows. This is why it is important for children to have the opportunity to play at different play grounds, or be encouraged to use one piece of playground equipment in different ways. Climbing, pulling, pushing, and carrying weight over, under and through obstacles all provide the body with vital feedback about its position in space and how it is moving. This feeds into the child’s internal map of what his body looks and feels like. Your child needs a good body map when learning about depth perception and spatial concepts. Without this foundational skill, he may struggle later on to position his letters on a line, size his letters in relation to one another and grasp mathematical concepts. When a child is offered the opportunity to challenge his body and test the limits of what he can and cannot do, he will develop the ability to use the two sides of his body in a smooth and coordinated way. Many everyday tasks rely heavily on the ability to use both sides of our brain to effectively complete complex movements, from brushing our hair, buttering our bread and tying our shoelaces to cutting, ruling a line with a ruler and riding a bicycle. Clambering over carefully thought-out playground equipment can challenge and develop these skills. Initially children may find playgrounds daunting and need some help to explore the adventures that lie inherently therein. Do not be too tempted to pick your child up and simply place him where he wants to be! Try offering him a foothold, and simply give him some verbal cues or allow him some time to watch you or other children climb and play. There is so much learning potential in moving from one spot on a playground to another, e.g. getting from the ground up the ladder to the fireman’s pole! Often in our bid to help our children, we sometimes rob them of that opportunity to figure it out for themselves. Rather help him just as much as he needs and remember to praise his effort and not simply his success! Often younger children will need a few trips to the same playground before they are confident to attempt some of the climbing by themselves. Sometimes just having you close by is enough motivation. If he is hesitant about a particular part of the playground, check that it is not too hot, rough or unstable for him! Some newer playgrounds offer interesting and varied textures and surfaces for little hands and feet! Where possible, encourage him to take his shoes and socks off to allow for easier climbing and a fuller sensory experience.

February 23, 2017

Introducing BabyLine

Parenting is a joy but it can also be overwhelming and just a little daunting. There is no degree or diploma, you are simply launched into it and there’s a steep learning curve. You instantly have a new life depending on you and, combined with sleep deprivation, the challenges of adjusting to being a parent and wanting to do the best for your child, you need all the help you can get. Bonitas Medical Fund is doing just that with the launch of the first dedicated toddler’s health advice line, called Babyline, to its members. Here help is at hand, from professionals, as you take the necessary baby steps along the path of looking after the health of your toddler, up to the age of three. Essentially Babyline is a 24-hour children’s health advice line manned by paediatric trained registered nurses. They are on the other side of the phone to assist with any parental concerns, or health related issues, 24/7, 365 days of the year. ‘Parents are often confronted with a host of children’s health issues, particularly in the first three years. In an effort to help educate and support Bonitas moms and dads and to ensure their medical aid benefits last longer, we have partnered with Paed IQ’s babyline service,’ explains Bonitas Medical Fund. ‘The service was developed in conjunction with the Department of Paediatrics at the University of Pretoria and is based on a concept used by the top providers of child health advice in the USA.’ ‘The system of telephone advice, guarantees members instant and real time access to pre-eminent, professional advice and standardised paediatric protocols,’ explains Dr Iqbal Karbanee of Babyline. ‘Our aim is to give parents the best possible resources to help them maintain and improve the health of their child. It’s about giving anxious parents peace of mind when it comes to an urgent health concern and, hopefully, will also alleviate unnecessary trips to doctors or hospitals.’ How does it work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to reach a paediatric trained nurse. Through a series of questions asked regarding the health issue, parents will be provided with professional advice on what to do next. Depending on the symptoms, the advice might be to head straight to the ER or to see a doctor or specialist. The nurse will advise which healthcare provider is the most appropriate, given the health issue. The services offered by the Babyline include: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the ER The Babyline service is available to members across all the Bonitas plans, for children under 3 years. ‘We do have to stress that although the Babyline is designed to assist parents with health concerns, nurses do not provide diagnosis or prescriptions. They are on call to offer advice on how best to deal with the current health problem or refer you to the nearest healthcare facility,’ concluded Bonitas Medical Fund.

February 15, 2017

What is Free Sugar Costing our Kids?

It’s no longer a secret that the vast majority of us are blissfully unaware sugar addicts. Modern conveniences in consumables are great at making life easier in the short term, but what about the long term implications? A report published in 2009 showcases that food addiction is plausible as “brain pathways that evolved to respond to natural rewards are also activated by addictive drugs. Sugar releases opioids and dopamine and thus might be expected to have addictive potential.” A further report published in 2013 indicates that sugar is as, if not more, desirable than addictive drugs such as cocaine. This research aims to prove that “sugar and sweetness can induce reward and craving that are comparable in magnitude to those induced by addictive drugs”. With these two findings it’s hard to believe that as parents we are still largely oblivious to the long term, damaging effects of over consuming sugar-dense foods and beverages. So a sugar tax maybe introduced, this will certainly help moderate and potentially reduce the average consumption of free sugars (sugar added to food and drink, as well as sugar found naturally in honey, syrups, fruit juices and fruit juice concentrates). But it will take a deeper understanding of what we consume to avoid the top health issues South Africans currently face – obesity, diabetes and heart conditions? All directly resulting from amongst other factors, but largely to sugar-dense diets and little to no exercise. According to a statement released by the World Health Organisation “adults and children need to reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (6 teaspoons) per day would provide additional health benefits”. So what is a safe recommended daily allowance for sugar? Although we all lead different lifestyles and have varying metabolic requirements, the UK’s Scientific Advisory Committee on Nutrition (SACN) have suggested the following: • Children aged 4 to 6 should have no more than 19g or five teaspoons of free sugars per day • Children aged 7 to 10 should have no more than 24g or six teaspoons of free sugars per day •Children aged 11 years and upwards, as well as adults, should have no more than 30g or seven teaspoons of free sugar per day To illustrate what this means, take a look at some of the popular beverages our children love, and their approximate sugar contents: • 250ml iced tea = 19g or four teaspoons of free sugar • 250ml flavoured drinking yoghurt = 26.8 g or five and a half teaspoons of free sugar • 330ml cola = 35g or seven teaspoons of free sugar • 330ml ginger beer = 37g or six and a half teaspoons of free sugar Overcoming an addiction is by no means an easy feat and the same holds true for sugar dependency. Almost all modern convenience consumables contain added free sugar especially children’s favourites such as cereals, beverages, fast foods and treats. So how do we reduce the excess sugars from our diets? Become aware, understand that food is medicine and always try to ensure that that all consumables remain as close as possible to their natural state. If sweetening is required, look at healthier options such as fresh fruit or vegetables. Read labels carefully, not all free or added sugars are labelled as sugars. For example: agave nectar, corn sweetener, dextrose, honey, corn syrup, sucrose, fructose, glucose and molasses. Limit sugar added beverages, cited as being responsible for the majority of added sugar in US diets. Try naturally flavouring water or using a SodaStream to make fun, healthier drink options. Their syrups also comprise one third of the sugar compared to regular sodas. Reduce your family’s super sweet sugar tolerance with a moderated sugar and bolstered wholefood diet. Over time consumables high in sugar will start tasting too sweet as your tolerance returns to its normal natural state. Bake instead of buying treats. Homemade treats will no doubt contain less added and highly synthetic sweeteners, and you have the ability to further reduce the sugar content with natural sweeteners like fruits or vegetables. One favourite cupcake recipe calls for swapping out a large portion of the sugar for a glass of white wine, the alcohol cooks out and makes a delicious, moist cupcake. The key to all healthy living is moderation and a balanced diet. This is not to say indulgent foods high in fat and/or sugar can’t be enjoyed, they can, but just not daily. Herewith a quick and easy recipe from SodaStream, for more fun recipes, please visit www.sodastream.co.za/recipe/. Raspberry Coolers for Kids Ingredients 1 bottle SodaStream Zero Cranberry Raspberry Fresh organic raspberries Mint Instructions Prepare the SodaStream Zero Cranberry Raspberry (flavoured to your liking) Throw in fresh organic raspberries Garnish with mint

February 13, 2017

Infant Food Fallacies – “Rice cereal is the best first food for baby.”

This is an excerpt from the “Unlearn” chapter in my book Mila’s Meals: The Beginning & The Basics. Disclaimer: As with everything concerning food there are two sides to any debate raging around every one of the topics in this chapter – both sides will be defended with scientific proof, and ‘absolute’ recommendations. I am merely presenting my beliefs formed by my research and first hand experience of both Mila’s, and my own digestive issues. I encourage you to do your own research should anything mentioned here not ‘sit well’ with you. I am not trying to convince you of anything – I simply hope to provide information, and at the very least prompt you to question what has previously or otherwise been presented as absolute fact and truth. “I’ve got to say I was fooled by this – by the clever marketing of the food companies and by the advice of the clinic sister. I fed her rice cereal (organic – but that really did not help the situation much). Poor thing! I stopped as quickly as I started (her tummy cramps were too awful after that first meal) and, this is why… Food has to be broken down into its nutrient components: amino acids, fatty acids, cholesterol, simple sugars, vitamins, minerals, etc. – our bodies absorb nutrients, not food. The body produces digestive enzymes that break down our food into nutrients. These nutrients are then absorbed and nourish the body. Digestive enzymes are produced in the pancreas, small intestine, saliva glands and stomach. Different digestive enzymes are needed to break down different types of food. In order to digest grains, your body uses an enzyme called amylase. Guess what? Pancreatic amylase is not produced by your little one (in sufficient quantities) until they are a year old – sometimes even later. The rule of thumb here is that it is not until your little one’s molar teeth are fully developed that they have sufficient quantities of pancreatic amylase to properly digest grains – this can be anywhere from 13 – 24 months of age. Amylase is provided in a mother’s breast milk and is produced by your little one’s saliva – but these are not sufficient to properly digest grains. Especially processed grains, or grains that have not been prepared properly. So what happens to this undigested rice cereal (or other grains)? Some undigested food (from other vegetable carbohydrate sources) benefits your little one – fermentation in the colon produces short chain fatty acids, which can improve nutrient absorption, enhance gut health, and even be used as a source of energy for both the microbes and baby. But since grains (especially) cannot be adequately digested, they start rotting. This rotting food matter feeds pathogenic bacteria and fungi (such as Candida) – and this imbalance can lead to food allergies, asthma, eczema, and other autoimmune disorders. Over time, the pathogenic bacteria and fungi (and their toxic by-products) create holes in the gut wall (known as Leaky Gut). A leaky gut allows toxins and partially digested food to spill directly into the blood creating an unpredictable mix of physical, behavioural, emotional and neurological symptoms. This is explained in great detail in Dr. Natasha Campbell-McBride’s book Gut and Psychology Syndrome. What else is wrong with commercially available rice cereal? Rice cereal is processed – meaning it is no longer a whole food. In order for the cereal to have a longer shelf life, the bran and the germ (the most nutritious parts) have been removed, simultaneously stripping the grain of its protein, fibre, nutrients and minerals. Artificial vitamins have to then be added back in – these are far less bio-available to your little one’s body and a poor replacement for nature’s version. Rice cereal is an extremely high glycaemic food – that is, it spikes the blood sugar. Rice cereal contains phytates (the salt form of phytic acid). Phytic acid is a naturally occurring chemical in grains, nuts and seeds. Phytic acid binds to essential minerals (such as calcium, copper, iron, zinc, and magnesium) in the digestive tract, making them less available to our bodies – and actually flushing them out of our bodies. While the majority of the phytic acid (or phytates) are found in the bran of the rice (which is removed during processing), there will still be some present. So, eating processed rice cereal may actually remove iron, zinc, calcium and magnesium from your little one’s body! Phytates also reduce the digestibility of starches, proteins, and fats. Please note that simply grinding grains at home and cooking them will result in an even higher amount of phytates in your little one’s food. All grains, nuts and seeds must be soaked, sprouted or fermented before cooking in order to break down the phytic acid. Please see the chapter Convenience vs. Conscience: Enzymes, Nutrients and Anti-nutrients in my book for more information on this. Commercial rice cereal fortified with iron. But surely this is a good thing? A baby is born with sufficient iron reserves to last them until they are 6 months old. While a mother’s breast milk is low in iron, the iron that is present is readily absorbed by her little one – as opposed to the artificial sources of iron found in fortified cereals and formula. While your little one may need additional sources of iron at the age of 6 months, it is far better to provide this from whole foods as opposed to supplemental drops or an additive in a nutrient deficient food. Good sources of additional iron are liver (raw), other cooked meat, blackstrap molasses, avocado and… soil! No, I am not suggesting you feed your little one soil, but the iron from soil is absorbed by the body. So a mouthful here and there while playing outside, as well as digging in the soil and walking barefoot is beneficial. Healthy soil is also a great source of probiotics! By healthy soil – I mean organic, not chemically fertilised and with

