`I LET GO OF BEING A

ISSUE 14 l AUTUMN 2013
FOUR
FUNNY
GUYS
on what
makes
them
laugh
FEIT OF
FIKSIE?
Vier kosmites
in die kollig
THE FIRST
15 MINUTES
for you and
your baby
‘I LET GO OF
BEING A
hero’
WILMA VAN DER BIJL
SHARES HER JOURNEY
WITH BREAST CANCER
R
YOUEE
FR PY
CO
Like us on
Facebook
www.phonak.co.za
ISSUE 14
| AUTUMN 2013
D I D YO U K N O W ?
YOU CAN READ MEDICLINIC
FAMILY ONLINE AT
WWW.MEDICLINIC.CO.ZA
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CONTENTS
12
CHECK UP
2
WELCOME From the editor.
5
MAILBOX Your news, views
and letters.
6
MEDICAL NEWS Groundbreaking
procedures at Mediclinic hospitals.
8
DIE KWELPUNT Goeie handhigiëne
kan verhoed dat kieme versprei.
10 ASK US We take your questions
to the experts.
12 FEIT OF FIKSIE? Ons ondersoek
vier algemene kosmites.
14 THEN AND NOW Here’s how
cancer treatment has evolved
over the years.
32
16 BEDERF ’n Paar
pragtige geskenkidees.
18 THE FIRST 15 MINUTES
What those first few
minutes of life mean
for everyone involved.
16
CHECK IN
20 ‘MY JOURNEY WITH
BREAST CANCER’
Miss SA 1987 Wilma
van der Bijl shares
her story, plus tips for
managing treatment.
24 BEAT THE ODDS
A mammogram is essential
for all women after 40.
Here’s what you can expect.
26 THE ORGAN YOU CAN
LIVE WITHOUT Did you
know your body can survive
without its gall bladder?
28 BE BLISSFULLY UNAWARE All you
need to know about anaesthetics.
‘The simple things in
life get me laughing.’
30 ALIVE AND KICKING
The day football player
Fabrice Muamba should
have died.
32 LAUGHTER IS THE
BEST MEDICINE
Four local comedians share
what they find funny.
38 EGGS-TRAORDINARY!
All about eggs – let’s give
breakfast a makeover.
42 JUST A MINUTE
Exercise your mind with
these fun puzzles.
44 STAR NOMINATIONS Some
of the Mediclinic staff who
go the extra mile.
47 MY HOSPITAL Our tips for
hassle-free admission.
48 BEFORE YOU GO
Award-winning chef
Margot Janse pays tribute
to her adoptive homeland.
– Joey Rasdien
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EXPLORE OUR INFO HUB
www.mediclinicinfohub.co.za
ON OUR COVER
COVER MODEL Wilma van der Bijl
PHOTOGRAPHER Danie Nel
HAIR & MAKE-UP Alet Viljoen
from Supernova Creative Management
STYLING Megan Perks
AUTUMN 2013 |
WELCOME
MAKE THAT CALL
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IN THIS ISSUE
Mediclinic at the forefront
Groundbreaking procedures
that save lives. See page 6
ERIKA BORNMAN
Editor
Gesondheidsgeheim
Wie sou kon dink dat
handewas jou gesond
kan hou? Sien bladsy 8
Winning the war
A look at how far we’ve
come in the fight against
cancer. See page 14
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LIKE US ON
FACEBOOK
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MediclinicSouthernAfrica
2 I
MEDICLINIC FAMILY
I
MAAK DAARDIE
OPROEP
E
k was glad nie bang om 40 te word nie – tot my
dokter my gedurende my jaarlikse ondersoek
gesê het dit was tyd om vir my eerste
mammogram te gaan. Paniek het ingetree (‘Dit gaan
seer wees!’), asook vrees (‘Wat as daar iets fout is?’)
en uitstellery (‘Dit kan sekerlik nog ’n maand wag, of
’n jaar?’). Maar toe ek ons inspirerende voorblad-ster
Wilma van der Bijl ontmoet, het haar storie (bladsy
20) my aangespoor om daardie oproep te maak en
die afspraak na te kom. En so het ek weereens aan
myself bewys dat ‘vrees meer pynlik is as die pyn
wat dit vrees’ (bladsy 24).
Ons bring hulde aan ’n hele paar kreatiewe mense
in hierdie uitgawe. Margot Janse vertel roerend wat
Afrika haar geleer het (bladsy 48), en vier plaaslike
komediante deel met ons wat hulle laat lag (bladsy
32). Ons kyk ook na die merkwaardige storie van
sokkerspeler Fabrice Muamba, wie se hart voor
’n wêreldwye gehoor gaan staan het (bladsy 30).
Kom ons wees proaktief en maak daardie oproep
vandag nog. Wie weet? Dit kan jou lewe red.
ERIKA BORNMAN
Redakteur
AUTUMN 2013
EDITOR Erika Bornman
ART DIRECTOR Sean Robertson
FEATURES EDITOR Mandy Freeman
BRAND ASSISTANT Luyanda Ceketwane
ACCOUNT DIRECTOR Jason Curtis
CONTENT DIRECTOR Adelle Horler
Published in association with Health24
and the Faculty of Health Sciences,
Stellenbosch University
PUBLISHED BY
New Media Publishing
New Media House
19 Bree Street
Cape Town 8001
Tel 021 417 1111 Fax 021 417 1112
ADVERTISING
Head office – Cape Town 021 417 1111
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Aileen Lamb 021 417 1228
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Published on behalf of Mediclinic Southern Africa,
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www.mediclinic.co.za
MEDICLINIC EDITORIAL BOARD
CORPORATE COMMUNICATION
MANAGER Tertia Kruger
CORPORATE PUBLICATIONS
Gerda Pretorius
Editorial submissions may be sent
to mediclinic@newmediapub.co.za.
A response is not guaranteed.
For all new business enquiries, contact
Andrew Nunneley on 021 417 1143.
Copyright © New Media (Pty) Ltd. All rights
reserved. While all precautions have been taken to
ensure accuracy of information, neither the editor
and publisher, nor New Media can be held liable
for inaccuracies, injury or damage that may arise.
Subscribe to our digimag
Email mediclinic@newmediapub.co.za if you
would like us to send you a link to the digital
version, so you can read Mediclinic Family
cover to cover on your computer screen.
PHOTOGRAPH Sean Laurénz
T
urning 40 didn’t scare me at all until my doctor
told me during my annual checkup that I now
needed to go for my first mammogram. Cue
panic (‘It’s going to hurt!’), fear (‘What if they find
something wrong?’) and procrastination (‘Surely
it can wait a month, a year?’). Until I met our
inspirational cover star Wilma van der Bijl, whose
story (page 20) motivated me to make that call and
go to the appointment. During which I proved yet
again that ‘fear is more pain than is the pain it fears’
to myself (page 24).
We celebrate a number of creative people in this
issue. Margot Janse talks movingly of what Africa
has taught her (page 48) and four local comedians
tell us what makes them laugh (page 32). We also
take a look at the remarkable story of football player
Fabrice Muamba who suffered cardiac arrest in front
of a worldwide audience (page 30).
Here’s to being proactive and making that call
today. Who knows? It could save your life.
Love them . . .
Cherish them . . .
Protect them against Whooping Cough
CONGRATULATIONS!
You’re about to bring a new life into the world
As you prepare to take care of your new baby, did you know that;
• Close contacts of infants, especially parents and siblings are responsible for 71% of whooping cough transmission to babies 1
• Most whooping cough related hospitalisations and deaths occur in children under the age of 6 months 2
• A prolonged cough may be the only manifestation of whooping cough in adults 3,4,5
Ensure your family is vaccinated before your baby is born.
Speak to your baby clinic sister about the whooping cough booster vaccine.
www.kiddivax.co.za
References:
1. Wendelboe A, Njamkepo E, Bourillon A, et al. Transmission of Bordetella pertussis to young infants. Pediatr Infect Dis J.2007;26. 2. Wood N et al. Pertussis in infants :
Preventing deaths and hospitalisations in the very young. J Paediatr Child Health 2008;44:161-5. 3. Crowcroft NS, Pebody RG. Recent developments in pertussis. Lancet.
2006;367(9526):1926-36. 4. Hay JW, Ward JI. Economic considerations for pertussis booster vaccination in adolescents. Paed Infect Dis J. 2005:24 S44-47. 5. Hewlett EL,
Edwards KM. Clinical Practice Pertussis – Not Just for Kids. N Engl Med. 2005; 352:1215-22.
Sanofi Pasteur, Division of Sanofi South Africa (Pty) Ltd. 2 Bond Street, Grand Central Ext 1. Midrand, 1685. Private Bag X207, Midrand 1683. Company Registration No:
1996/010381/07
ZA310.12.12.02
OLESCENTS &
ULTS
Pertussis Booster Vaccine
LETTERS
| AUTUMN 2013
MAILBOX
We enjoy hearing from you! Send us your letters and stand
chance to win a cooler bag.