February 7, 2017

How to Treat and How to Protect Against Head Lice

With summer season upon us, head lice will again be making their way into many homes. Thankfully, Controlice® helps moms to combat the infestations with a range of products designed to eliminate* and repel* head lice. All mom has to do is to decide whether she needs to eliminate or to repel head lice and then select the right Controlice® products for the job: When to eliminate head lice: When head lice are already in the hair, the clinically proven Controlice® Oil Spray or Controlice® Head Rinse are the best fit to eliminating the little monsters.* Once applied to the hair, Controlice® Oil Spray only requires a 15 minute application to kill live head lice. Controlice® Head Rinse requires an 8 hour application and is the best option for an overnight lice treatment. Both treatments must be reapplied again seven days after the initial treatment because that is when the little lice eggs, called nits, hatch. A Controlice® Lice Buster Comb or Controlice® Triple Comb should be used as a part of the treatment. These precision engineered combs can assist to remove nits attached onto the hair. Tip: Rest the child’s head on a paper towel on mom’s lap and let him/her watch TV while mom combs out the nits. When to repel head lice: If you hear that there is a head lice outbreak at your child’s school, or if you have managed to get rid of the little crawlers and don’t want them coming back, you can use the Controlice® Defence range on a daily basis. Controlice® Defence Shampoo or Controlice® Defence Spray are not suitable for eliminating a head lice infestation, but they can put up a line of defence to stop head lice from moving in.* Controlice® through a magnifying glass: Treating with either Controlice® Oil Spray or Controlice® Head Rinse Lotion and combing out nits Controlice® Oil Spray. The clinically tested formula of Controlice® Oil Spray has been shown to combat head lice infestations. It is formulated with plant oils including coconut, aniseed and ylang-ylang. Controlice® Oil Spray can be used as a treatment whenever required as head lice cannot build resistance to the product.* To kill adult lice, spray Controlice® Oil Spray onto dry hair. Work it through the hair with your hands until the entire head of hair is moist enough to glisten and feel slick. Wait for 15 minutes. Comb out the lice and nits from the hair with the Controlice® Lice Buster or Controlice® lice comb. Wash and rinse the hair with Controlice® Defence Shampoo or another shampoo. Repeat seven days later to avoid re-infestation.* Price and availability: Controlice® Oil Spray is available from selected pharmacies and retail stores at approximately R158 for a 60 ml bottle, which gives two to four treatments depending on the length of the hair. Controlice® Head Rinse Lotion has no chemical pesticides. Its active ingredient is dimethicone which forms a wax layer around lice that suffocates the lice to death.* The colourless and odourless liquid is worked through dry hair with the fingers or one of the Controlice® combs, and left on overnight or for eight hours. Then comb out the nits (lice eggs) and dead lice, before washing and rinsing out the hair. Repeat the treatment after seven days. Price and availability: Controlice® Head Rinse Lotion is available from selected pharmacies and retail stores at around R118 for per 100 ml bottle. Comb out with Controlice® Lice Buster Comb or Triple Comb While treatment is on the hair, de-tangle the hair with any comb. Then remove the nits (eggs) and dead lice from the hair with one of the Controlice® combs. It is recommended that mothers invest in one of the two Controlice® precision engineered combs either the Controlice® Triple Comb or the Controlice® Lice Buster. The Controlice® Lice Buster Comb is designed for long, curly or very thick hair. The Controlice® Triple Comb is ideal for short hair. Price and availability: Controlice® Triple Comb retails at around R83, the Lice Buster Comb at around R86, from selected pharmacies and retail stores. Prevent head lice in the first place with Controlice® Defence Shampoo and Controlice® Defence Spray Controlice® Defence Shampoo is an oil-based formulation with active ingredients that can assist to repel head lice and avoid re-infestation.* It can also be used to cleanse and condition children’s hair and is suitable for daily use. Price: approximately R79 per 125 ml bottle at selected pharmacies and retail stores. Controlice® Defence Spray is an oil-based formulation with active ingredients that can help to repel head lice and protect against a re-infestation.* Controlice® Defence Spray moisturises and detangles the hair, leaving it manageable and shiny. Price: around R79 for a 100 ml bottle at selected pharmacies and retail stores. *For a diagnosis or if symptoms persist, consult a medical practitioner. Efficacy of support may vary between users.

February 3, 2017

More Precious Than Pearls

Teeth are designed to last a lifetime. Why do so many people suffer during their lifetime with dental issues? Why do people lose some of their teeth or all their teeth during their lifetime? We as health professionals have an obligation to help people become aware of how precious teeth are and how important it is to look after them properly. Teething is an awful time for both mother and child. It is often accompanied by a temperature, nappy rash, restlessness, drooling mouth and sore gums. Teething gel or powder will help. Teeth begin to erupt in a particular sequence and teething is usually complete by the age of two. The first teeth to erupt are the two lower front teeth followed by the upper front teeth and then the rest follow in succession going backwards. It is right at this early stage that one should take care of the teeth in the appropriate way. Rubbing the teeth with gauze is most effective until the child is old enough to accept a toothbrush in their mouth. Baby bottle syndrome may occur when the child is put to bed at night with milk in the bottle. The milk promotes the development of tooth decay very rapidly. The same applies with juice. Try water. It is the best. Start off with water and the child will not even be aware of the existence of any other alternative. If you have started with milk already, then wean the child off by diluting the contents of the bottle with water, bit by bit each day so the child will not notice the change that is taking place. Dental decay is a bacterial disease caused by the accumulation of plaque on the teeth. This provides a substrate for the normal bacteria that live in the mouth to aggregate. These bacteria metabolise the carbohydrates in the diet promoting tooth decay. Many mothers have a tendency to lick the dummy first before placing it in the child’s mouth. This is not recommended because of the transfer of bacteria from the mother’s mouth to the child. Brushing teeth with a young child is really a case of monkey see monkey do. If you as a parent show the child how enjoyable tooth brushing is, they will want to do the same. A children’s toothpaste with a pleasant flavour is well accepted. The size of the toothbrush is important. Small children small brush. The child may want to brush their own teeth to show independence. That’s fine to let them do that, but as the parent you should finish the job. Having been the parent of young children myself, I know how difficult it is to keep candy away from children. Better not to start if you can but peer pressure can be daunting. Stay away from lollipops or anything that allows the sugar to settle on the teeth for a lengthy period of time. How about trying a carrot instead! When should a child visit the dentist for the first time? The first visit can be at the age of about 3 to 4 and should be fun. All that the dentist would need to do is give the child a ride in the dental chair and perhaps blow some air on the hand to tickle. Coming away from the dentist with a sticker and colouring pad is fun. What about fluoride for a young child? Our water is fluoridated and the toothpaste is fluoridated. With effective brushing, adjunctive fluoride is probably not necessary. Some children have large gaps between their baby teeth and in some the teeth are tightly spaced. Don’t be alarmed about the gaps. The bigger the gaps the better because the baby teeth maintain the space for the permanent teeth to erupt from the age of 6 to 7. At the same time as you see the permanent teeth erupting in the front of the mouth, the first permanent molars also begin to appear. These teeth are extremely vulnerable to tooth decay and need very special care and attention to maintain their health. These are the teeth that many adults lose at an early age because of inadequate attention to plaque control. Parents have a responsibility towards their children’s dental health. The permanent teeth continue to erupt through to the age of 11 to 12. Whilst this happens, the deciduous (baby) teeth fallout. You may wonder what has happened to the roots of these teeth. They are resorbed as the permanent teeth make their entry into the mouth. The anticipation of losing baby teeth and welcoming the tooth fairy is every child’s delight. How much does the fairy deposit? Well that, we leave to you. An adjunct to monitoring the effectiveness of tooth brushing, is the use of disclosing solution which can be bought over the counter in the form of a tablet which is dissolved in the mouth and stains the plaque pink. It is then easy for the young person to see the plaque and exercise effective tooth brushing. Many children require orthodontic treatment to assist in the development of their permanent teeth. Your dentist may refer you to an orthodontist in the early teenage years or even slightly younger. Regular topical application of fluoride in the dental office is recommended from an early stage through adolescence. Fissure sealants are also recommended to protect the developmental grooves on the six-year-old molars. Again, teeth are designed to last a lifetime. How wonderful it is for a child to jump out of the dentist chair and exclaim, “Look Ma, no cavities”

January 30, 2017

4 Ways To Live Authentically

4 Ways to Improve Your Living Authentically, So you can be a living Example for Your Children So They can grow into adults who are content within themselves. I was sitting in the third row close to the middle when the man on the stage said, “if you are not true to yourself, then it is impossible to lead others.” The year was 2000 and the man was John C. Maxwell. Over the years, John’s words have again and again come back to me. The question he asked. Are you being true to yourself? Over the years I have asked over 7,500 parents the same question. Parenting requires authenticity. I define authenticity as the alignment of belief, thought, words, and actions in your everyday living. This requires a time of self-focus on those four areas. Examination of Beliefs Most people think they know what they believe. However, when I ask parents to write down their top ten values most get stuck at five, several get to seven no one has gotten to ten. So, write down those values. How far did you get? We will get back to that. Paying attention your thoughts and your beliefs flow together with them.The old saying as a man thinks in his heart, so he becomes. Is true. Our thoughts are affected by our beliefs. So, another way to check our beliefs is to examine our thoughts. How does what you think reflect your beliefs or what you thought you believed? Get the two to line up. Once your beliefs and thinking are fully aligned it helps the two outer or public areas to fall into place. Your values are the most closely tied to your beliefs. However, your conscious thoughts are framed by your unconscious values. If your values and your thoughts are at odds you can live a very conflict cited love fe. Get these three aligned an your authenticity living will flow much smoother. Once the inner self is examined, do your words and actions align with your beliefs and your thoughts to reflect authenticity? Monitor what Comes Out of Your Mouth What we think we often end up saying. In addition, what we say little ears hear and they repeat. More importantly little hearts hear and believe. This determines not only what they believe about themselves and the world. It creates the beliefs they use to create their own authenticity. One thing to always remember is you are the authority in your child’s life. Whatever you say they will both believe and internalize. We often say words are not important, but the truth is words are the most powerful force for good or ill in the world. Behave in Ways which Reinforce your Authenticity If I said it to one parent I have said it to thousands. “”Do as I say, not as I do”. Does not work, and it never did. The absolute truth is if you want a better life for your children, and every parent does. You have to live the life you want them to exceed. Parents are the model children emulate for their lives. How to Use Authenticity in Parenting. I have a question for you. Are you talking about and encouraging your children to live the same way through conversation and moral support? Living authentic lives requires coaching and mentoring. Parents can talk about children living their lives based on what they themselves believe. As long as it does not cause hurt, harm, or danger parents can support a child’s belief, even if they know their children need more information to make a better choice. Teaching kids to live authentically requires all five steps of mentoring. The five steps of mentoring are teaching, coaching, counseling, negotiating, and listening. Teaching authentic living requires living it, talking about your successes and challenges, listening to your children talking about their successes and challenges, clearing up misconceptions and discussing mistakes. Coaching requires being there to listen and give feedback. Counseling means being a siding board and asking thought providing questions, then leaving them to make their own decisions. Negotiating comes into play as you discover real differences between you. You need to work through your differences, and come up with something you can both live with. Listening with both an open mind and an open heart is the only way to help your child to develop true authenticity. In this world being true to yourself is not easy. Getting there is difficult, but getting there and helping your children get there, makes life worth living. Living in ways which are gratifying in immeasurable ways. Good Luck! Resources Using an Authenticity Audit can help you to begin aligning your beliefs, thoughts, words, and actions. Here is a link to one. https://www.youtube.com/watch?v=8j-VyDAbY_k

January 27, 2017

Dare, Truth, Promise

Most people who can still remember their teenage years will remember a sometimes wild and inappropriate game of Dare, Truth and Promise. I enjoy games of all sorts, and I find that most kids do too, so I propose a reinvention of this crazy game with an alternative motive – to get to know your kids, to build family spirit and to help them through things they might be struggling with. It works like this: You have a bottle or something you can spin (yes, I know you all remember spin the bottle too!) and everyone sits in a circle. You spin the bottle and the person that it lands up facing has to decide whether they are going to choose Dare, Truth or Promise. Once they’ve made their choice, one of the other family members can entice them to do something (Dare), or ask them a question (Truth) or give them a task for the next week (Promise). Each family member will have a chance to be the one giving the instructions or asking the questions, so the adults don’t get to just boss everyone around like they usually do. Keep this in mind when you think up your tasks – it may come back to bite you! It can be fun to have a points and rewards system or a penalty for dares attempted or not attempted, truths told or lies caught out, and promises fulfilled or not. The idea though is to keep it light and fun. So that’s the basics of the game as we’ve always played it. Here’s how it can be adapted, keeping in mind that it is only as limited as your imagination. DARE The idea here is to get your kids out of their comfort zones and help them to grow and extend themselves. Offer enough challenge to be slightly uncomfortable, but not so much as to be distressing. Some ideas… Help them to face their fears: Challenge your child to do something that normally makes them nervous (note – nervous, not terrified) eg. Run into a dark room, go to the toilet by themselves, look under the bed, hold a spider (a harmless one, of course). Help them to step out socially: Dare them to tell someone something that they’ve been putting off, to ask someone to be their friend, to write a love letter to someone they like. Get them to try new things: Dare them to taste a new food, to smell something weird, to touch something with an icky texture. Help them to learn something: Challenge them to learn to spell a difficult word, to memorise something, to tackle a problem, to finish a puzzle, to figure something out. Help them to become independent: Challenge them to try tying a shoelace, dressing themselves, washing their own hair, making their own breakfast. TRUTH Get to know your kids by asking questions that they may not always answer or that you wouldn’t normally ask in everyday conversation. Some examples: What is your greatest fear? What is the best dream you’ve ever had? Who makes you smile? What was the last lie you told? What do you love about yourself? Have you ever kissed a boy/girl? What is the naughtiest thing you’ve ever done? What is the kindest thing you’ve ever done? What is something that someone in this family does that makes you mad? What do you love most about living here? PROMISE Get your kids to help out around the house as part of the game (here is where a points system really pays off) or to do something that they normally avoid. Make sure you have a mix of fun and not-so-fun tasks to keep them interested. Remember to choose this option yourself when playing so that they can also get you to do things that they would like. Some examples: Clean up the dog poo for 2 days Help to prepare one dinner Make your bed for a week Bring me tea in bed Find a sneaky way to do something fun for someone in the family De-weed the garden Wash the car Give someone a foot massage Do something nice for a sibling Not bite your nails for a day Remember that it’s a game and therefore supposed to be fun. Children are wired to play, so if you can link what you want them to do or what you want to learn from them to something playful they are far more likely to cooperate. This is one way to do that. Happy gaming!

January 26, 2017

Children Suffering From Migraines In Sport

“A new fact on migraines and participating in sport” Claims that participating in sporting activities is detrimental for migraine patients are untrue – a new study found that participating in sporting activities actually has health benefits for migraine patients. The study, recently published in the Sports Neurology Journal ascertains that under Neurological supervision sporting activities can be safely integrated into the lives of migraine patients. This is the first time empirical research has been done to review known risks involved with participating in sporting activities by migraine patients. “It was a study that sampled patients with; epilepsy, migraines, and multiple sclerosis”, says Dr. Elliot Shevel, South Africa’S migraine research pioneer and the medical director of The Headache Clinic. Shevel confirmed that as long as there is proper supervision in place for migraine patients, playing sport is not harmful. Dr. Elliot Shevel says that migraine patients are often discouraged from participating in sports based on theoretical detrimental effects, when in actual fact they can and should be encouraged to participate in sports provided that the exercise does not trigger the pain. Where exposure to prolonged sun triggers the pain indoor sports should be pursued. With schools re-opening and sporting activities being part of the academic experience, children that suffer with migraine should take the time with parents and teachers to work out which sporting activities suit them best. To find out more about how migraines affect your child, call 0861 678 911 or visit www.theheadacheclinic.net

January 20, 2017

‘Super Allergies” Could Hit SA This Summer

Last year was the hottest year on earth since record-taking began, but 2016 is expected to blow this record out of the water, which according to experts could trigger so-called ‘super allergies’. Mariska van Aswegen, spokesperson for Pharma Dynamics – a leading provider of antihistamine medication – says the weather and atmospheric temperature make a huge difference to the levels of pollen and other irritants such as dust and diesel particulates in the air. “The downside of a long, hot summer is that these irritants stay suspended in the air for longer, entering the mouth or nose and landing on the delicate mucosal layer of the upper airways. Once these particles land on the membranes that line the airways, the allergen diffuses into it, setting off an allergic reaction. Not only could symptoms worsen, but hot and dry conditions could result in an extended pollen season. The hayfever season typically starts with trees pollinating from August until October. However, grass pollen then takes over with its greatest peak from November to March. “According to SA’s foremost authorities on aerobiology, climate change will significantly increase the amount of pollen in the air with average world temperatures forecast to rise 3°C to 4ºC by as early as 2060. Warmer temperatures allow trees to pollinate earlier and longer than usual. Spring in many countries already begins much earlier than a few decades ago, which means that pollen-producing plants, such as flowers, trees, grasses and weeds have a much longer pollen-producing season than in the past. Should the predicted combination of prolonged periods of warm, dry weather with intervals of some wet weather occur, we’ll experience high grass pollen counts for some time,” she remarks. Not only is this depressing news for the estimated 30% of South Africans that suffer from hayfever, but the extended hot and dry conditions could also trigger nasal allergies in those who haven’t previously suffered from hayfever. To make matters worse, people who live in towns and cities where there are higher levels of traffic pollution are at greater risk. Van Aswegen points out that the tiny particulates released by diesel fuel irritate the lining of the nasal passages and lungs making them more sensitive. “When an allergen such as pollen is also present, the airways are already primed to react, which could lead to a more severe allergic response. “Pollution may even make other airborne allergens more potent as some pollen-producing plants exposed to high levels of nitrogen oxide may spawn modified pollen that is more potent and can elicit a more severe allergic episode, also referred to as super allergies.” To ensure that super allergies don’t get in the way of your summer holiday plans, van Aswegen gives the following advice: Get pollen-wise:check the pollen forecast in your area or holiday spot (online or in the local newspaper) to plan your outdoor activities and avoid being outside when the pollen count is highest, which is usually early in the morning and evening. Also find out which pollen you’re allergic to via a skin-prick test or blood test to detect specific IgE (immunoglobulin E) antibodies.. Remember to keep doors and windows closed during peak pollen times. When the outdoors beckon: apply balm or petroleum jelly around the rim of your nose which can act as a pollen-trap. Alternatively, block pollen and other irritants by wearing a mask or bandanna over your nose and mouth. If the pollen count is very high, opt for less intense exercises. The faster you breathe, the more allergens and irritants you inhale. Traveling by plane: make sure your epinephrine injection (used to treat a severe allergic reaction known as anaphylaxis) is within date and always carry a spare. Pack these in your hand luggage along with a supply of antihistamines. If you are prone to anaphylaxis, obtain a written letter from your doctor explaining why the medicine you carry is essential, to ensure you don’t get delayed at customs. If you’re traveling alone, let the pilot or air hostess know of your condition. Do the same if you’re traveling with friends and make sure they know how to administer the emergency medication. Also have the names of those who should be contacted in an emergency handy. Using a saline nasal spray every hour could also help keep your nasal membranes moist. Planning a road trip: turn your car’s air conditioner on 10 minutes before you get in the car, preferably with the windows open, which will help remove dust and mould from the air-conditioning (AC) system. Keep car windows closed when driving to prevent pollen and other irritants from entering the car. If you’re hiring a car, ask for a model that comes with a high efficiency particulate filter as part of the AC system. Staying at a hotel: bring your own hypoallergenic pillow and mattress cover or ask for an allergy-proof room where no smoking or pets are allowed. Avoid red and swollen eyes:protect your eyes during the day by wearing sunglasses and rinsing contact lenses to get rid of dust and pollen particles. If your allergies have left you with itchy, red eyes, then take eye-drops to reduce the symptoms. “When it comes to essential hayfever treatments, such as antihistamines, these should be taken early on in the season to be most effective. If you haven’t started, start taking them now to reduce symptoms,” concludes Van Aswegen.

January 18, 2017

Get bang for your buck

Most medical aids have launched their benefits and premium contributions for 2017 and, as in the past, the increases passed on to members are double figures, which outstrip inflation. Bear in mind that your actual increase may be somewhat different because often these are weighted, vary from option to option or even from dependant to dependant. The medical aid landscape can be tricky to navigate. So now, more than ever, is the time to learn how to ‘box smart’ to ensure that you maximise the value you derive from your medical scheme benefits. Dr Bobby Ramasia, Principal Officer of Bonitas Medical Fund, provides some insight into maximising the benefits on your chosen medical aid. Understand your benefits Take the time to read the information sent to you by the scheme and/or your broker. If you have access to information sessions at your place of work, or have a consultant who visits your workplace, attend the sessions to get a better understanding. Getting the best out of your hospital cover: If your scheme has appointed a Designated Service Provider (DSP) network for hospitals, you will usually pay a lower monthly contribution in exchange for using a hospital from this network for planned procedures. In the same manner, if your scheme has an arrangement in place for doctors and specialists, there will usually be an incentive (full cover by the scheme) for using ‘these’ providers. The penalty for using providers not contracted with the scheme is usually the payment of shortfalls or co-payments. For planned procedures, it’s also worth checking with your scheme if you will obtain better cover by using contracted providers or having the procedure performed in the doctor’s rooms or day clinic, where possible If you are going to be admitted to hospital for a planned procedure, always check with your scheme, at authorisation stage, if there are any co-payments or sub-limits that will apply. An example here is for joint replacements, where most schemes have specified sub-limits if you do not use their DSP. Chronic Illness Benefits: In terms of the Medical Schemes Act, there are 26 common chronic illnesses which all options on all schemes are required to cover for medication and treatment. However, here too, schemes have the ability to apply measures designed to contain costs. Almost all options on all medical schemes apply a medicine formulary. This is a list of drugs which the scheme will cover in full. If you use medication that is not on the scheme’s formulary, you will be liable for the difference in cost. So it is best to discuss the formulary medication with your doctor to see if this is appropriate for you The schemes can also specify that you obtain your medication from DSP pharmacies. Check to see if you are able to use the scheme’s DSP – if there are none close to you, most schemes also designate a courier pharmacy which will deliver the medication to you at a preferred address. So, the golden rule for chronic illness benefits is to try to utilise the medication on your scheme’s formulary and to obtain this from a specified pharmacy. Many medical schemes also cover additional chronic illnesses – although this is usually from the more expensive options. If your particular condition is not covered on your current option it is worth further investigation. It’s important to understand that this cover is at the scheme’s discretion and the additional conditions covered vary from scheme to scheme. Know your rights! In terms of a High Court ruling, Medical Schemes are obliged to meet the cost of in-hospital Prescribed Minimum Benefit procedures at cost, in full. Make sure you know what ‘in full’ means – so you don’t get any surprises. So if you have been admitted to hospital check with your doctor if it’s for one of these procedures. If so, as a general rule, you shouldn’t be saddled with any shortfalls – so ask for your broker/consultant’s assistance if you are! Why you might have co-payments A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. The medical aid would not cover 100% of the costs and the member would have to pay for a certain percentage of the medical service before the medical aid pays their portion. These co-payments usually apply to specialist or elective medical procedures. This will differ from one medical aid scheme to another. It is one of the reasons why you should always do thorough research before deciding which medical aid scheme is the best option for you. The ideal option would, of course, be the one that does not require many or any co-payments from the member. If your benefits and/or savings were exhausted before the end of the year and you had to pay out-of-pocket for some medical expenses; it might save you money to upgrade to a richer plan with more benefits, albeit at a higher contribution amount. Conversely, if you are young, healthy and generally did not utilise your benefits and/or savings, it may be prudent to downgrade to a cheaper medical aid option Talk to your providers! Talk to your doctor/specialist before being admitted to hospital for a planned procedure. Check what they are going to be charging and what your scheme will cover. If there is a large difference don’t be afraid to approach your doctor to see if they are prepared to adjust their fee, especially if you could afford to pay upfront.

January 16, 2017

What Is The Recommended Screen Time For Children’s Eyes?