Email your letters to mediclinic@newmediapub.co.za or post
them to Family magazine, PO Box 440, Green Point, 8051.
PHOTOGRAPHS Shavan Rahim, Gallo/Getty Images, iStockphoto FAMILY reserves the right to edit letters as we deem necessary. Please note, main photograph is a stock image.
GROOT VERLIGTING
Ek is vroeg die oggend van 8 Januarie
by noodsentrum by Mediclinic Hoogland
opgeneem. Ek wil graag baie dankie sê aan
die personeel by eenheid B en C en ook by
die teater vir hulle vriendelike en flink diens.
Su-Mari Scholtz
EXCEPTIONAL CARE
WINNING
LETTER
LIKE FAMILY
I would like to express my gratitude towards the staff of Nursing Unit B at Mediclinic
Highveld. I was admitted with a lot of pain and needing an operation. During my stay
at the hospital, I met wonderful, loving and caring people who show passion for what
they do. On my birthday, I woke up to the night-shift staff singing to me. It made me
feel very special.
I believe that nursing is not a just career but a calling. Every member of staff
deserves praise and gratitude. They are people you can rely on, they are always there
for you and, when you look up, there’s always a smile. They made me feel like part of
the family.
I’ve lived in Secunda for 32 years and have visited many hospitals in Pretoria – but
I have never found the same warmth and care that I experienced at Mediclinic Highveld.
This hospital is in our town and it is our home.
So thank you to everyone who contributed to my 10-day stay at the hospital –
you’re all great!
Sandra Coetzee
We are so grateful to the staff at Mediclinic
Paarl for taking such good care of Shaundre
Jacobs. The competency of the team is
awe-inspiring and we couldn’t have been
more lucky to have chosen Mediclinic to
deliver her baby boy, Jade. The work you
do is so important and you excel at it in
every way possible.
The Jacobs family
INNIG DANKBAAR
Ek wil Mediclinic Panorama graag
komplimenteer met hul diens. Ek het
oor Kerstyd baie swaar gekry tot ek
op 26 Desember na die noodsentrum
gebring is. Ons het die vriendelikste
behandeling gekry en my vrae is
geduldig beantwoord. Baie dankie.
Hendrika Lambert
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A WORD FROM OUR PATIENTS
What essential items would you advise patients take with them to hospital?
Brian Fourie
Zola Hartnick
Terry May Gilbert
Rhenis Ras
Nompi Siyoko
Mediclinic Milnerton
Mediclinic Milnerton
Mediclinic Sandton
Mediclinic Welkom
Mediclinic Sandton
Your cellphone
(and charger).
Don’t forget to pack
your pyjamas!
A cellphone charger
and a two-prong adapter.
You’ll be miserable when
your phone battery dies.
Definitely a cellphone
charger. This way you
can communicate with
family and friends.
My top essential would
be a toothbrush.
The verdict? Your cellphone charger!
AUTUMN 2013
I
MEDICLINIC FAMILY
I 5
CHECK UP |
MEDICAL NEWS
NEWS
Mediclinic Family brings you groundbreaking
medical developments that are changing
the lives of our patients every single day.
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HEART-VALVE REPAIR
A WORLD FIRST
DEXTROCARDIA SITUS INVERSUS OCCURS
IN ABOUT ONE IN 12 000 PEOPLE. MOST
HAVE NO SYMPTOMS OR COMPLICATIONS
RESULTING FROM THE CONDITION.
Marianna Cronje (59) of Stellenbosch was born
with dextrocardia situs inversus, an unusual
physical anomaly that means the heart is an
exact mirror image of a normal heart and is
positioned on the right side of the chest, rather
than the left.
As a result of rheumatic fever, she had
undergone four open-heart operations over
a period of 40 years. Her last operation, a valve
replacement in 2000, was successful but scar tissue
and other complications meant this was considered her
final surgery.
However, this valve developed a leak and her condition deteriorated
to the point where she could do little for herself. She was referred to
Dr Hellmuth Weich at Mediclinic Panorama as a possible candidate for
a non-surgical heart-valve repair operation.
The six-hour, non-invasive procedure was performed
through a needle puncture in the patient’s groin. A tube
was fed through a vein into the right atrium of the heart
and a hole was made in the wall of the heart to provide access
to the left atrium. The leak in the mitral valve was then closed
with two disc-like devices, which are usually used to close birth
defects in children’s hearts.
‘This procedure is technically difficult in a patient with
normal anatomy and had never been done on someone with
dextrocardia,’ says Dr Weich. For this reason he called on the
expert advice and assistance of two international experts,
Professor Eric Eeckhout and Dr Alain Delabays, who flew to
Cape Town from Lausanne, Switzerland.
The operation was considered a success and the improvement
of Marianna’s quality of life once she has made a full recovery
will be significant.
IMAGES Getty/Gallo Images, iStockphoto
International medical history was made at Mediclinic
Panorama earlier this year when a team of
doctors performed the first ever nonsurgical closure of a leaking heart
valve on a transposed heart.
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22
Of the 784 multiple births at Mediclinic hospitals last year there were:
MEDICLINIC
BY
NUMBERS
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761
MEDICLINIC FAMILY
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sets of twins
AUTUMN 2013
sets of triplets
1
set of quadruplets
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HOPE FOR BRAINCANCER PATIENTS
A drug new to neurosurgery in South Africa is helping
to lengthen the lives of brain-cancer patients.
The removal of a brain tumour is complicated by the fact that
tumour cells look very much like normal brain tissue, which often
means only parts of a tumour are removed during surgery. However,
a drug called Gliolan (5-Alanine) makes tumours appear pink under
purple light, meaning it’s much easier for doctors to identify the
cancerous cells and remove them all.
Hester Erasmus (56) of Fichardtpark was one of the first South
Africans to benefit from this advance in neurosurgery when she had
a second malignant tumour, or glioblastoma, removed at Mediclinic
Bloemfontein by Dr Wynand van Jaarsveld.
After suffering from headaches and epileptic fits, Hester was
diagnosed with brain cancer at the end of September 2011 and
had a 4 cm tumour removed. However, a year later another 5 cm
tumour had developed. This was successfully removed in a fivehour operation, thanks to the use
of Gliolan and a special
microscope imported
from Switzerland.
‘Conventional surgery
and treatment result in
a survival rate of 20 %
after a year, and zero
percent after two years,’
said Dr Van Jaarsveld.
‘This more advanced
surgery could see lives
lengthened by up to
seven years. However,
repeat surgeries are
possible, as this type
of tumour recurs in
100 % of cases.’
A JOINT COLLABORATION
The life of a young woman with a rare bone
disease has been transformed with a jaw
prosthesis – the first of its kind in South
Africa – created via an international
medical partnership.
Fibrous dysplasia was a fact of life for Anika Behrendt
(24), who had been coping with the effects of this painful
condition since childhood. The disease is caused by a
defective gene in the cells that form bone – in her case, the
bones on the right side of her lower jaw and the associated
joint complex, causing significant physical impairment. But
Anika’s consultation with maxillofacial surgeon Dr Hermann
Kluge at Mediclinic Kloof would ultimately end years of
suffering in one complicated six-hour operation.
Different treatment options were discussed but it was
decided to do a complete resection of the jaw and the
joint complex. Such a large defect would normally be
reconstructed by placing a bone graft in the affected area
and later adding dental implants.
However, Dr Kluge decided an all-in-one approach
would be the best option – the first time this has been
done in South Africa and one of the few worldwide.
After scans of the patient’s jaw were taken, web-based
meetings were arranged with product specialists Selective
Surgical in South Africa and Biomet Fixation in the US,
as well as design engineers from US company Medical
Modeling. The result was a custom-made prosthesis,
manufactured from hi-tech materials similar to those used
in hip or knee replacements, that incorporated Biomet 3i
dental implants.
‘The patient was restored to a fully functional level with
optimal jaw movement and teeth,’ Dr Kluge said after the
operation. ‘Her pain is gone and she can now continue her
life without disability and disfigurement. Her prognosis is
excellent and she probably won’t need any other surgery
to this area in the future.’
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4 340 1,8
The new Mediclinic Gariep in Kimberley will take
m3 of concrete
million bricks
8,45
AUTUMN 2013
I
km of
copper piping
for water
supply
MEDICLINIC FAMILY
I 7
CheCk UP |
die kwelpunt
Die een hanD
was die ander
Speel klaar met gevaarlike kieme en aansteeklike siektes:
was jou hande gereeld – en maak seker jy weet hóé!
Hoe dit werk
Mikro-organismes groei blitsvinning
op jou hande wanneer jy aan besmette
oppervlakke raak. Dink net aan die
deurknop by die werk of die oefenfiets
by die gim...