Many people are struggling with parenting given all of today’s modern technology, especially when it comes to the many omnipresent screens that children are currently using. Our grandparents were likely more concerned with a single screen, the one found on a lone television set in the living room. But nowadays, kids have a plethora of screens on their smartphones, tablets, televisions, computers, both at home and school. To ensure their children’s visual acuity remained intact, past parents from generations gone by were likely reminding kids to sit further away from the T.V. and limiting their screen time. So what are the recommended screen times to ensure today’s children aren’t suffering visually, mentally or emotionally? According to recent news reports, pediatricians have changed their antiquated and outdated recommendations for screens when it comes to the time kids spend using these devices currently. While experts still believe children younger than two shouldn’t be exposed to this type of digital technology, 30% of tots in diapers are comfortable using mobile devices. Paediatricians have also tweaked their recommendations about toddlers and screen exposure to include times it’s used to video chat with another parent or close relative. Screen time should also be age appropriate and younger usage should always be monitored. For example, for those children over the age of two and younger than five: Limit screen time to one hour per day and watch along with them to see how they’re absorbing and reacting to the content Avoid screen time that’s associated with either placating them or keeping them distracted Test apps or pre-watch visual materials before allow children to use or view them During meals, playtime or when in their rooms should all be screen-free zones No matter their age, parents should always be on the lookout for violent and inappropriate websites and other forms of technology. Parental controls were invented for a reason. School Aged Children Parents, teachers, faculty and physicians are all encouraged to work together in creating a “media plan” since there’s really no “one-size-fits-all” approach for children as they continue to mature. For example, research has shown that adolescent use of social media can be beneficial for their development, give them exposure to new ideas and promote circles of emotional support from their peers. On the other hand, too much time spent on these platforms can lead to depression, weight gain and a lack of sleep. Keep in mind that parents should: Be consistent, but at the same time, allow for some flexibility when it comes to circumstances like a special school project that may require online research Avoid the use of media at least an hour before bedtime and as mentioned previously, it’s not allowed during meals or other family times Communicate these guidelines to caregivers and babysitters to ensure they’re being enforced when you’re not in the picture Be sure to have ongoing discussions with your child about cyberbullying and what is (and is not) appropriate behaviour, posting and content on the world wide web. There’s a new-age idiom being used today that recommends parents advise their children to avoid posting or viewing anything that their grandparent would find offensive. It’s not only about how much time a child spends online, but how they are occupying themselves while on the internet. There should be a balance between engaging in valuable content and experiences with some recreational usage while they’re using their devices. As with almost anything else that goes with family and parenting, it’s all about balance.

January 10, 2017

Beating The Baby Blues

Having a baby is a momentous event. The kind of event that kicks you so far out of your comfort zone that you don’t even know what planet you’re on. We all know about the nice side of it – the miracle of a new life, the immense and overwhelming love, the snuggling baby at your bosom. In fact, we’re inundated with images and articles and information about how wonderful it is to have a baby. But what about the dark side? What people seldom talk about is how tough it is – how those first days and weeks are so overwhelming and scary and strange and intimidating. Nobody tells you how difficult it is to care for another little being when you are trying to recover both physically and emotionally from a birth. Nobody speaks about the terror of leaving the hospital with a stranger in your arms – one that doesn’t even speak your language. Your antenatal classes were unlikely to show you video footage of what prisoners of war look like after a few weeks of sleep deprivation. The magazines are not filled with pictures of mothers crumpled on the floor in their pyjamas weeping. We see movies of mothers doting on their newborns, not mothers calling the cops to take their screaming baby away from them before they kill it. We hear stories of overwhelming love, not overwhelming disinterest. We get advice on how to breastfeed not advice on how to not commit suicide. And I feel that it is the lack of this other side of life that causes half of the problems with post-natal depression. All depression has an element of fantasy in it. We become depressed because we compare reality with how we hoped or wished it would be (the fantasy) and then find our life to be somewhat lacking. Now if you are bombarded with information telling you that motherhood is instantly wonderful, that you will fall in love with your baby at first sight, that your life will be changed forever in wonderful ways, and then this is not your experience, you’re already on the slippery slope to depression. I believe that new mothers ought to have a more balanced perspective and a more realistic picture of what they’re in for. Of course there are good sides to having kids, but they don’t always surface immediately. It is normal, for instance, to not love your baby instantly. You are tired, emotionally and physically recovering, in shock, overwhelmed, confused and often feeling a bit panicky. There may not be space in your internal world for a rush of love and affection. That’s ok. It doesn’t mean you will never love your child or that you won’t care for them, or that there is anything wrong with you. It is also normal to really struggle in the first weeks and months. Everyone tells you that caring for your child is a natural instinct, but how many of us are in touch with our natural instincts? Some things you may figure out on your own, some things you’ll mess up and others you may need to ask for help. That’s ok. You are not a bad mother if you don’t know what to do or if you can’t interpret your baby’s every cry. It is normal to lose it sometimes. Go and watch those videos of sleep-deprived soldiers! Even the toughest, trained men will fold under the pressure of not getting some much-needed rest. You may collapse in a weeping heap, you may shout at your baby, you may think you’re losing your mind, you may do crazy or irrational things. You are not insane, you are not a bad person, you are not unable to cope. Having a baby will turn your world upside down. It takes time to adjust. It takes time to find a rhythm. It takes time to feel like yourself again. You may even go through a period of resenting your baby, your partner, yourself. You may question your choices. You may want to run away. You may throw things. It does ultimately settle down. You will eventually find the good side. And if you don’t, there are plenty of people out there who can help you. Find a coach or a therapist or a good friend (particularly one who has gone through what you are going through). Most importantly, know that where there is a positive there is a negative and where there is a negative there is a positive. Babies are like life, they come with both sides. The more prepared you are for reality (and not fantasy) the more likely you are to take it in your stride.

January 9, 2017

Healthy skin tips for your little one

Glossy magazines keep us well-informed on keeping adult skin moisturised, cared for and looking beautiful. When it comes to our children, especially babies, looking after their skin is just as vital, if not more important. “When our children enter this world, we are armed with equipment that took much care and consideration to select. The same care and consideration needs to be taken for your child’s skincare products,” says Su-Marie Annandale, Krayons’ brand manager. Krayons’ baby skin care products have been providing South African babies and children with the necessary products to keep their skin protected for over 20 years. “Healthy baby skin is just as important to Krayons as it is for parents,” says Annandale. When bringing your little one home from the hospital, and even as they grow, Annandale provides 5 tips on how to keep your baby’s skin healthy: Although babies love playing in the bath, and splashing about – limiting the time they spend in the bath can help keep their skin from drying out. Make every second or third day “fun” bath time, and the others can be short washes. After bath time, keep your little one moisturised. Using Krayons’ Aqueous Cream after every wash accompanied by a soft and gentle baby massage will give your little one’s skin all it needs to be kept moisturised throughout the day. It is recommended that you wash your baby’s new clothes and linen before use, but be sure to use a gentle fabric conditioner that will ensure that baby’s clothes are soft and won’t cause any skin irritations. Personal Touch boasts a Baby love variant which boasts the Krayons scent. It is soft and delicate, just like your baby’s skin. The weather outside dictates how your baby should be dressed to keep them comfortable and also to protect their skin, but no matter if it is hot or cold your baby needs to be protected from the sun. Your baby’s skin is too sensitive to be exposed to the harsh sun and needs to be kept covered. For more, like Krayons on Facebook: www.facebook.com/krayonsbabies

December 19, 2016

Ambidextrous kids – disorder or gift?

I watched a film once where the main character was completely ambidextrous – he could write a poem with one hand while drawing a picture with the other. How I would have loved to have a skill like that. So why is it that teachers push kids to choose a dominant hand? The reason teachers and OTs will encourage a child into one-handed dominance is predominantly for practical reasons in the classroom – the sooner they choose a hand, the sooner they perfect their control with that hand, and the sooner they will learn to write quickly and efficiently. I strongly disagree with this. The majority of children will naturally slip into right or left dominance at around 7 or 8 years of age and shouldn’t be forced into writing exercises before the body is naturally ready. Unfortunately this doesn’t fit in with the school curriculum, which requires kids to be practicing pre-writing skills from as early as 3 or 4. Very very few children are truly ambidextrous (and usually this only happens when one hand is injured for a period of time or some other environmental factor), but there are a fair amount who are mixed-handed (i.e. They will tend to use one hand for certain tasks and another hand for different tasks e.g. Writing with the right hand and cutting with the left hand). The schools will try to discourage this as sometimes it slows kids down as they’re still trying to decide which hand to use for what and not getting on with the task at hand. There are some things that will be helped by choosing a dominant hand – for example crossing the midline or bilateral integration, but these can easily be included in a child’s life with some simple exercises to ensure that they don’t miss out on any brain integration that may come from choosing one hand as dominant and using the other as a helper. For example, pushing a car round a track, holding the car with one hand and the track with the other; reaching over the body to grab something on the opposite side of the body; holding paper with one hand and cutting it with the other; or my personal favourite, playing “Twister”. In OT they will essentially do these kinds of exercises with a child, but it will cost you. If you hop onto Google you can find plenty of exercises like these and do them yourself. You can have a lot of fun and your child never needs to wonder about why he/she is in “therapy”. Most researchers on the subject agree that it is useful for everyone to sometimes try using their less-preferred hand for tasks normally done with the dominant hand as it improves brain function and dexterity! Being mixed-handed can also have great advantages in sports like baseball and snooker where you can switch hands to get a better shot. The only real concern with a child who isn’t naturally finding a dominant hand is a learning disorder known as dysgraphia, which involves problems with motor skills. This disorder would not only affect their ability to choose a hand to write with, but would also manifest with other noticeable problems such as struggling with the concepts of right and left, difficulty catching a ball or skipping or even basic motor movements like walking and jumping. It is unlikely that your child would have problems of this nature without you noticing them and they definitely would be picked up in an assessment with an OT if you choose to have one. The other thing to consider is that your child may be gifted. Around 48% of gifted children are ambidextrous at some stage of their development. Take a look at some of the other criteria for gifted kids and if you think your child is, then it is definitely worth getting an IQ test done as gifted children do need additional stimulation in order for them to develop optimally. · Unusual alertness, even in infancy · Excellent memory · Learn to speak early and have an unusually large vocabulary and complex sentence structure for their age · Understand word nuances, metaphors and abstract ideas · Enjoy solving problems, especially with numbers and puzzles · Often self-taught reading and writing skills as preschooler · Highly sensitive · Thinking is abstract, complex, logical, and insightful · Idealism and sense of justice at early age · Longer attention span and intense concentration if something interest them · Preoccupied with own thoughts—daydreamer · Learn basic skills quickly and with little practice (1-3 repetitions) · Asks probing questions · Wide range of interests (or extreme focus in one area) · Highly developed curiosity · Interest in experimenting and doing things differently · Puts idea or things together that are not typical · Keen and/or unusual sense of humor · Desire to organize people/things through games or complex schemas · Vivid imaginations (and imaginary playmates when in preschool) If your child is still in preschool, he/she may just not be ready to choose a dominant hand and making a child ‘wrong’ for this seems unfair and unnecessary. Ultimately you will have to make a decision based on your own child whether your child would benefit from having an assessment or if it is worth waiting to see what naturally develops. Please remember to trust yourself. You know your child better than any teacher or therapist and if you feel that their opinion is incorrect, trust that. You can always get a second opinion or even just hold off on getting an opinion at all. Whether your child’s ambidexterity is a gift or a disorder is often determined by how it is handled, and that is up to you as the parent.

December 15, 2016

Flying with kids? Remember your tablets and rooibos

As the December holidays loom, many of us are planning some well-earned family time. Reconnecting with loved ones often involves travelling by air and for those of us with kids, that prospect can fill us with dread. It needn’t be that way, says Shaun Pozyn, Head of Marketing at British Airways (operated by Comair), who offers these timely tips for managing youngsters in the air and en route to your destination. Give yourself enough time: rushing while trying to marshal kids and their kit can be harrowing and conjures images of Kevin McCallister (played by Macaulay Culkin) being left abandoned by his family in the 1990 comedy, Home Alone. One way to score yourself a little time is by using apps like ba.com to check your family in online. Know the rules: documentation requirements when flying domestically are fairly simple: you need to carry identification. But if you’re travelling internationally with children you need an unabridged copy of their birth-certificates. Get the squad to help: the cabin-crew are your allies, so don’t be afraid to ask them for assistance. You can, for example, use a push-chair to the door of the aircraft, and on international flights, infants can be accommodated in bassinettes. Take your tablets: mobile devices can largely alleviate the need for toys, and picture-editing apps like Prisma, or games like MineCraft can temporarily replace Lego, for example, which can be lost in the cabin. Just make sure your devices are charged and consider investing in a power-bank to ensure that have plenty of power. Handle the pressure: one of the major irritants for small children and infants when flying is pressurisation. This is because their ears haven’t fully developed yet, so they can’t equalise changes in air-pressure when the aircraft ascends and descends. Swallowing and chewing can help with this, so depending on the child’s age, drinking fluids or snacking on chewy foods can help. Foods with less sugar can help prevent the child from becoming too energetic: opt for biltong, fruit-rolls, nuts and fruit-juice diluted with rooibos tea rather than sweets and cool-drink. Don’t plan too much: travelling can be very exciting for kids, but too many activities in one stint can leave them tetchy and overstimulated. If a child is enjoying a particular pastime – working on a travel-log to document their journey, say – leave them to it. That can also give you, the parent, the chance for a welcomed breather. See: http://www.britishairways.com/en-gb/information/family-travel for more information.