Hiervandaan versprei kieme vinnig
na jou oë, neus en mond, en kan jy jouself
en ander gou infekteer indien jy nie jou
hande was nie. Só kan griep byvoorbeeld
blitsvinnig sommer ’n hele gesin of ’n
handjievol kollegas gelyktydig plattrek.
Goeie handhigiëne kan egter verhoed
dat kieme van een mens na ’n ander,
en dwarsdeur ’n gemeenskap, versprei.
drie goue reëls
Volgens die Amerikaanse Centers for
Disease Control and Prevention kan
handhigiëne diarree-verwante sterftes
met tot 50 % verminder.
Hierbenewens toon Britse navorsing
dat ’n miljoen sterftes jaarliks voorkom
kan word as almal gereeld hande was.
En goeie handhigiëne kan selfs
voorvalle van respiratoriese
siektes met 16 % verminder.
Bly gesond deur die volgende
stappe te doen:
Was jou hande gereeld met seep
en lopende water. In die huis is
gewone seep en water, en die wrywing
van jou hande teen mekaar, genoeg
om van kieme ontslae te raak. (Vermy
antimikrobiese seep wat tot antimikrobiese
weerstand kan lei.)
1
2
gebruik lopende water, aangesien jou
hande weer gekontamineer kan word
as jy dit in ’n wasbak met vuil water afspoel.
3
droog elke keer jou hande af – met
’n skoon handdoek, papierhanddoek
of warm lugdroëer. Die wrywing tussen
jou hande en die materiaal help om
enige oorblywende mikro-organismes
te verwyder.
goeie tydsberekening
Hoe jy jou hande was is net so belangrik
as hoe gereeld jy dit doen:
• Voor, tydens en ná jy met kos gewerk het.
• Voor etenstyd.
• Ná jy buite gespeel of in die tuin
gewerk het.
• Ná jy aan diere gevat het.
• Ná jy die toilet besoek het.
• Ná jy jou baba se doek omgeruil het.
• Ná jy na siek gesinslede omgesien het.
• Voor en ná jy snye en wonde behandel het.
• Ná jy aan enige liggaamsvloeistof
geraak het.
• Ná jy jou neus geblaas, gehoes of
genies het.
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’n leWensBelangrike les
• Kinders luister nie graag wanneer
ons hulle leer om hande te was nie,
maar dis belangrik om die boodskap
te herhaal en só ’n roetine vas te lê.
• ’n Slim plan is om kinders twee keer
8 i
Mediclinic faMily
i
autumn 2013
‘Veels geluk, liewe maatjie’ te laat sing
terwyl hulle skrop. Die singery sal
15–20 sekondes duur – lank genoeg
om van vuilheid en mikro-organismes
ontslae te raak.
• ’n Alkohol-handjel is ook ’n doeltreffende
manier om met mikro-organismes klaar
te speel – mits hande nie sigbaar vuil is
nie. Dis boonop maklik om in ’n handsak
rond te dra.
foto Gallo Images/Getty Images
ie beginsels van handhigiëne
is iets wat ons van kleins
af leer, maar, soos ons
ouer raak, dikwels vergeet.
Hou in gedagte dat dit
’n uitstekende manier is
om siektes te vermy veral as jy kontak
gehad het met iemand wat verkoue,
griep of ’n onaangename maagkiem
onder lede het.
Op 5 Mei loods the Wêreldgesondheidsorganisasie hul ‘Red lewens: was jou
hande’ veldtog. Hoewel dié dag veral op
handhigiëne in gesondheidsorg gemik is,
gee dit ons almal kans om weer krities na
ons eie roetine te kyk.
Bladder Control
Break taboos. Take control. Get treatment.
InterStim® Therapy has shown to be of
benefit for patients who suffer from various
urinary voiding and bowel disorders or so
called pelvic floor disorders.
InterStim® Therapy involves stimulation of
the sacral nerves, which regulates pelvic
floor function, with mild electrical pulses.
InterStim Therapy involves two phases:
the test stimulation and the permanent
implantation of a neurostimulator. If you have
had a test stimulation and experienced a
marked improvement in your symptoms then
a permanent implantation can be carried out.
InterStim® Therapy has been successfully
prescribed in more than 100 000 patients*
over the years. It has been approved in
Europe since 1994.
(Medtronic Inc. data: May, 2011)
amazing solution indeed! Interstim Therapy’s
effect was almost immediate - increasing
my bladder’s capacity to retain urine and
allowing me to reach the toilet in time – with
an increase in volume of up to 3000ml without any bedwetting or embarrassing
moments! Interstim Therapy was without a
doubt the best decision I could have made
and thanks to this I completed my B.ED
Degree with flying colours.
I want to thank Dr A. Cronje and Medtronic
for changing my life. Interstim truly is a lifechanging Therapy!
Nadia Janse van Renburg (25)
Schweizer-Reneke (North-West Province)
B ED Degree North West University, Potchefstroom
Still living with urinary incontinence?
For more info on InterStim® Therapy, ask your doctor or contact:
Medtronic: +27 11 260 9300
Website: www.medtronic.com
UC201106532EE ©2011 Medtronic. All rights reserved. Printed in Europe.
I was born a Spastic Diplegic. Since birth I have
had absolutely no control over my bladder
because of the severe urological problems
this caused. Bedwetting and soaked clothes
were an everyday occurrence – even as an
adult - and if I was lucky enough to reach the
toilet in time, it would be for a mere 20ml! In
2009 my journey to recovery began. I was
referred to a Urologist, Dr A. Cronje at the
Medi-Clinic in Potchefstroom and have not
looked back since. After several tests he
concluded that Interstim Therapy could be a
solution to my long-awaited problem and I
agreed to go forth with the implant. What an
CHECK UP |
ASK US
Earache is common during descent, when
the pressure between your middle ear and
the air outside your ear differs. If you have
a cold or infection, it’s much more difficult to
equalise the pressure by swallowing or sucking
sweets. Flying when Eustachian tubes are
blocked can actually cause the eardrum to burst,
although this is not common (and they tend to heal
spontaneously). Severe allergies can also lead to an
inability to equalise pressure. Make sure your
ears and nasal passages are not congested
next time you fly by taking prescribed
antihistamines and nasal spray.
– DR CHRIS HOFMEYR, ENT surgeon,
Mediclinic Milnerton
My ears have
been ringing ever
since I went to a
music concert – when
will it stop? Do I have
permanent damage?
You have what’s called noise-induced
tinnitus, which is caused by loud music
damaging the nerves in your ear. This
ringing should fade over time as noiseinduced tinnitus is usually temporary.
However, it can be permanent if the
exposure was severe (for example, a
gunshot next to the ear) or repeated
(for example, from working in a very
noisy factory). Needless to say, you
should have it evaluated by your doctor.
And next time, take some earplugs along to
the concert – you won’t enjoy it any less and
you’ll protect your ears from permanent damage.
– DR CHRIS HOFMEYR, ENT surgeon,
Mediclinic Milnerton
DID YOU KNOW?
WHILE PREGNANT,
WOMEN HAVE
50 % MORE BLOOD
IN THEIR BODIES.
Ears won’t stop ringing?
Tired legs? Our experts
answer your questions.
Words Lisa van Aswegen
DOES STANDING
TIRE YOU MORE
THAN WALKING?
This is not as odd as it
may sound: standing
places more demands on
the same set of muscles
for a long time, which can
be tiring for the body.
My husband constantly kicks
me in his sleep. Is this restlessleg syndrome and can it be cured?
Restless-leg syndrome is a neurological disorder that
causes a pulling or tugging sensation in the legs
with an urge to move. It occurs mostly at rest and
the feeling is improved by movement. Some
people respond to an increased iron intake but
this can cause constipation and should only be
used if the blood iron and/or transferrin levels
are decreased. Medication like pramipexole
(pexola) can also be used. Speak to your
doctor about visiting a sleep laboratory
where a professional can identify the
cause and treat your husband.
– DR KEVIN ROSMAN, neurologist,
Mediclinic Morningside
Email your questions to mediclinic@newmediapub.co.za, write to us at Mediclinic Family, PO Box 440, Green Point 8051,
visit our Facebook page at www.facebook.com/MediclinicSouthernAfrica or our info hub at www.mediclinicinfohub.co.za
10 I
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PHOTOGRAPHS Thinkstock, Getty/Gallo Images SOURCES babyexpert.com, healthaliciousness.com, health24.com, rls.org, livestrong.com, patient.co.uk
Last time I flew in an aeroplane
I had a cold and my ears hurt
so much during the descent.
They wouldn’t ‘pop’ and I’m
scared my eardrums could
be damaged. What can
I do to prevent this pain
in future?
PROMOTION
Make colon
screening an
easy choice
1. FAECAL OCCULT BLOOD TEST
Taking a sample of your stool and sending it to
a laboratory for analysis.
2. FLEXIBLE SYGMOIDOSCOPY
A slender tube is inserted inside your rectum and up
to 60cm into the colon to look for polyps.
C
olon cancer is the second biggest cancer
killer in South Africa. Although it’s
understandable that many people feel
embarrassed to talk about their intestinal
tract, colon and rectum, the health choices you make
will have a dramatic outcome on your quality of life.
The disease knows no social boundaries –
celebrities such as actresses Farah Fawcett-Majors
and Audrey Hepburn succumbed to colon cancer,
as did musician Robin Gibb of the Bee Gees. Yet the
fact is that colon cancer is preventable if it’s detected
early by a doctor specialising in the gastrointestinal
tract. While 40% of patients diagnosed with colon
cancer will die of the condition, up to 90% of colon
cancers, if caught in the early stages, are curable.
WHEN ARE YOU AT RISK?
Don’t wait longer than six weeks to see your doctor if
you experience a change in bowel habits, for example,
having loose stools, bleeding from the bottom when
having bowel movements, persistent rectal bleeding
or abdominal pain. You should be screened the first
time at age 50, as 90% of colon cancers are detected
after this age. If one or more members of your family
has or had colon cancer, have a colonoscopy at least
10 years earlier than the age at which the family
member was diagnosed. If your doctor detects polyps
(small, benign, flat or finger-like growths) you will be
advised when to have a follow-up colonoscopy.
HOW IS THE SCREENING DONE?
Bowel tumours begin as harmless polyps. The purpose of
screening is to detect and remove them. Doctors know
more about the molecular biology of bowel tumours than
almost all other malignancies. Taking your risk profile into
consideration, the doctor would recommend you have
one or more of the following procedures done:
3. DOUBLE-CONTRAST BARIUM ENEMA
This test is done by a radiologist in the X-ray
department. Liquid barium is put into your colon
and the X-ray helps the doctor to detect polyps or
abnormal growths.
4. COLONOSCOPY
The colonoscope is a modern aid in the diagnosis of
colon cancer. This flexible tube has a light source that
makes it possible to explore the full length of the large
intestine. It’s equipped with air to inflate the colon for
good visualisation, a tweezer and snare to snip off
polyps, and a digital camera to show the doctor on a
screen exactly what’s going on in the colon.
It’s crucial that the patient follows the doctor’s
instructions for the colon-cleansing procedure.
A clean colon enables the doctor to detect all the
polyps and other abnormalities, and to make an
accurate diagnosis. The good news is that patients no
longer have to dread colon cleansing, and intestinal
flora can be quickly restored by taking QuatroFlora
capsules after the procedure. So make the right health
decision now by having your colon screened.
Sodium Picosulphate Oral
Powder for Solution
S0 Each sachet contains: Sodium Picosulphate 10mg, Magnesium Oxide Ph Eur 3.5g, Citric Acid Ph Eur 12.0g, Aspartame 36mg. Reg. No A38/11.5/0389
CHECK UP |
FEIT OF FIKSIE?
REG
OF
WEG?
ONS VERKLAAR VIER KOSMITES
Kan wortels jou die sig van ’n kat gee? Sal jy gesonder wees as
jy jou mikrogolfoond uitgooi? Tracy Ugarchund, ’n dieetkundige
by Mediclinic Constantiaberg, plaas hierdie en ander bekende
opvattings wat ons al jare vir soetkoek opeet, onder die loep.
Woorde Brent Smith
MITE
Pomelo’s laat jou gewig verloor
Die pomelo-dieet het in Hollywood in die 1930s sy debuut gemaak en sedertdien
elke nou en dan weer gewild geword. In die sewentigs het mense geglo dat
pomelo’s vet letterlik laat wegsmelt. In die tagtigs het die dieet bekend geword
as die ‘10-’n-dag, 10-pond-minder dieet’.
MITE
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MITE Wortels verbeter
jou sig
Gedurende die bomaanvalle in die
Tweede Wêreldoorlog het Brittanje
’n radar ontwikkel wat kon bepaal
presies waar Nazi-bombardiers snags
was. Om hierdietegnologie geheim
te hou, het die regering beweer dat
Koninklike Lugmag vlieëniers in die
donker kon sien omdat hulle baie
wortels eet. Dit het wortels gewild
onder Britte gemaak.
FIKSIE ‘Wortels is ryk aan betakaroteen,
wat omgesit word in vitamien A,
’n voedingstof wat noodsaaklik
is om gesonde sig te onderhou,’
verduidelik Tracy. ‘Maar dit sal nie help
om verswakte sig te verbeter nie!’
So moenie jou bril vir ’n sak wortels
verruil nie. Onthou, vitamien A kom ook
in melk, eiergeel, kaas en lewer voor.
12 I
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MITE Om groente in ’n
mikrogolfoond gaar te maak,
vernietig voedingstowwe
Vandag sal jy ’n mikrogolfoond in byna
elke kombuis kry. Maar mense het hulle
nog altyd teësinnig gebruik omdat hulle
glo die bestraling wat hulle afgee, die
voedingstowwe in kos uitwis. ‘Bestraling’
is natuurlik ’n gelaaide woord.
FIKSIE As gerief in die kombuis
vir jou belangrik is, sal jy bly
wees om te weet hierdie mite
is onwaar. ‘Hoe langer kos
aan hitte blootgestel
word, hoe meer neem die
voedingswaarde daarvan af,’
sê Tracy. ‘Mikrogolfoonde stel kos
vir baie korter tye aan hitte bloot
as konvensionele prosesse – dit is
dus eintlik beter vir die behoud
van voedingstowwe.’
Spinasie maak jou
so sterk soos Popeye
Die strokiesvisserman wat wonderbaarlik
sterker word as hy spinasie eet, was
die rede hoekom verkope van díe
blaargroente die hoogte ingeskiet het.
Daar word vertel dat Popeye se skepper,
Elzie Crisler Segar, die groente gekies
het na aanleiding van ’n studie in 1870
wat beweer het dat spinasie dieselfde
hoeveelheid yster as rooivleis
bevat. Dit was natuurlik onwaar.
’n Verdwaalde desimaalpunt was
waarskynlik die skuldige.
FEIT Daar steek egter waarheid in hierdie
opvatting. ‘’n Blikkie spinasie sal dalk nie
jou armspiere binne sekondes laat rys
soos Popeye s’n nie, maar navorsers het
bevind dat die nitraat in spinasie spiere
help sterk maak,’ verduidelik Tracy, ‘en
dít help met krag en uithouvermoë.’
FOTO’S Getty/Gallo Images BRONNE guardian.co.uk, livestrong.com, scienceblogs.com
MOONTLIK ‘Alhoewel dit afgemaak is as bloot nog ’n foefie-dieet, wys die
jongste navorsing dat daar ’n verbinding in pomelo’s is wat die insulienvlak
kan verlaag om verslanking aan te moedig,’ sê Tracy. Vrugte vorm deel van
’n gesonde eetplan, dus is dit goed om pomelo’s te eet. Maar om net van pomelo’s
te lewe, of pomelo’s as deel van ’n ongesonde dieet te eet, sal sekerlik nie gesonde
gewigverlies tot gevolg hê nie.
CHECK UP |
THEN AND NOW
WAGING THE
Improved diagnosis and
treatment are producing
encouraging results in
the fight against cancer.
THEN…
Look back into the past at how little was really
known about cancer, and you might be shocked –
and relieved that you weren’t a patient in those days.
It was only in the 16th century that scientists,
such as Galileo Galilei in Italy, began to glean some
understanding of the human body – and of the progress
and effects of illness. The first autopsies carried out in the
17th century helped people understand that blood circulated
through the heart and body, but when tumours were first
observed, there was little understanding of what they were.
In fact, there was no way of identifying a tumour in a living
patient and successfully treating it.
For a very long time surgery was extremely primitive, and
it wasn’t until the 19th and early 20th centuries that, with the
development of anaesthesia (see page 28 for more), major
advances were made. Even then, diagnosing cancer often
required ‘exploratory surgery’, in which a surgeon would open
a patient’s abdomen or chest to take tissue samples to be
tested for cancer – an invasive and unsatisfactory procedure.
As recently as the 1960s, medical oncology didn’t exist
as a clinical speciality. There was controversy about whether
cancer-fighting drugs caused more harm than good, so they
were seldom used. And when chemotherapy and radiation
were developed, they tended to blast all the tissue within
reach, meaning that many perfectly normal, healthy cells
were casualties along with the ‘rogue’ cells.
SINCE THE 1950s, CANCER
MORTALITY RATES HAVE
FALLEN FROM 45 IN
EVERY 100 000 MEN TO
NINE. FOR WOMEN, RATES
HAVE FALLEN FROM 25 IN
EVERY 100 000 TO FOUR.