December 14, 2016

The monster around your middle

Metabolic syndrome is a health condition that everyone’s talking about. Although it was only identified less than 20 years ago, metabolic syndrome is as widespread as pimples and the common cold. It is estimated that around 20-25 per cent of the world’s adult population have metabolic syndrome. Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it? Keep reading for some insight. UNDERSTANDING METABOLIC SYNDROME Metabolic syndrome is not a disease in itself. Instead, it’s a collection of the most dangerous risk factors: high blood sugar, pre-diabetes, diabetes, high cholesterol levels, high blood pressure and abdominal (tummy) fat. Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for serious problems. People with metabolic syndrome are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. They have a fivefold greater risk of developing type 2 diabetes!! The underlying cause of metabolic syndrome continues to challenge the experts but insulin resistance and central obesity (excess tummy fat) are considered the most significant factors responsible for this syndrome. What comes first, the chicken or the egg? Insulin resistance is very often the starting point of metabolic syndrome. Insulin is a hormone that helps your body convert food into glucose and enter your cells to be used as fuel. Insulin resistance occurs when cells in the body (e.g. muscle cells) become less sensitive and eventually resistant to insulin. Glucose can no longer be effectively absorbed by the body cells and therefore remains in the blood, so your body keeps making more and more insulin to cope with the rising level of glucose in an attempt to process the glucose. Eventually, this can lead to diabetes. Even long before diabetes happens, excessive amounts of insulin is causing damage to the body. The dangerous part of this syndrome is the long term effects of raised insulin levels to your blood vessels often leading to premature heart attacks, strokes and type II diabetes. METABOLIC SYNDROME – ARE YOU A VICTIM? To identify if you have metabolic syndrome it is necessary to take a few basic measurements. There are five risk factors that make up metabolic syndrome. To be diagnosed with metabolic syndrome, you would have at least three of these risk factors. Body Mass Index (BMI) BMI of 30kgm/m2and higher Waist circumference For men: 102cm or larger For women: 88cm or larger Cholesterol: High Triglycerides Either 1.7mmol/L or higher or Using a cholesterol medicine Cholesterol: Low Good Cholesterol (HDL) Either For men: Less than 1.03mmol/L For women: Less than 1.3mmol/L or Using a cholesterol medicine High Blood Pressure Either Having blood pressure of 135/85mm Hg or greater or Using a high blood pressure medicine Blood Sugar: High Fasting Glucose Level 5.6mmol/L or higher Even if you don`t have these measurements available it`s possible for you to know if you are at risk by asking yourself a few basic questions. The American College of Endocrinologist has identified that if you have 2 of the following risk factors you are at risk for developing metabolic syndrome, or may have insulin resistance already: You have ever been diagnosed with coronary heart disease, high blood pressure, polycystic ovarian syndrome, non-alcoholic fatty liver disease. You have a family history of type II diabetes, high blood pressure or coronary heart disease. For women: you have a history of pregnancy-related diabetes or impaired glucose tolerance in pregnancy. You have a sedentary lifestyle and do not engage in regular exercise. You are overweight with a Body Mass Index (BMI) of greater than 25kg/m2 OR if you have a waist circumference measurement greater than 102cm (male) or greater than 88 cm (female). You are older than 40 years of age. CAN METABOLIC SYNDROME BE REVERSED? YES!! Controlling and normalising insulin levels is key to improving metabolic syndrome. Physical activity, weight loss and healthy food choices help the body respond better to insulin. Studies showed by losing weight (through cutting carbohydrates, fat, calorie intake) and being more physically active, people with metabolic syndrome may avoid or delay developing type 2 diabetes or suffering a stroke or heart attack. WHAT TO DO? Weight loss Research confirmed that people with metabolic syndrome can significantly improve their health by losing 5 to 10 percent of their body weight. Weight loss is often a difficult task when you are insulin resistant and have metabolic syndrome. Not only will you have cravings for carbohydrates most of the time, your body is resistant to fat breakdown due to the high amounts of circulating insulin. Normal weight loss diets and quick fixes are ineffective to aid weight loss seeing that the raised insulin levels are not treated. Not only do we need to decrease the calorie content of the diet, one need to look at what your diet consist of. Certain foods are known to worsen insulin resistance and others to improve insulin resistance. Rethink refined carbs and sugar Carbohydrates and sugar in your diet is known for increasing the amount of insulin in your blood. It is therefore necessary to exclude sugar as much as possible. The other concern lies with the amount of carbohydrates that is consumed per meal as well as during the whole day. Insulin levels can be dramatically increased by the amount of carbohydrate as well as the type of carbohydrate consumed. It is crucial to eat only carbohydrates which are low in Glycaemic index (GI). The Glycaemic Index is a ranking of foods based on their immediate effect on blood glucose levels. It is a physiological measure of how fast, and to what extent, a carbohydrate food (starch containing food) affects blood glucose levels. If the glucose reaches the blood stream quickly, your insulin levels will rise dramatically. Low GI foods will result in a smaller insulin response and help with losing

November 30, 2016

So what does dyslexia really mean?

(All information was obtained from Stark – Griffin’s book Dyslexia) Definition of dyslexia – A neurological-functional problem manifesting as a deficit in word decoding (reading), encoding (spelling) and nemkinesia (writing) due to a minimal brain dysfunction and/or differential brain function. More use full information regrading dyslexia Eidetic: give meaning to text in general and recognising words from previous experience. Phonetic: allocating a sound to each letter and using these sounds in groups to produce words. People suffering from dyslexia usually have an average to above average intelligence. 10% – 20% of all children suffer from dyslexia. Children suffering from dyslexia feel confusion, frustration, anxiety, withdrawl and compensating behavioural patterns. These children are often teased and humiliated by their classmates.Dyslexia may lead to poor self image and even depression. These feelings may manifest in behavioural problems which inlcude aggression, vandalism, disruption of class and a hostile attitude. Types of dyslexia Dysnemkinesia Deficit in the ability to develop motor engrams (memory trace) for written symbols Child wil revers letters A child should have no letter reversals by Gr. 4 When writing the alphabet 1 reversal is acceptable in Gr. 3 When writing the alphabet 3 reversals are acceptable in Gr. 2 When writing the alphabet 5 reversals are acceptable in Gr. 1 Dysphonesia Deficit in visual-symbol and sound integrations Child will struggle to read unknows words as he cannot decode them / will have difficulty spelling e.g. slow/solw, does/dose Dyseidesia This type of dyslexia is genetic Deficit in the ability to perceive whole words and to recognise words from previous experience. Child will struggle to read words that he cannot relate to a picture e.g. did / will struggle to read sight words / will struggle to read word that cannot be divided /will spell word the way they sound e.g. does/duz Dysphoneidesia Mix between dysphonesia and dyseidesia Dysnemkinphonesia Mix between dynemkinesia and dysphonesia Dysnemkineidesia Mix between dysnemkinesia and dyseidesia Dynmemkinphoneidesia Mix between dysnemkinesia, dysphonesia an dyseidetia One has to rule out the following deficits before a diagnosis of dyslexia can be made: Problematic vision and/or eye muscle functioning Impaired visual perceptual skills Impaired auditive perceptual skills Cognitive impairment Emotional problems/psychological factors Attention deficit disorder Health factors: e.g. nutrition, infections, allergies, trauma Environmental factors Treatment The child needs to be evaluated by a professional (usually an occupational therapist/speech therapist/educational psychologist/optometrist) that is registered with RADA (Red Apple Dyslexia Association). The test used is called the Dyslexia Test developed by Stark-Griffin. If dyslexia is identified it needs to be specified which type of dyslexia as each one has a different treatment approach. All types of dyslexia can be improved although the percentage differs from person to person. Dyseidesia cannot be 100% cured as it is genetic. Dysphoneidesia is the most difficult type of dyslexia to treat. Dysnemkinesia is easily treated. Build on the child’s strengths and later give attention to the weaknesses. Work around the problem to improve reading/writing and spelling. Famous dyslexics No matter what your dissability – you can still be successful !!! Just look at these famous dyslexic people: Pable picasso Tom cruise Richard Branson Leonard daVinci Thomas Edison Whoopi Goldberg Development of the child checklist The Developmental checklist will assist you in determining whether you child is functioning according to his/her age level. Download your order form Here It is divided into 29 categories namely: Movement (Activities of daily living) Communication skills (Cognitive skills) Personality traits / temperament (Playing) Ball skills (Coordination) Perception (Grasps & hand function) Basic concepts (Body concept) Number concept (Form concept) Colour concept (Size concept) Building with blocks (Working with beads) Cutting with scissors (Drawing / painting) Drawing a person (Picture-reading) Story-time (Writing) Eating / feeding (Sleeping) Prepositions (Senses) Teeth When determining if your child is developing according to his/her age level it is important to remember that each child is unique. Each child develops at his/her own pace; therefore no 2 children’s milestones will be achieved at exactly the same time. Please give a 2 – 3 month leeway to either side of the time frame given (e.g. if it says that a child has to walk when he is 1 year old it can mean that the child may start walking when he is 9 months old or 15 months old). When you see that your child has a delay in more than 2 important areas, please consult your developmental paediatrician and take him/her for an occupational therapy assessment. A child that has a developmental delay usually reaches a plato when 12 years old. Thus it is so important that a child receives therapy from as early an age as possible.

November 28, 2016

What is Klinefelters syndrome?

Klinefelters syndrome (KS) is not as rare as one may think, it is not life threatening but has life altering consequences. About one in 500 boys are born with an extra X chromosome, this affects learning, behaviour and growth. This was identified in 1942 by Dr Harry Klinefelter who was working with male patients at a hospital in Boston Massachusetts. This is a genetic condition where a male baby is born with 1 extra X chromosome. This due to an error in meiosis at conception known as meiotic nondisjunction. The condition is also known as XXY. Normal boys are XY while girls are XX. The KS baby develops an abnormal pituitary gland and hypothalamus part of the brain. Klinefelter syndrome is a random disorder and it is not hereditary. It appears that its occurrence may be linked to the age of either parent. It is not more prevalent in any specific race .This is the most common sex chromosome disorder. According to research done in Australia only about 20-30% of males with KS are ever diagnosed, partly due to the hesitancy of men to seek medical attention and the somewhat non-specific nature of the symptoms. Often men only find out they are KS when they present with fertility issues. They are almost always sterile. Unfortunately there is little awareness about the syndrome, even amongst health professionals, which often sends parents on a diagnostic odyssey trying to find out why their boys are different and the underlying cause remains unidentified. Another difficulty with it is that the symptoms are highly variable, sometimes subtle and sometimes not present at all. Only about 35% present with stereotypical symptoms but up to 80% have learning difficulties and behavioural issues. Many will have developmental delays and trouble with their muscles (low muscle tone) and motor skills. Dyslexia, reading difficulties and data retrieval problems are common. A large percentage are attention deficit (ADD) While their intellect is not compromised, their verbal IQ is below average, they often have difficulty expressing themselves. This often leads to frustration and angry outbursts. It is unclear whether some behavioural difficulties are directly caused by the syndrome or are exacerbated by early speech and learning difficulties. KS in very young boys is especially difficult to recognise and only at puberty do some of the more obvious signs begin to show. The physical characteristic common to all KS males is that they have very small underdeveloped testicles. It is because of this that they cannot produce enough testosterone to produce sperm. This androgen masculinising hormone is also responsible for producing secondary sexual characteristics. Other more common signs are: They are often somewhat taller than genetically expected, their limbs are slightly proportionately longer. They often have knock knees (genu valgum) and high arches (pes cavus). Taurodontism (Large molar teeth with thin enamel) is common. They will have more feminine fat distribution and rudimentary breast development, (gynecomastia) high pitched voice and sparse hair. They usually have “softer more girlish faces and are generally more sensitive than most boys, they tend to be emotional and cry easily. 33% of KS males experience psychosocial issues particularly shyness and low self-esteem. KS men also have added complications whereby they have a predisposition to developing diabetes, osteopenia and osteoporosis It must be noted however that Klinefelter syndrome does not affect sexual orientation. When correctly treated with supplemental testosterone KS men can have normal sexual relations in adulthood. If you suspect your son may be KS you will need to consult a geneticist. They will probably request blood tests which will include a karyotype. An endochrinologist will monitor further treatment. Klinefelters syndrome symptoms can be mitigated by correct intervention. Testosterone supplementation must continue throughout life. This can be administered by injection or with creams or a patch. If KS is identified early there is a better chance of normal development. A thorough psychoeducational examination will need to be conducted to determine what educational interventions are required as KS boys need assistance with the learning issues most of them have. A speech therapist can assist them and occupational therapy is recommended. Many KS boys also have motor dyspraxia. While this all may seem alarming particularly that the syndrome is so relatively common yet somewhat unrecognised there are some positives. These are wonderful sensitive human beings. They can be encouraged that they are usually taller than average, tend to keep their youthful looks, have better intuition and emotional skills than most men and usually get on really well with women. Further reading : www.xxy47.co.za www.andrologyaustralia.org www.checkyourballs.com.au www.csvxy.org Plus information taken from: Lawley pharmaceuticals KS info brochure 2016 Amy Herlihy BSc, Grad Dip Genetic counselling : Thesis 2010 Exploration of prevalence and psychosocial aspects of KS in the context of population based genetic screening.