A TIMELINE FOR CANCER
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1 500BC
Mid-1700s
1761
The first documented case
of cancer – a breast tumour –
is recorded in ancient Egypt.
Scottish surgeon John Hunter
found that some cancerous
growths could be removed
by surgery.
In Italy, Giovanni Morgagni
carried out the world’s first
known autopsies to examine
the possible reasons why
a patient’s illness led to death.
I
PHOTOGRAPHS Getty/Gallo Images, iStockphoto SOURCES Cancer.org; Health24.co.za, Newyorker.com
Words Deborah Louw
SUMMER 2012
CANCER WAR
THE FIVE MOST COMMON TYPES OF
FATAL CANCER:
…AND NOW
Today the picture is very different and the good news is
that cancer survival rates have doubled in the last 40 years.
More accurate detection techniques, the targeted use of
drugs and radiation therapy, and improved surgery are
among the reasons.
Surgeons have now developed techniques to minimise
the amounts of normal tissue they remove during cancer
operations. Thanks to improvements in ultrasound techniques
and scans like computed tomography (CT) and magnetic
resonance imaging (MRI), invasive exploratory surgery has
been reduced. In addition, the targeting of cancerous cells
is far more precise – like a guided missile that hits only its
destined target, not the surrounding healthy tissue. (Read
more about the advancement in brain-cancer detection
on page 7).
Of the many different types of cancer, breast cancer has
the most advanced diagnosis and recovery system, says
Dr Jill Harris, an oncologist at Mediclinic Constantiaberg in
Cape Town. The norm for most women with breast cancer is
now less extensive surgery: a full mastectomy is hardly ever
performed. Instead, most women with breast cancer have the
primary tumour removed, and then undergo radiation therapy.
Promising work that is being done overseas could hold
more good news in future in South Africa too: cancer vaccines
are being tested, including vaccines to treat a type of lung
cancer, pancreatic cancer, ovarian cancer and melanoma.
The efficiency of hormone therapy is particularly
encouraging: with DNA profiling, the same cancer can be
treated differently – in a way that is specific to each individual.
In the future, says Dr Harris, oncologists will be able
to predict a particular individual’s response to cancer by
testing medication on the tumour and prognosticating its
response and outcome – that is, by ‘tailoring the treatment’
for each patient. ‘This is a most exciting time to be an
oncologist,’ she says.
LUNG
BREAST
STOMACH
LUNG
LIVER
STOMACH
COLORECTAL OESOPHOGEAL
COLORECTAL
CERVICAL
RAYS OF SUNSHINE
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In 1999 Chris Corlett, an 18-year-old leukaemia
sufferer, became the symbol and spearhead
of a South African initiative to combat cancer
of the bone marrow and other life-threatening
blood disorders.
Although Chris lost his own battle after
a long, determined struggle, his courage caught
the attention – as well as the respect and affection – of people
around the country. Before he died, he painted a colourful
picture, ‘Sunflowers of Hope’. As a result, The Sunflower Fund
was launched in his memory to further the work of the South
African Bone Marrow Registry (SABMR). The picture now
hangs in the Sunflower Unit at Mediclinic Constantiaberg,
and replicas adorn similar units in Johannesburg, Durban and
even Auckland, New Zealand.
A non-profit organisation based in Cape Town, the fund’s aim
is to support the SABMR as a source of potential bone-marrow
donors – of all races and income groups – to improve the chances
that blood-disorder sufferers will find a matching donor for
a life-saving transplant.
Visit www.sunflowerfund.org.za for more information on how
to become a bone-marrow donor.
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1800s
1971
The invention of the modern
microscope enabled the study
of diseased body tissue.
US President Richard Nixon
launched the ‘War on Cancer’.
As a result, more than
US$200-billion has been spent
on cancer research in the US.
2013
Researchers are discovering new carcinogens,
explaining how they cause cancer and
providing insight into ways to prevent it.
Research is also helping us understand how
hormones influence cancer growth – and how
we can counteract it.
AUTUMN 2013
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MEDICLINIC FAMILY
I 15
I N KO P I E S
The Secret
Keeper R204
Exclusive Books
Hemp Hand Protector
R110 The Body Shop
Nougat Assortment
R24,95 Woolworths
Pantoffels
vir haar R110
Woolworths
‘Word gou
gesond’ kaartjie
R39 Typo
Rainforest Shine Shampoo
R75 The Body Shop
BEDERF
Orgideeplant R99,99
Woolworths
Pot R49,99
Mr Price Home
Wys jou ondersteuning en streel
die sintuie met iets spesiaals.
Spa Wisdom Africa Honey &
Beeswax Hand And Foot Butter
R165 The Body Shop
Kamerjas R499,99
Woolworths
Rainforest Moisture Hair
Butter R95 The Body Shop
Aloe Vera Body Wash
R220 Crabtree & Evelyn
iPod Classic
160GB R2 799,95
kalahari.com
Pantoffels
vir hom R180
Woolworths
16 I
MEDICLINIC FAMILY
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AUTUMN 2013
FOTO’S Shavan Rahim PRODUKSIE Lizl Jackson BESKIKBAAR BY Woolworths www.woolworths.co.za, Mr Price Home www.mrpricehome.com,
Typo 021 552 2635, The Body Shop www.thebodyshop.co.za, Exclusive Books www.exclus1ves.co.za, Crabtree & Evelyn www.crabtree-evelyn.co.za,
Kalahari www.kalahari.com
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MOM’S CORNER
THE FIRST
15 MINUTES
OF LIFE
You’ve waited nine months for your baby. Here’s
what happens in those first crucial moments.
Words Lisa Templeton
rom the moment your baby
first enters the world it’s all
systems go.
‘The first breathing
movement and the
establishment of adulttype blood circulation are surely the most
important events in the first 15 minutes,’
says Dr Francis Elemva, gynaecologist
and obstetrician at Mediclinic Sandton.
‘And the meeting between mom and
newborn is probably one of the most
touching moments you can witness –
it’s one of the things that inspired me
to become an obstetrician.’
WHAT
WILL HAPPEN
TO YOUR BABY…
As soon as your baby’s head
emerges, fluid will be cleared
from her mouth and nose with
a bulb syringe to clear her airways
and help her take her first breaths.
Next your baby should bellow, which
happens spontaneously or with a little encouragement by
rubbing her back or tapping her feet. This helps to get her
breathing and get oxygen flowing around her body.
Once delivered, her umbilical cord will be clamped and cut,
and a sample of her blood taken from the cord for analysis.
Next it’s time for the Apgar test, which is performed at one
minute and again at five. She’ll be scored between one and
10 on heart rate, muscle tone, respiratory effort and reflexive
response to stimulation and colour. It’s a quick way to
assess how she is adapting to life outside the womb.
She’ll also be weighed and measured; and she’ll
get an identifying band on her wrist or ankle.
If necessary, she’ll be placed in
an incubator.
18 I
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WHAT MOM
CAN EXPECT…
AFTER A NATURAL DELIVERY:
PHOTOGRAPHS Getty/Gallo Images, iStockphoto SOURCE www.babyzone.com
The placenta comes next, and the doctor
may press your stomach to make sure it is
delivered completely.
If you’ve had an episiotomy (a small, controlled
cut to make it easier for the baby’s head to emerge)
the doctor will stitch the cut.
Once your baby is breathing and free of her
umbilical cord, you’ll be introduced to her.
You may want to breast-feed your baby.
Your breasts will hold colostrum initially,
which is full of immunising power, proteins
and fats for your new baby.
DID YOU KNOW?
In the old days babies were dangled upside down
by their feet and spanked on the bottom to
bring on crying, but now we know that
that just isn’t necessary.
AFTER A
CAESAREAN SECTION:
WHAT THE
DOCTOR DOES…
Once your baby has been delivered,
the amniotic fluid will be suctioned out and,
with the cord cut, your doctor will remove the
placenta and close the incision. This may take up
to 30 minutes because of the layers of muscles that
must be closed.
Now’s the time to meet your baby (this happens while
the doctor closes up your cut).
Don’t be alarmed if your baby coughs and splutters –
it’s normal for Caesarean babies. During natural childbirth,
fluid would have been squeezed out of the baby’s lungs,
but a baby born by Caesarean may take shallower,
quicker breaths until their airways are clear.
You’ll now be wheeled into a recovery room,
where you’ll be monitored closely for a few hours.
If your baby doesn’t require further attention,
she’ll join you here.
The doctor is in charge of
seeing you and your baby
through childbirth safely.
A paediatrician will also
be on hand to check
your newborn.
WHAT
THE BIRTH
PARTNER
CAN EXPECT...
In natural childbirth
you may be invited to
cut the cord – this is
not for everyone, but
very meaningful to some.
With a Caesarean you
won’t actually see the
operation but will get the first glimpse
of your baby over the screen.
After your baby has been
cleaned, you’ll get to
hold her.
WHAT
THE NURSING
PRACTITIONER DOES…
It’s generally the nursing practitioner
who will get your baby to cry, wipe away
the vernix (the greasy deposit that covers
your baby’s skin at birth) and dry off the
amniotic fluid, before placing your baby on
a warming table for a quick check by the
paediatrician. She may also give your baby
eyedrops and a shot of vitamin K, which
prevents internal bleeding that was once
common in newborns. Then she’ll
wrap your new baby in a nappy and
blanket, and hand her to you or
your birth partner.
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Fast fact
How aware is your newborn?
Babies can be amazingly alert
and keen to socialise in their first
hour of life. Reseachers have
proven that new babies can see,
hear, taste and smell better than
we thought, and respond to the
sight and touch of their parents.
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AUTUMN 2013
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CHECK IN |
SPOTLIGHT
‘MY JOURNEY
WITH BREAST
CANCER’
When South African beauty icon Wilma van der Bijl
discovered cancer in her breast, her life took a turn in
a surprising direction. She shares her tough but ultimately
triumphant race against the seemingly impossible.
Words Rose Cohen Photographs Danie Nel
o-one is immune to cancer. We hear
this all the time and yet it’s always
a tremendous shock when someone
we see as untouchable is diagnosed
with ‘the big C’. We try to justify the
inevitable ‘why’ with reason. We tell
ourselves: ‘Oh, but he had a pack-a-day
habit,’ or ‘She had it coming, she was overweight’
but Wilma van der Bijl had none of these things.
The former Miss South Africa (she won the title in
1987) has always been the picture of health. She was
fit, had no risk factors and no direct family history
of the disease when she was diagnosed. ‘I’ve always
stayed in tune with my body,’ says Wilma. ‘I was a
purist when it came to my health.’ Sure, she was
stressed at times, and perhaps a little highly strung,
but what busy, hard-working mother-of-two isn’t?
THE BOMB DROP
Just before she was diagnosed, Wilma went through
a period of feeling utterly exhausted. She also had
that nagging feeling something was wrong. ‘It
was like I knew all was not well with me,’ reflects
Wilma. ‘I had strange shooting pains, similar to the
letdown feeling breast-feeding mothers get, in my
right breast. I had a mammogram scheduled and I
asked the radiologist please to check the right side
thoroughly.’ And there it was, the evidence of what
she’d suspected.
What happened next was all a bit of a blur.
Wilma was scheduled for a biopsy, during which
a small needle was inserted into the area in question
to extract a tissue sample for testing. ‘I didn’t tell my
husband,’ she says. ‘I didn’t want to worry anyone
until it was certain.’
The biopsy was tougher than Wilma had
anticipated. ‘It’s a tricky procedure,’ she says.
AUTUMN 2013
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LEFT Wilma
van der Bijl
during her reign
as Miss SA in 1987.
‘I was given a local anaesthetic and had to sit very still
while they used a sonar to locate the exact spot under
suspicion. I drove myself home after the procedure,
which is not advisable [after any procedure].’
Wilma waited two very long and nerve-racking
days for the results. Her gynaecologist called her in,
confirmed it was cancer and sent her to a surgeon,
who advised a bilateral mastectomy. ‘That was a
shock!’ says Wilma. ‘I was expecting a lumpectomy
[surgical removal of the lump in her breast] but
I remained calm.’
She told the surgeon to do whatever he had to do
to make sure she was fine. Her husband had had four
heart bypasses in recent years and with her children
(then aged five and six) top of mind, she decided she
had to survive.
Declaring war
The pace picked up after that. Wilma broke the
news to her husband, who was reassuring and
very supportive. He was composed and said,
‘Wilma, it is what it is.’
She had to see a chain of specialists who would
form her core treatment team. Wilma opted for
breast reconstruction to take place immediately
after her bilateral mastectomy. ‘It’s essential to be
cOVeR Me
Wilma’s
top
biopsy
tip
‘Tell a friend
what’s
happening
and take her
with you to
the procedure.
you’ll need her
to drive you
home because
you’re likely
to be sore
and emotional
afterwards.’
Wilma’s top theatre tip
Once Wilma knew she had cancer, she felt like
she had a tick on her body that she couldn’t get
rid of fast enough. ‘But there is seldom a need
to rush into the operating theatre,’ says Wilma.
‘i would advise taking a few days to wrap your
head around what’s happening to you and prepare
yourself mentally. don’t be panicked. There
are many options you need to weigh up and
consider before you can move forward.’
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informed and to feel safe and empowered, so do
your research,’ advises Wilma. ‘There’s nothing
wrong with a second opinion. Seek out doctors
who are encouraging and sensitive, but don’t
compare yourself with others who’ve had cancer.
There are many different types of cancer and no
two treatment plans are the same.’
Wilma also felt the need to have a woman
on her medical team, so she requested a female
anaesthetist. ‘A woman’s breasts are the greatest
expression of her femininity. They’re a fully formed
part of our bodies from about the age of 13. We wear
them like accessories and they shape us. I needed
someone on my side who would understand the
psychological as well as the practical impact of
what I was going through.’
One battle at a time
Looking back, Wilma realises that although
surgery is a big deal, it wasn’t as challenging as
the chemotherapy and radiation treatments that
followed. ‘It’s not like a 10-step programme,’ she
explains. ‘You have to remain flexible because the
goal posts keep changing.’
Although chemo was every bit as unpleasant
for Wilma as we would all imagine, knowing that
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Wilma van der Bijl has graced many magazine covers over the years. Her confidence has always been inspiring.
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CHECK IN |
SPOTLIGHT
STYLING Megan Perks HAIR AND MAKE-UP Alet Viljoen from Supernova Creative Management PHOTOGRAPH Gallo Images
WILMA’S TOP 10 TIPS FOR CONQUERING
CHEMOTHERAPY AND RADIATION
it had a purpose to fulfil helped to make her resilient.
Being informed about what’s happening to your body
and why, is the secret Wilma cites to enduring the
unpleasant side effects (such as fatigue, nausea and
compromised immunity) successfully.
‘Let go of being a hero,’ is Wilma’s advice to
anyone undergoing cancer treatment. ‘You need
support. Accept and ask for help, call in those
favours your friends owe, because you never know
when you’re going to need it.’
Radiation, while still uncomfortable, was a lot
more manageable for Wilma. Skin sensitivity
(similar to sunburn) is a common side effect but
a minor discomfort in the grander scheme of things.
‘Some individuals do report shortness of breath and
a dry throat from radiation treatment,’ says Wilma,
but she cautions that no two people’s experiences
are exactly the same.
THE NEXT CHAPTER
Since her brush with breast cancer, Wilma has
a new perspective. She tries to live in the present,
aware of every single moment. She goes for annual
checkups but avoids fretting about the future.
Her experience has made her an avid campaigner
for breast-cancer awareness.
‘Have you had a mammogram?’ Towards the
end of the interview Wilma turns the tables on
her interviewer.
‘Uh, no,’ I responded, a bit guiltily. ‘I’m too
young.’ But I know better now. Wilma’s story
teaches us all that cancer does not discriminate.
Everyone is at risk and it doesn’t pay to be blasé.
ABOVE Wilma’s
advice is simple:
‘Let go of being
a hero’, and ask
for help when
you need it.
1
Try to eat. Your appetite may be gone but
you need to keep up your strength. Healthy,
fresh and green should be the mainstay of
your diet.
2
Drink lots of fluids. It may make you nauseous
but try to find a drink that’s soothing. A mix
of Coca-Cola and water worked for me.
3
4
5
6
Rest. You need lots of sleep. Your body is
taking a knock and needs time to recover.
Avoid using body lotion, deodorant or talcum
powder on areas affected by radiation.
Wear loose-fitting shirts to avoid aggravating
skin irritation from radiation.
Be quiet, slow down. This is your chance
to pause and seek out the positives in
your life.
7
Your family suffers as much as you do
through the process. Find a good counsellor
and support network for them.
8
Where possible, schedule any treatment
for a Friday so you have the weekend
to recover.
9
Stay away from crowds and sick people.
Your immunity will be at an all-time low
and you can’t afford to get an infection.
10
Hang on to your sense of humour.
There are times when laughter really
is the best medicine.
AUTUMN 2013
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CHECK IN |
TA K E T H E T E S T
BEAT
THE
ODDS
A routine mammogram could be
your best defence against breast
cancer. Don’t delay because
you’re unsure of what it involves –
make an appointment today.
Words Erika Bornman
Approximately one in 27 South African
women will develop breast cancer in
her life. But early detection saves lives –
especially when the cancer is still small and
less likely to have spread to other parts of
the body. A Swedish study found that high-quality
mammograms can locate some breast cancers when
they are very small, about two to four years before
they would have been felt in a manual examination.