November 22, 2016

Childhood obesity in South Africa to soar unless we act now

If obesity in South African children continues to increase at the current rate, 3.91 million school children will be overweight or obese by 2025. On world Obesity Day, the Heart and Stroke Foundation South Africa, together with the World Obesity Federation, calls for decisive action from government, private sector and parents. Today is the second annual World Obesity Day and the theme is Ending Childhood Obesity: Act today for a healthier future. The Heart and Stroke Foundation (HSFSA) supports the World Obesity Federation (WOF) in this initiative to stimulate and support practical actions to address obesity. South Africa’s obesity epidemic could be described as complex. Our country’s past of poverty, inequality and a lack of education, coupled with rapid urbanisation has created a vulnerable population amidst a nutrition transition. The population group that is most vulnerable to this ‘obesogenic’ environment is children. Both children of overweight parents and children subjected to malnutrition during pregnancy or infancy are likely to become obese later in life. Children are brought up in an era of energy dense foods, increasing screen time and sedentary behaviour. The World Health Organisation (WHO) reports the fastest growth of obesity in the African region, where childhood overweight and obesity has more than doubled from 1990 to 2013 1. Childhood obesity in SA – our girls at greatest risk According to the most recent national survey, 14.2% of primary school children are already overweight 2. This prevalence is highest at 30% in girls living in urban areas. Being overweight as an infant increases the risk of being overweight as a child, which in turn increases the risk of being overweight as an adolescent and adult. Results from the Birth to Twenty study in Soweto recently showed that girls who were obese between the ages of 4 – 6 years, were 42 times more likely to be obese as teenagers compared to their normal-weight peers! 3 Clearly interventions should already be addressed at infants and toddlers. Cultural beliefs and poor knowledge of the consequences of obesity lulls many parents into inaction. Childhood obesity is not prevented, recognized or treated adequately. New figures from the World Obesity Federation estimate that by 2025, 3.91 million South African school children will be overweight or obese. This will result in 123 000 children with impaired glucose tolerance, 68 000 with overt diabetes, 460 000 with high blood pressure, and 637 000 with first stage fatty liver disease 4. The global action plan The complexity of the obesity epidemic is often cited to explain the little success in turning the tide and perhaps as an excuse not to make the changes we know are necessary. The 2016 WHO Report on Ending Childhood Obesityclearly outlines a comprehensive action plan. Recommendations include addressing norms, treating children who are already obese, promoting intake of healthy foods and physical activity, improved preconception and pregnancy care, healthier school environments, and curbing the marketing of unhealthy foods. The South African Department of Health have incorporated these guidelines in their own Strategy for the prevention and control in South Africa of obesity framework. Childhood obesity is singled out within this strategy as a specific area of focus, “given the large perceived benefit the interventions may yield”. We can end obesity if we act now Obesity is not a complex problem, for we have the tools to address it. We can end the childhood obesity epidemic if we act together. The President of the World Obesity Federation, Professor Ian Caterson, calls for decisive action “If governments hope to achieve the WHO target of keeping child obesity at 2010 levels, then the time to act is now.” Government action In the National Obesity Strategic Framework, Deputy Minister of Health Dr Joe Phaalhla writes “…It is our responsibility to empower people to make informed decisions and to ensure that they have access to healthy food by raising awareness and increasing the availability of effective initiatives and interventions.” The Government has shown intent by announcing tax on sugar-sweetened beverages, strategies to increase school sport, and draft legislation to restrict the advertising of unhealthy foods to children. Swift and effective implementation of these policies are vital. Professor Caterson from the WOF urges governments to act “Introducing tough regulations to protect children from the marketing of unhealthy food, ensuring schools promote healthy eating and physical activity, strengthening planning and building rules to provide safe neighbourhoods, and monitoring the impact of these policies.” Private sector and in particular the food industry There is no singular solution for obesity, and involvement of all sectors is needed. Food industry and especially fast food restaurants – still largely unregulated – needs to become part of the solution by producing healthier products and meals that are lower in added sugar, salt and fat, and by partnering with government and civil society to make healthy food choices more affordable. Collective advertising spend on unhealthy foods and meals are staggering, overpowering education efforts by government and NGOs. The HSFSA calls on the food industry to realise the vital role they play in South Africa’s obesity epidemic. It is time to make a choice to either help or hinder- practicing responsible marketing of foods aimed at children is a good place to start. Parents and caregivers Professor Pamela Naidoo, CEO of the HSFSA implores primary caregivers “Parents have the single biggest influence over their children’s risk of obesity. Mothers should aim for a normal weight before pregnancy, appropriate weight gain during pregnancy, and exclusive breastfeeding for the first six months. Parents should introduce healthy eating habits from six months onwards and lead by example to create an active lifestyle for the whole family.” Prof. Naidoo concludes “The HSFSA will continue its efforts to advocate for a healthier environment and create public awareness to prevent obesity as a major risk factor for heart diseases and strokes”. The Heart Mark is one such tool used to make it easier for consumers to make the healthier choice when faced with a variety of options at the supermarket. It helps

November 21, 2016

Why should we limit out children’s screen time?

Our kids are growing up in a technological age. They are confronted with tablets, smartphones, laptops, DSTV and so much more. Your phone is seen as part of your image and our kids want the latest and greatest. So why should we limit them? The biggest concern I have is that kids are not spending enough time outside playing. The reasons for this are: It’s not safe Preschools are focusing more on academic performance More and more screen time is available in different formats Safety In the society we live in in South Africa it is a valid concern that our kids are not safe to play outside by themselves any more. Kids are told to stay indoors and this force them to play stationary games or be involved in screen time. Screen time The inventors of children’s television shows and games/apps target the primitive brain. They use fast moving images and bright colours to target our visual system. They use loud and quickly changing sounds to target our auditory system. When I ask parents how long their child is able to concentrate they usually tell my ‘O he can watch television for hours’. This is not concentration ability!!!! This is your child’s primitive brain being targeted and activated. Our poor teachers have no way to compete with TV and games and apps and we wonder why our children cannot concentrate anymore and why ADD and ADHD is being diagnosed more frequently in our kids!!! According to research a child younger than 2 who watches television has a 15% higher risk of developing ADD/ADHD. Thus a child under 2 should not be exposed to ANY screen time. Another big concern is that parents don’t play with their children any more. Most families are dual income households and thus mom and dad work full day and are too tired to play with their kids. This is not ideal but this is what is happening. Out toddlers don’t know how to play any more as they are not used to thinking up games or spend time inventing games. Creativity suffers. We now have to teach our kids how to play house-house, how to play with cars and how to entertain themselves by playing in the garden. Screen time takes away creativity. Academic performance We as a society are placing more and more pressure on our children to grow up faster. Some pre-schools tend to focus more on academic performance like counting and getting to know the letters of the alphabet than playing outside. Children should be playing outside nearly all day long to facilitate the necessary skills they need for development. Benefits of playing outside: Bilateral integration Postural control Activating the proprioceptive system Activating the vestibular system Sensory integration Socialising Gross motor skills Eye-hand coordination Eye-foot coordination The impact of limited outside play: Poor postural control So what is postural control? It is the ability to have stability at your big joints and to maintain different postures. Our kids are not able to sit still any more. The reason for this is that they don’t get enough vestibular (movement) and proprioceptive (deep-pressure) input. These 2 systems underwrite postural control. Children tend to slouch in their chairs, support their heads while doing table top tasks, exhibits fidgeting, rides on their chairs, changes their posture frequently while sitting. All of this is their bodies craving movement and deep pressure input. So what happens in class? Most teachers tell the learners to sit still. This will cause postural control to diminish thus postural control will decrease. Now the learner with spend so much energy and effort staying upright and still in the chair that no energy is left to pay attention to what the teacher is saying or to complete given work. These kids tend to rush through tasks or tire easily and fine motor skills then decrease thus they write untidily and make unnecessary mistakes. Poor vision Kids start using ipads /phones at a very young age, when the visual system is not yet fully developed and not able to withstand this prolonged visual demand at near. This leads to a generation that is becoming increasingly myopic (nearsighted), as we have seen in China in the last 20 years. Digital screens also emit a lot of blue light, which has been shown to cause premature aging to our eyes – our children will need reading glasses 10 years earlier than what we do, and research shows that degenerative eye diseases due to this excessive blue light exposure is happening at a much younger age (up to 15 years earlier than in the previous generation). Weight gain Obesity in our kids is getting out of hand! This leads to many other health and self-esteem issues Poor communication skills This affects their ability in making friends, initiating conversations and to resolve conflict So what can we as parents do? I am a mom myself and I know we sometimes use the television as a nanny. When we want to prepare a meal or have some time to ourselves it is easy to switch on the television and entertain the kids. When you have to do this please then make sure it is a program of some value and appropriate for your child’s age No screen time for kids under 2 years of age Children’s screen time should be limited to 1 hour daily while in primary school and to 2 hours when in high school Have certain times during the day when no screen time is allowed e.g. while eating dinner/having a braai No televisions/X-boxes allowed in children’s rooms Set the parental control on your television and internet (especially google) Spend time playing outside with your kids doing gross motor tasks e.g. kicking a ball, rolling down a hill, playing in the sand pit or sliding down a slide. Have their vision and eye-muscle functioning evaluated by an optometrist If you suspect that your child has poor postural control – take your child to an occupational therapist to assist you in improving this

November 17, 2016

What people without special needs kids need to know

Parenting is a tough job. Parenting a special needs child is a tougher one. And as human beings interacting with a special needs parent, we have the opportunity to make things a little bit better or a little bit worse. Here are some things you need to know if you’re hoping to do the former. It is rude to stare. Kids with special needs will often look different or behave differently to other children. This does not give you the right to stare, judge or gawp at them. These kids and their parents already have their plates full. They don’t need the added discomfort of your judgements. What to do instead? If you see a child having a meltdown in the shopping centre, how about asking the parent if there’s anything you can do to help. Don’t offer sympathy. It may seem strange to those of you not in this situation, but parents of special needs kids want to be treated like normal families – not like some charity case to be pitied. Yes they have bigger challenges, yes they have things they feel sad about, but they’re also proud of their kids, and have incredible gifts from their children that you could never understand if you didn’t stand in their shoes either. Never use insulting labels. Believe it or not, there are still people who will call a child a ‘retard’ or other such derogatory names. Please be aware of the language that you use and how hurtful this can be. We’re very aware of racist or homophobic comments and so should we be with any kind of intolerance. Be inclusive. If there is a special needs child at your school or in your child’s class, include them in parties and play dates. Go beyond your own fear and discomfort and allow these children to be part of the greater community. You will be surprised how much you will learn from them and you will give your own children the opportunity to go beyond labels and judgements. Don’t judge the parents. Parents of special needs kids are likely to be more tired, stressed, and overwhelmed with daily tasks than you are. Give them a break. If you see them losing their temper, know that they have probably been pushed beyond their limits. Give them a break. Even better, lend them a hand. Stop talking about your perfect child. Parenting a special needs child can be scary and lonely, and parents can often feel jealous of others whose lives are less complicated. They may even resent you and your child for getting to do the ‘normal’ childhood stuff and celebrate the ‘normal’ childhood milestones. Of course you are happy for your child, but be sensitive about not rubbing it in. Watch your questions. Please do interact with parents of special needs kids, but don’t bombard them with questions. They will talk when they are ready to talk, and some days (like all of us) they just don’t feel like discussing the intricacies of what they are going through. Have normal conversations. Speak to them like other parents – they are. And don’t ask: “What is wrong with your child?” Special needs parents are parents just like you. They love their children. They have good days and bad. They have challenges and joys. They worry about their child’s future. They want to talk about their child’s achievements. They need friends and date nights and girl’s nights and time out and a shoulder to cry on – just like you. Every child is special. Every child is unique and has their own specific challenges, talents, gifts, and difficulties. Keep this in mind whenever you want to judge any parent, and particularly one with a special needs child. You have no idea what someone else is dealing with, what kind of a night they’ve had, when last they slept, what new obstacle has just been thrown in their path. If we start every interaction with another human being by first understanding where they’re coming from, we are more likely to be kind, considerate and compassionate. Every parent is trying their best. Let’s start with that assumption.