Ask any woman who has never had a mammogram,
and the chances are high that she thinks of the
procedure as painful and unpleasant. I walked
around with my doctor’s letter prescribing the
mammogram for a full six months before making
my first appointment. And walked out thinking that
all my procrastination and nervousness had been so
unnecessary. In my experience, a mammogram
really is no big deal.
WHAT YOU CAN EXPECT
On the day, don’t wear
deodorant or powder, or
apply body lotion on and
around your breasts. And
wear a top with jeans or a
skirt rather than a dress as
you’ll be asked to remove
your top and bra – don’t
worry, you get a gown to
cover up.
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The mammographer will
take you to a room where
you’ll stand in front
of a machine used only
for mammograms. Your
breast will be positioned
on a flat plastic plate that
is placed against you ribcage.
AUTUMN 2013
2
A second plastic plate is
lowered onto the breast,
and with pressure evens out
the breast tissue. This allows
the machine to get as
clear a picture as possible.
(I found this to be only
mildly uncomfortable.)
3
The moment the low-dose
X-ray is taken, the pressure
lifts. This is then repeated on
the other breast. A similar
procedure is followed on
both breasts for the side
view. (It was all over in seven
minutes for me. And I felt
very silly for having been
so scared.)
QA
WITH DR TOM DICKER, A RADIOLOGIST AT MEDICLINIC MILNERTON
At what age should a woman have her first screening
mammogram? We generally recommend that all
women aged 40 and over have an annual mammogram.
However, it is imperative that you discuss when to start
and how regularly to have one with your own doctor.
Together, look at your risk profile by taking into account
family history, lifestyle and any hormone-replacement
therapy you may be on.
Also, a general rule of thumb for women whose
mother or grandmother had breast cancer is this:
deduct 10 years from their age when they were
diagnosed and start your screening mammograms
at that age. In other words, if your mother or
grandmother was diagnosed with breast cancer
at the age of 41, start your screening at 31.
When is the best time to make the appointment?
Don’t schedule your mammogram in the week before
your period if your breasts are usually tender during
this time. It’s probably best to make your appointment
one week after your period.
I had an additional ultrasound examination because
of dense breast tissue. What is that? Breasts contain
different types of tissue: fatty, fibrous and glandular.
Fibrous and glandular tissues appear white on a
mammogram, while fatty tissue shows up dark.
Because cancer cells also appear white
on a mammogram, it may be harder to identify
disease. So, if most of the tissue is fibrous and/or
glandular, the breasts are considered dense.
Younger women usually have denser breasts –
as women age, their breasts tend to become
less dense.
Does the size of the breasts matter when reviewing
the data? No. What matters is the breast density
when viewing a mammogram (see above). In very
large breasts, multiple views maybe required,
meaning more than two X-rays per breast.
And what about breast implants – how do they
affect clarity? Breast implants may obscure a cancer,
which is why we usually follow up with an ultrasound
examination. Also, there is a small theoretical
possibility that implants may rupture during the
test. The benefits of mammography in the early
detection of breast cancer outweigh this risk.
Think pink
PHOTOGRAPHS Corbis, iStockphoto
The PinkDrive’s two mobile screening trucks are becoming
a familiar sight on South Africa’s roads. Together with three
cars, they travel to semi-urban and urban areas around
our country to give disadvantaged communities access
to free mammograms, physical examinations and education.
Visit www.pinkdrive.co.za for more information and a list
of fundraising events.
PINKDRIVE
BY NUMBERS*
*From inception to
24 January 2013
4 464
free mammograms
41 759
51 604
clinical breast
examinations
women educated
about breast health
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4
You will then be asked
to wait before you get
dressed, so they can check
the images to make sure
they’ve got a good picture.
5
That’s it for most mammograms. In my
case, however, the radiologist reviewing the
mammogram decided to perform an ultrasound
as well. I immediately panicked, thinking he had
found something wrong. Luckily this was not the
case: he wanted a second look as my breast tissue
was quite dense (see more on this in the Q&A
above). I found the thoroughness of the whole
screening procedure to be hugely reassuring.
6
You’ll get dressed and
wait a few minutes in the
waiting room, where they’ll
give you a disc containing
the images and a report to
the referring doctor, with a
recommendation of when
you should return for your
next routine mammogram.
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CHECK IN |
STEP BY STEP
The organ we can
You probably don’t think about your gall bladder very often
(if at all). But what happens when it stops working?
Words Lisa Templeton
ost of us don’t give a thought to the welfare of our
gall bladders – until they go wrong.
A humble little pear-shaped organ just below the
liver on your right-hand side, it plays the important
role of collecting and storing bile to help us digest
fatty foods. And while we might take good care of
major organs such as our hearts, brains and skin, we tend to pay
little attention to our gall bladders.
But – unlike with other major organs – we can live without it,
should things go wrong.
Gall bladder
What is my gall bladder and why might I need it
removed? This little sac stores bile produced by your liver.
After you’ve eaten, the gall bladder contracts and bile is released
into your small intestine to help break down the foods you eat,
especially fatty foods.
This hardy little organ can develop gallstones. It’s estimated
that some 90 % of people with gallstones won’t develop symptoms.
Yet, in some people, they can cause nausea, vomiting, bloating
and pain. Should you suffer repeated symptoms such as severe
discomfort and pain or inflammation of the gall bladder, it would
typically be removed surgically.
Why can I live without a gall bladder? ‘We can live without
it because the normal flow of bile can still go to the duodenum (the
first part of the small intestine) without a gall bladder,’ says Dr Dirk
Pretorius, general surgeon at Mediclinic Sandton. In other words,
through surgery, the flow of bile is simply redirected straight to
the small intestine and bypasses the missing gall bladder.
My gall bladder has to be removed – what can
I expect? In 1990 doctors began to remove gall bladders
laparoscopically through a tiny incision.
‘A gall bladder removal is a commonplace, straightforward
procedure that takes about 40 to 60 minutes,’ says Dr Pretorius.
What can I expect afterwards? ‘You’ll probably only be
in for an overnight stay, and you can expect some discomfort
initially, but it’s not painful and you shouldn’t show any symptoms
within 10 days,’ says Dr Pretorius. You also won’t need to change
your diet, although a healthy balanced diet and exercise are still
the best way to protect your health!
Should I be worried? ‘A gall bladder removal is one of
the most common surgeries performed,’ says Dr Pretorius.
‘Complications are very rare but can include injury to the
common bile duct.’ The risks, however, are less than they
would be if you left a problem gall bladder where it is.
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Large
intestine
Small
intestine
live without
Liver
Stomach
Pancreas
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HERE IS WHAT YOU
CAN EXPECT DURING
THE OPERATION:
1
2
Firstly, you’ll be anaesthetised
and won’t feel a thing.
Surgeons will typically make four small
incisions in your abdominal wall. One
near the bellybutton, one just under
the xiphisternum (this is the notch
where your lowest ribs meet) and
two below the ribs on the right-hand
side of your body.
3
Carbon dioxide will be pumped
into your body through the incision
near your bellybutton to inflate your
abdomen, making access and
visibility much easier.
PHOTOGRAPH Gallo/Getty Images ILLUSTRATIONS Gallo/Getty Images SOURCE everydayhealth.com
4
MY GALL BLADDER HAS BEEN REMOVED –
AND I DON’T MISS IT AT ALL!
‘My gall bladder problems began so subtly,’ says James*, 69, of Fish
Hoek, Cape Town. ‘I felt small levels of discomfort around meal times
that imperceptibly grew worse until I suffered a massive feeling of
indigestion, such that I sometimes could not sit still.
‘One night when we were visiting the Waterfront I had such
a huge discomfort in my chest that we went straight to Mediclinic
Cape Town. After various tests a radiologist diagnosed it
as a gallstone. It was such a relief. My gall bladder was then
removed. On the first night I felt a little uncomfortable, but
gall bladder
ever since then I’ve been fine. Initially I was nervous about
eating high-fibre foods, but now it seems to be no problem
at all, and I can eat anything I like.’
* Name changed at his request to protect his privacy.
5
6
cystic
duct
The laparoscope –
a tube with a camera
and a highintensity light –
will be inserted
via another
cut near the
bellybutton.
This will allow
the surgeon
to see what is
happening.
The cystic duct and cystic artery
will be severed.
Once your gall bladder is free, it is
removed via the xiphisternum port.
7
After a check that all
is well, each of the
little incisions will
be stitched up. You’d
generally only need
one to three stitches
per incision.
common
bile duct
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CHECK IN |
HOW IT WORKS
BE BLISSFULLY
UNAWARE
Anaesthetics allow a patient to undergo surgery and other procedures
without experiencing distress and pain. Our experts explain the
different types of anaesthesia and answer some common questions.
Words Michelle Coburn
naesthesia is a pharmacologically induced
reversible state, created by either a single
type of drug or a combination of drugs,
that results in some or all of the following
effects: amnesia, loss of awareness, pain relief, loss
of responsiveness, loss of skeletal muscle reflexes
and a decreased stress response.