November 17, 2016

An open letter to divorcing parents

Dear Parents, Divorce/separation sucks for the simple reason that when two people get together and have children, they make plans to build a future together. They do not plan for an eventual separation. So when it eventually happens, everything as they know it, crumbles. Everything will be different, and that is scary as hell. Today, thanks to extensive resources available, providing a wealth of information on all aspects of separation and referencing many people having gone through a separation before, separating parents are being presented with more options to separate with less trauma, and receive more knowledge on how to face and proceed mindfully with this life changing event. It gifts them a head start to engage on this journey in a manner that will not only allow them to move forward with less anger and bitterness, but mostly in sparing their children from broken childhood memories. Yet, there is increasing evidence of a rise in parental conflicts, court battles, evasion of parental roles and responsibilities, and using the children to control certain outcomes of their agreements not being met. Life is a never ending learning process. To discard available information and valuable support, is choosing to be a victim of your circumstances. Yes, a separation is distressing and hard on a person. It can make you feel like there is little justice and that life isn’t fair, but it should not become an excuse to waste your life focusing on a dream that did not materialise. Instead, evaluate if your conflicts are about hurting your ex or rather hurting your sons and daughters, because your conflicts are wounding your children in ways they cannot control. Recognise that there is in fact no problem. What you see as a problem is actually a change of direction. It’s not the end, it’s not a beginning. It’s a transition that allows you to plan for some different and new life choices. The time has come for separating and separated parents to address the crisis their families are in when going through a divorce/separation. Parents who are hostage to an acrimonious battle over custody and/or maintenance are not fighting for what is in the best interest of their children, they are out to hurt and destroy each other, no matter who stands in the cross fire. It is time to raise awareness that being in control of your emotions is the solution to forgiveness and healing, so that you can mend, and not destroy, your children’s families. The time is now to change the way you, parents, separate, so that you can give your sons and daughters a life which feels normal being happy and not which feels normal being broken. The Law doesn’t raise children, parents do! Nadia Thonnard

November 16, 2016

Choosing Medical Aid

Most medical schemes have launched their benefits and contributions for 2017 and it is the time when you should be re-looking at your existing medical aid cover or, if you are wanting to join a scheme, investigating which one suits you best. The medical aid landscape can be tricky to navigate so it is important to compare options and schemes to ensure you find a medical aid that works for you and your family’s health and is within your budget. Dr Bobby Ramasia, Principal Executive Officer of Bonitas Medical Fund, helps guide you through choosing the best plan, whether it’s through the open market or through an employer. If you are already on a medical aid scheme Before you choose the best medical aid option, you need an idea of what your typical health care costs are. You should also consider the following for you and your dependants over the past twelve months: How much you spent on day-to-day healthcare expenses Where you or any of your dependants admitted to hospital Did you need to visit a specialist regularly How much often do you or your dependants visit a GP Do you and your dependants have any chronic conditions How much do you spend on dentistry, optometry and over-the-counter medicine Did you exhaust your day-to-day benefits and/or savings this year How much did you pay in co-payments and/or deductibles Then consider which of the expenses listed above were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu). You should be able to find a list of your medical claims on your current medical aid’s website. The day-to-day detail: Often the cost containment measures medical schemes apply for the day-to-day benefits are broad. So investigate, or bear in mind, the following: Does your medical aid contract with doctors and specialists and, if so, are you willing to use them? Using contracted or network doctors usually means obtaining full or improved cover levels, while using doctors outside of the network usually results in restricted benefits or co-payments. It also helps ensure you are getting more value for money as doctors on your medical scheme’s network will not charge you more than the rate agreed with your medical scheme. Must you be referred to a specialist by your GP? Does your medical aid offer additional GP consultations, which they will pay for, after you have exhausted your day-to-day benefits? Does your medical scheme offer any additional benefits such as maternity, preventative care or wellness benefits that are paid from risk and not savings or day-to-day benefits? You can also follow these tips to get more value for money: Use generic medication wherever possible – get into the habit of asking your doctor and pharmacist about this Try to keep your claims within any specified sub-limits, e.g. optometry Find out if your option has any day-to-day benefits that are paid by the scheme from risk (not from your day-to-day sub-limits or savings). Two examples where this sometimes applies are dentistry and optometry. Additional benefits: Ask what supplementary benefits might be available to you that can potentially save significant day-to-day expenses. These could include the following; Preventative care benefits, ranging from basic screenings (blood pressure, cholesterol, blood sugar and body mass index measurements) through to mammograms, pap smears, prostrate testing. In some cases this extends to maternity programs, dental check-ups, flu vaccinations and more. These usually require authorisation from the scheme, failing which they are simply met from your day-to-day benefit limits. A mammogram costs in the region of R900, so don’t look a gift horse in the mouth! Age impacts your decision If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family, check that your option provides sufficient cover for maternity benefits. However, if you are slightly older then ensure that the option you select covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation. Ensure the affordability of the medical aid plan selected. When comparing the different medical aid options available, consider all the costs involved before you make your final decision, such as: The monthly contributions, as a rule of thumb, you medical aid contributions should not exceed 10%of your monthly income at an individual or household level Other costs associated with your medical aid option e.g. if your option only allows consultations with doctors on a network, then you must ensure that the cost of travel to a network doctor (including hospitals and other healthcare service providers) The cost of co-payments for various benefits claimed. A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. The medical aid would not cover 100% of the costs and the member would have to pay for a certain percentage of the medical service before the medical aid pays their portion. These co-payments usually apply to specialist or elective medical procedures. This will differ from one medical aid scheme to another. It is one of the reasons why you should always do thorough research before deciding which medical aid scheme is the best option for you. The ideal option would of course be the one that does not require many or any co-payments from the member.

November 15, 2016

8 Kid-Friendly Yoga Poses for Peaceful Mornings

As parents, getting our sons and daughters out the door every morning can be a monumental task. Whether it is getting them to eat their breakfast, tie their shoes, find their homework, or brush their teeth, something inevitably goes wrong. However, by taking a few minutes everyday to teach our kids yoga, we can help our kids stretch, strengthen their cores, and naturally clear their minds. This can make a big difference in how our children’s and even our own day unfolds. Why Yoga For A Peaceful Morning? Each morning is a new day offering us the possibility to teach our kids confidence, relaxation techniques, and help them be a little more grounded as they start the day. Yoga offers to help our kids release pent up tension and emotions, while helping them physically. In addition, yoga can be done with the whole family, within a matter of minutes, without requiring a gym or host of athletic equipment. Adding yoga to our routines can help us all be more mindful throughout the day.. Yoga teaches our children to breathe, re-center, and notice their emotions, which is a life skill that they can carry with them into adulthood. Not only is yoga good for the soul, but research has repeatedly proven exercise helps kids perform in the classroom. Oh, and did we mention that it’s fun! 8 Kid-Friendly Yoga Poses for Peaceful Mornings Introducing our boys and girls to yoga while they are young is beneficial and helps them develop lifelong healthy habits. Whether you watch a child centered yoga class online or create your own workout, remember to have children breathe as they move. For example, stretch on inhale and release their muscles while breathing out. Listed below are poses to get the entire family started: The Sunrise and Sunset Pose. Stand tall and take 3 to 5 deep breaths. On the last inhale, raise your arms above your head and press your legs into the ground. Stretch your spine up, toward the sky. On exhale, bend at your waist and bring your upper body toward your feet, similar to diving in a swimming pool. Reach down as far as you comfortably can go and inhale again, slowly opening your arms as you stand, reaching for the clouds. Repeat 6 to 10 times. Help children see the resemblance to the rising and setting sun. The Mountain Pose. Once again, standing tall, press your feet down and straighten your spine. Slowly roll back your shoulders, bringing your palms together in front of your chest. Take several deep breaths. The Cat/Cow Pose. Get down on all fours, resembling a cat and cow. For the cat position, exhale and gently arch up your back with your head looking at your belly button. As you inhale, gently reverse your back and push your stomach to the ground for the cow. Exhale, and return to the cat pose. Repeat three or four more times. The Cobra Pose. Lay down on your stomach, stretching your legs back with the tops of your feet pressed on the floor so you resemble a snake. Spread your hands out and place them under your shoulders so you can raise your torso up. Stretch your head back to open the chest. Hold for 5 deep breathes. The Downward Facing Dog. You want to create a V shape by putting the palms of your hands on the ground and lifting your hips up toward the ceiling. As children get better at this, encourage them to straighten their legs or stand flat footed. The Fish. This pose resembles a fish jumping out of a river. Lay down onto your back and use your elbows to prop up your body, arching your chest up so your head rests on the floor. Hold for 3 to 4 breaths, coming down as you exhale. The Bridge Pose. While you are on your back, press your feet down into the earth and thrust your hips into the air. Hold for 3 to 4 breaths and come down slowly on an exhale. The Resting Pose. Lie down on your back and take in a deep breath. Exhale. Now, wiggle your body and then rest. As you breathe, imagine that you are filling up with a warm light that starts at your feet and spreads up your body slowly. When you are ready, sit up slowly. What yoga poses do you use with your children?

November 9, 2016

Cut to the chase…

I work with a lot of high-school aged people, in fact they form about half of my professional interactions. As a result of this, I come across many who self-harm in one way or another. It can be hard to understand why people deliberately hurt themselves. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or relationship problems. They are often dealing with feelings and situations that seem insurmountable. Some people cut because they feel desperate for relief from their emotional state, while some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness. It can also form a system of self-punishment or punishment to those who love and care for the person in question. People who self-harm may not have developed adequate ways to cope with their challenges, or their existing coping skills may be overpowered by emotions that are too intense. When emotions aren’t expressed in a healthy, regular way, tension can build up, like a pressure cooker, to the point of boiling over. Cutting and other types of self-harm are often attempts to release the pressure and tension felt. For some, it seems like a way of feeling in control. For others it’s just a way of feeling something…anything. How common is it? Much more common than it used to be. Studies from the 1990’s suggested rates of 3% or lower. But more recent studies focussed on females, suggest that as many as 20% of girls between 10 and 18 years of age are now self-harming. Researchers at Yale University recently reported that 56% of the 10- to 14-year-old girls they interviewed reported engaging in self-harm at some point in their lifetime, including 36% in the past year. Cry for attention? So many people will take one look at the behaviour and say that it’s just a cry for attention and should be pandered to. Sometimes they are half-right in that it is a way of drawing attention to themselves, but to ignore it? Never. Think of it this way: If your child does not know a better way of drawing attention to themselves and their emotional turmoil, that is a huge, flashing warning sign that they have inadequate skills for dealing with their challenges. Why don’t they just talk to us? The urge to cut might be triggered by strong feelings the person can’t express such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don’t fit in or that no one understands them. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection. They often lack the perspective required to realise that even if we don’t fully understand what they are going through, we can still be of help and support to them. It’s addictive. When we are injured, you brain releases a bunch of dopamine (our most addictive happiness hormone) to compensate for the pain. It becomes like a distraction from the mental pain that a self-harmer goes through, a really exhilarating one at that. It’s something that can be leant on when they are not feeling happy and need an instant “fix”. Think about the stressed person who needs a quick smoke to relax and you’ll be a bit more in the picture. Except that this “smoke” can accidently kill you a lot more quickly and maim you in a much more visual way. It’s dangerous! Firstly, there is the risk of accidental death as a result of self-harm. An artery or vein pierced or nicked accidentally can be fatal. A head bashed against a wall can cause concussion or fitting that could lead to death or permanent brain damage. Burning can lead to full combustion… let me not go on. Aside from this there is the risk of infection and septicaemia. Take it from someone who nearly lost an appendage to a simple thorn-prick, it’s no joke. Types of self-harm to look out for: Scratching or pinching: severely scratching or pinching with fingernails or objects to the point that bleeding occurs or marks remain on the skin. This method of self-injury is probably the highest reported type. Impact with objects: Banging or punching objects to the point of bruising or bleeding. This is no joke and I’ve seen one person repeatedly break their wrist this way. This same individual took his own life many years later, sadly. Cutting: Usually synonymous with self-harm, this type of self-harm occurs in roughly 1/3 of cases and is more common among females. This is accomplished with anything from scissors to surgical blades and can be the riskiest in terms of accidental death. Impact with oneself: slapping or punching oneself to the point of bruising or bleeding. Ripped or piercing skin: This type of self-harm includes ripping or tearing skin, usually with objects like needles, pins, hooks or other jagged surfaces. Carving: this type of self-harm is when a person carves words or symbols into the skin and is considered separate from cutting. Burning/Branding: using lighters to brand themselves is a very common as its relatively quick and uncomplicated. Look for tell-tale “smiley” marks. One thing to note, 70% of those who repeatedly self-harm use multiple ways to self-harm with the majority reporting between 2-4 self-harm methods used.

November 8, 2016

When do we get back teeth?

This panoramic x-ray is fascinating in the detail that it shows of a seven-year-old child growing and developing. Let us look at the x-ray very closely so that you will understand why back teeth are so important in looking after from an early age. The first thing that you might notice is that the permanent teeth are in the process of development sitting under the roots of the primary(baby). All the primary teeth are still in the mouth except for the two lower front teeth. Both permanent lower central incisors are erupting. On the upper arch there is a full complement of primary teeth. The roots are still intact and these teeth except for the 2 upper front teeth will probably stay in the mouth for another four years. On the lower jaw the primary teeth are still firmly attached to the bone. As the permanent teeth develop and move upwards they cause the roots of the baby teeth to dissolve. At the age of approx. 11 these baby teeth loosen and fall out allowing the permanent teeth to erupt into the mouth. The permanent teeth that are most well developed are the first molar teeth which can be seen at the back of the mouth. These teeth have now erupted into the mouth at the tender age of between six and seven years old. These are called the six-year-old molars. All the teeth are in an ideal state of growth and development. These teeth should last a lifetime in a healthy pristine state…with proper care and good dentistry But, the reality is often not so. Why? Because they erupt into the mouth at such an early age, they are extremely vulnerable to ravages of dental decay. They need very special care and attention. They are precious. Great responsibility is needed on the part of the parent and child himself or herself to keep them sound and healthy. This involves effective plaque control; a controlled diet of as little sweets as possible; and possibly fissure sealants in the grooves on the biting surfaces of these teeth Little cavities must be detected early and treated appropriately. If not, further decay develops. It is important to understand what happens when these molar teeth become ravaged with the passage of time and inadequate care… A large filling may fail if improperly restored; the tooth then needs to be root treated; the root treatment fails; the tooth is then extracted; followed by leaving a space or placing an implant… A downward cascade with the negative consequences which all could have been prevented.

November 7, 2016

Exam Stress

A moderate amount of stress can be a good thing. It can sharpen concentration and performance and help to create the energy and motivation we need to keep studying. Too much stress, however, can be overwhelming and stop us from being able to study and function healthily in life. Undoubtedly, it would be disappointing if you do not do as well as you hoped. Thus, instead of thinking negative thoughts it is helpful to challenge the thoughts (I won’t get a good job, people will think I am stupid, my future is over) with a more realistic assessment of the situation. Enlist the help of a friend, counsellor or tutor to help you to do this. It is very common to think that we will be judged solely on our academic achievements rather than as individuals with contributions to make in all sorts of ways. If someone believes that his/her self-worth depends on academic achievement, there will be considerable anxiety surrounding any academic assessment. Too much anxiety can be paralysing. If the pressures to succeed from family or others is extremely high it may help to contact your local counselling service in order to talk about this. WHAT IS STRESS? Stress is part of the body’s natural response to a perceived threat. It causes our bodies to go into a fight or flight response. The main physiological reaction is the release of a rush of adrenaline which gives us the energy to act. If the perceived difficulty is not physical but psychological, the adrenalin is not used up and this can cause increased muscle tension, heart rate and breathing rate. This then leads to physical changes (headaches, neck aches, stomach problems), mood changes (irritability, tearfulness, feeling low or anxious) or behaviour changes (sleeping problems, increase or decrease in appetite, difficulty in concentration). Exams lead to stress because the marks will influence final degree results. Thus, the stress is derived mainly from the additional meanings which get attributed to exam results. ORGANISING YOUR TIME Draw up a weekly timetable including everything you need to do such as revision, eating, sleeping, lectures and relaxation. Allow for sufficient flexibility due to the unexpected. Be realistic about how much time you can spend revising – if you divide the week into 21 units (3 a day), you should work for a maximum of 15 units per week. You should have 6 units to do other things. Allow yourself time for relaxation as it will decrease your stress levels. This is not wasting time as it will help you work more effectively. Plan how you will use your time during your revision periods. Decide on the order of topics and how much time you will spend on each. Stick to your deadlines. Prioritise – do the most important topics first and allow more time for subjects you find difficult. Set specific goals for each revision period. WHAT FRIENDS AND FAMILY CAN DO TO HELP Listen to the individual’s concerns, be sensitive and give him/her support. Encourage him/her to take breaks and go out from time to time. Inform them about various strategies. Help them to seek additional help if the stress is getting too much for the person. Reassure them that this is a sign of strength, not weakness. Ensure that they are having regular meals, times of relaxation and emotional support. Give positive feedback. Keep distractions to a minimum. SLEEPING BETTER Do not work in or on your bed. Stop working at least an hour before you intend to sleep. Stick to a regular bed time and getting up time. Maintain good sleeping patterns – 6 to 8 hours a night are recommended. Do not drink too much alcohol – it will prevent you from sleeping properly. STUDY PATTERNS Take regular breaks from studying. When you notice that you are distracted, get up and take a break. Fifteen minutes when you can concentrate is better than three hours of staring into space and feeling guilty or anxious. TECHNIQUES TO COPE WITH STRESS Some individuals may use alcohol, smoking and drugs as a means to manage stress. These may have a calming effect in the short term, however, they are not ideal solutions since it may cause one to feel worse afterward and thus impair the ability to think clearly. Eat at least one proper meal a day and keep the body hydrated. Exercise. This increases the blood flow around the body which increases clearer thought. Just a 10 minute walk a day can be helpful, especially in using up some of the extra adrenaline created by the stress. BASIC REVISION METHODS Step One: Read your notes and seek answers to questions. Be as active in your reading as possible – talk to yourself, walk around the room, speak into a tape recorder. Step Two: Close up your notes. Step Three: Actively recall what you have just been reading, asking again the same questions without looking at your notes. Write down what you have recalled in brief notes. Step Four: Check the original notes with the new ones. If you recalled all the answers to the questions then you have created a master card which you can use to re-revise without having to consult lengthier notes. Step Five: If not all the questions have been answered, re-read your original notes, looking particularly to those you missed. Repeat steps two to four. ON THE DAY OF THE EXAM Do not try to learn any new topics since this may impair your ability to recall those you have learnt previously. Look at some brief notes or revision cards. Do not study for the last hour before the exam. Time your arrival at the exam room so you do not need to wait about outside with others who may increase your anxiety level. Give yourself time to settle before reading the questions and starting to write. Use a breathing exercise to regulate your breathing and calm yourself down. Have a plan for how you will use your

November 3, 2016

Four Ways We Teach Children – Can you think of others?

Asking Questions. Our children are smarter than we give them credit for. We are so worried that they are not going to do what is right, or we are in such a hurry that it just seems easier to give our children marching orders. But asking them questions is a far more effective teaching tool. Often, they know exactly what to do and when they come up with solutions to their own questions or challenges, it builds their problem-solving skills. I always encourage parents to refrain from telling their children what to do or from answering their questions so quickly. Instead, ask them questions such as “what do you think?” “what will you do now?” “what did you notice?” Asking children questions also builds their own confidence and strengthens their faith in themselves. Coaching. Taking the art of asking questions one step further, coaching adds two more elements that teach a child greater problem-solving skills: Telling a child what you see, and offering to help. Putting these three concepts together creates a powerful method for parenting that will build the child’s coping skills. You are not always going to be at your children’s side to protect them, so you have to arm them with the ability to cope and survive. Telling your children what you see provides a perspective that they can compare to their own assessment. Asking them questions invites creativity and solutions. And finally, offering to help gives them the courage to take on things that they might feel are too big for them; whether it’s putting on a bandage, choosing a book report project, or finding solutions to teen problems. Living Out Loud. Similar to living by example, this concept takes teaching one step further and works best with younger children. By living out loud, you seek opportunities to set an example by narrating what you’re doing. For example, you are watching television and your child is playing in the same room. You want your child to learn that television is not what life is all about and that it should be limited, so as you turn it off you say out loud for anyone to hear: “That’s enough television for me today.” If your spouse does something for you that demonstrates respect, say out loud: “I love it when mommy gets me a glass of water.” If you’re serving the meal and your child is at the table and watching, you could say: “Everyone gets a small serving of pasta because they need to leave room for the vegetables.” Using this narration will teach many wonderful messages about respectful living, boundaries and limits. Accomplishments. One final method for teaching your children is through the examples of your actions and individual accomplishments that will speak to them for many years. It is more than living by example and the things you do on a regular basis. It is about what you create that influences others. I think of these things as “our works” that contribute to making the world a better place to live. Doing so teaches children important lessons about the power we each have to give back to the world, and inspires them to do the same.

October 31, 2016

ADD/ ADHD And Alternative Treatments

Over the past years there have been many debates and controversy discussions around what Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) is? Furthermore how it is diagnosed and what are all the options to treating the disorder? The definition of attention-deficit/hyperactivity disorder (ADHD) has been updated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This revision is based on nearly two decades of research showing that ADHD, although a disorder that begins in childhood, can continue through adulthood for some people. Changes to the Disorder ADHD is characterized by a pattern of behaviour, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. As in DSM-IV, symptoms will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviours like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must present with five. Treatment options There are a number of treatment plans that are available to parents when making the appropriate decision when treating their child for ADD/ADHD. Nutritious meals, play, exercise, and learning better social skills are all part of a balanced treatment plan that can improve performance at school, improve your child’s relationships with others, and decrease stress and frustration. Pharmacological Treatment Stimulants such as Ritalin, Concerta and Adderall are often prescribed for attention deficit disorder. Such medications may help your child concentrate better or sit still, however there is a general debate as to whether or not medication is a ‘quick fix’ and what about the long term affects as well as immediate side effects of appetite suppression, insomnia and an overall change in the child’s personality? For some parents they have found medication to be the best result for their child, while others look for alternative treatments and see pharmacological treatment as the last resort. Homeopathy There are many other effective treatments that can help children as well as adults with ADD/ADHD to improve their ability to pay attention, control impulsive behaviour, and curb hyperactivity. According to Dr Raakhee Mistry who is a Homeopath, commented that Homoeopathy has often been used to assist with ADD and ADHD and has been effective. But unlike conventional medicine, there is no one particular homoeopathic medicine for these conditions. The ADD and ADHD symptoms for that particular child and factors that aggravate or ameliorate the symptoms, are taken into account when selecting the remedy for the child. Homoeopathic medicines do not numb or block symptoms, instead they work with the body to re-establish a state of equilibrium. When the patient is in this equilibrium state, the symptoms ease and the patient is able to function better. The aim of homoeopathic treatment is not to keep a patient dependent on medicine, but rather to bring the patient to the space where he/she can maintain this equilibrium state. Many homoeopaths also incorporate other modalities to their treatment such as supplements, herbs and probiotics. A child’s restlessness and ability to concentrate has also been linked to the state of the child’s gut Nutrition Good nutrition can help reduce ADD / ADHD symptoms. Studies show that what, and when, you eat makes a difference when it comes to managing ADD/ADHD. The following tips can be seen below By scheduling regular meals or snacks no more than three hours apart is a useful tip, which will help keep your child’s blood sugar level, minimizing irritability and supporting concentration and focus. Try to include a little protein and complex carbohydrates at each meal or snack. These foods will help your child feel more alert while decreasing hyperactivity. Check your child’s zinc, iron, and magnesium levels. Many children with ADD/ADHD are low in these important minerals. Boosting their levels may help control ADD/ADHD symptoms. Increasing iron may be particularly helpful. One study found that an iron supplement improved symptoms almost as much as taking stimulant medication. Add more omega-3 fatty acids to your child’s diet. Studies show that omega-3s improve hyperactivity, impulsivity, and concentration in kids (and adults) with ADD/ADHD. Omega-3s are found in salmon, tuna, sardines, and some fortified eggs and milk products. However, the easiest way to boost your child’s intake is through fish oil supplements Tips for supporting your child’s treatment In order to encourage positive change in all settings, children with ADD / ADHD need consistency. It is important that parents of children with ADD / ADHD learn how to apply behavioural therapy techniques at home. Children with ADD/ADHD are more likely to succeed in completing tasks when the tasks occur in predictable patterns and in predictable places, so that they know what to expect and what they are supposed to do. Follow a routine. It is important to set a time and a place for everything to help a child with ADD/ADHD understand and meet expectations. Establish simple and predictable rituals for meals, homework, play and bed. Use clocks and timers. Consider placing clocks throughout the house, with a big one in your child’s bedroom. Allow plenty of time for what your child needs to do, such as homework or getting ready in the morning. Simplify your child’s schedule. Avoiding idle time is a good idea, but a child with ADD/ADHD may become even more distracted and “wound up” if there are too many after-school activities. Create a quiet place. Make sure your child has a quiet, private space of his or her own. A porch or bedroom can work well too as long as it’s not the same place as the child goes for a time-out. Set an example for good organisation. Set up your home in an organised way. Make sure your child knows that everything has its place. Role model neatness

October 28, 2016

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