1
CHOOSING
THE TYPE OF
ANAESTHESIA
ANAESTHETIC PLAN:
Anaesthesiologist Dr Christo de Jager
at Mediclinic Brits explains that an
anaesthetic plan will be formulated before
the operation. ‘This will accommodate the patient’s
baseline physiological state, age, weight, any
medical conditions, previous operations, the planned
procedure, drug sensitivities, previous anaesthetic
experiences, current medication and psychological
make-up.’ The patient’s airway and condition of his or
her teeth will be examined should tracheal intubation
be required. Patients must also reveal whether or not
they smoke, drink alcohol or have any allergies.
PREMEDICATION: The doctor will decide on the
need for a premedication sedative, which can help
eliminate anxiety, reduce secretions and minimise
post-operative nausea.
1 IN
10 000
The approximate
number of
patients that
experience
serious
complications,
such as a lifethreatening
allergic reaction,
after receiving
a general
anaesthetic.
This is therefore
extremely unusual
and not a reason
to decide against
surgery. It’s
estimated that
there is one
death for every
100 000 general
anaesthetics
administered, also
a rare occurrence.
2
GENERAL ANAESTHETIC
This is used for major operations where
the patient enters a controlled state of
unconsciousness after receiving medication to inhibit
sensory, motor and sympathetic nerve transmission
at the level of the brain. These are injected into a
vein or sometimes given as an anaesthetic vapour
inhaled by mask – used more often for children.
A combination of anaesthetic vapours and gases
keeps patients ‘under’, while the anaesthesiologist
monitors the patient through these stages:
STAGE 1 (INDUCTION): The patient progresses
from absence of pain without amnesia to absence
of pain with amnesia before losing consciousness.
STAGE 2 (EXCITEMENT STAGE): Shortly after
losing consciousness, the patient enters a phase
of excited, delirious activity. Breathing and heart
rate can be irregular.
STAGE 3 (SURGICAL STAGE): Once the muscles
relax, breathing is shallow and eye movements stop,
the patient is ready. During surgery, the bloodoxygen level is monitored along with heart rate,
blood pressure, brain activity, breathing and body
temperature to ensure that the patient is stable.
When the anaesthetic drugs are withdrawn, the
patient recovers quickly.
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COMMONLY ASKED QUESTIONS ........................................................................................................................................................................................................
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Could I wake up during surgery?
Anaesthesia awareness is rare,
experienced by 0,1 – 0,2 % of those who
undergo surgery with general anaesthetic.
It can happen if one or more drug is
not administered in the correct amount.
However, monitoring brain activity,
which indicates the patient’s awareness
level, reduces this risk dramatically.
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Why do some people wake up crying
or fighting? Dr Hugo van Rensburg
at Mediclinic Limpopo says everyone
responds differently. ‘Just as it’s difficult to
predict how someone is going to act when
they have consumed alcohol, it’s hard to
know how a patient will behave after a
general anaesthetic. Some are hysterical,
aggressive or delirious; some are not.
However, this does not last for long.’
4
LOCAL ANAESTHETIC
3
PHOTOGRAPHS Getty/Gallo Images, iStockphoto
REGIONAL ANAESTHETIC
This is used often during Caesarean
sections, where patients remain awake
but are also frequently sedated. A large area of
the body, such as a limb or the entire lower half
of the body, is without sensation because the
transmission of impulses from the nerves in that
area, the spinal cord and the brain have been
blocked by means of an epidural or spinal block.
This is injected into the cerebrospinal fluid or
epidural space just outside the spinal canal
(pictured right). ‘A regional anaesthetic is also
sometimes given in conjunction with general
anaesthetic so that a patient wakes up with
no pain, in the case of a hip replacement,
for example,’ explains Dr Van Rensburg.
Local anaesthesia makes a specific location
on the body numb, for example the
area around a tooth, while the patient remains
conscious. Anaesthestics are administered
topically in the form of gels, creams or sprays, or
via injection. Local anaesthetics work by blocking
nerve impulses to the brain, although patients
usually feel pressure and sensation. They are
commonly used for dental work, wound suturing
and medical examinations that might be painful.
5
CONSCIOUS SEDATION
This is used for relatively minor procedures
such as setting broken bones. The same drugs
used for general anaesthesia are administered – either
orally, by injection or inhalation, or a combination
of all three – but in much smaller quantities to calm
the patient. They provide pain relief by inhibiting the
transmission of nerve impulses between the higher
and lower centres of the brain. The patient is sleepy
but responsive to instructions. He or she most likely
won’t know what is happening or remember the
procedure afterwards.
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Will I be nauseous? Around 33 % of
patients experience nausea and vomiting
immediately after surgery. This is more
common following gas-administered
anaesthetics and is easily treated.
Will I be shivery? A small group of
people do experience shivering during
recovery but this usually only lasts for
up to 30 minutes post surgery and
is carefully monitored to ensure
hypothermia does not occur.
Why should one not drive for 24 hours
after having anaesthetic? Residual effects,
such as drowsiness, may linger. Legally,
therefore, you may not operate machinery
or drive for one day after surgery for
safety reasons.
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CheCk in |
w h at h a p p e n e d n e x t ?
alive and kicking
Halfway through an Fa Cup soccer match,
Fabrice muamba felt a sudden dizziness
and a blinding headache. What happened
next would forever change his life – and
nearly end it.
Words Will Sinclair
he night of 17 March 2012 was the biggest
one of Fabrice Muamba’s life. It was the
night of his Bolton Wanderers team’s
FA Cup quarterfinal match against
Tottenham Hotspur. It was also the
night he died.
It happened 43 minutes into the game. With
the score tied at 1 – 1, Fabrice dropped back into
defence when he suddenly suffered a splitting
headache. He couldn’t run. He couldn’t see. His
head was spinning. And then he fell. Just like that.
He’d suffered cardiac arrest.
Within seconds, he was surrounded by both the
Bolton and Spurs medical teams, who were quickly
joined by Dr Andrew Deaner, a cardiologist who
happened to be at the game as a fan, and who ran
onto the pitch to help. They found Fabrice suffering
the textbook signs of cardiac arrest: unlike with
a heart attack (where blood flow to the heart muscle
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aBOVe Fellow
players look on
distraught as Fabrice
Muamba of Bolton
Wanderers receives
CPR treatment on the
pitch after collapsing
suddenly during
an FA Cup match
last year. The game
was abandoned.
is impaired), his heart had simply, suddenly, stopped
pumping. He required immediate CPR, and urgent
hospital treatment. And with every minute that
passed, his chances of survival dropped perilously.
SHOcK TReaTMenT
The medical teams spent six minutes trying to
resuscitate Fabrice on the pitch. It felt like an eternity
for the millions of fans watching on TV, for the 35 000
spectators at the stadium, for the players on the field
and for the doctors at the scene. As his team-mates
watched in horror, Fabrice was stretchered off the field
and rushed to London Chest Hospital.
He wasn’t responding to treatment. Fabrice received
two defibrillator shocks on the field, one in the players’
tunnel, and 12 more as the ambulance sped to the hospital.
Adrenaline injections, heart massage… Nothing worked.
Fabrice’s heart was showing lots of electrical
activity but no muscular activity. ‘It’s something that
HEART ATTACK
VS CARDIAC ARREST
PHOTOGRAPHS Getty/Gallo Images
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‘There’s a big difference between the
two,’ explains Dr Shirley Middlemost,
a cardiologist at Mediclinic Hermanus.
‘With cardiac arrest, the heart stops beating.
So it’s not pumping, not ejecting blood.
This could happen to anybody – even
a young patient or an active sportsman.’
A heart attack, meanwhile, happens
when an artery is blocked or occluded.
‘Here your heart could be pumping away,
but the blood can’t move through the
artery,’ Dr Middlemost explains. ‘A heart
attack is usually caused by risk factors
like high cholesterol, smoking or family
history, and we’ll treat it with a clot buster
or arterial stent, which opens up the
artery and lets the blood flow again.’
Dr Middlemost points out that a heart
attack could lead to cardiac arrest.
‘So while they’re completely different,
that’s where you can find a connection.’
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often happens in response to drugs and shocks,’
Bolton team doctor Jonathan Tobin would later tell
the BBC. ‘Now, heaven knows why, but Fabrice had,
in total, 15 shocks.’
Then, 78 minutes after it had stopped, Fabrice’s
heart suddenly started beating again. And within
three days, against all expectations, he’d regained
consciousness. As Dr Deaner would later recall:
‘I whispered in his ear: “What’s your name?” He said:
“Fabrice Muamba.” I said: “I hear you’re a really good
footballer.” And he said: “I try.” I had a tear in my eye.’
THE MIRACLE RECOVERY
Fabrice was discharged almost a month later, with
a newly fitted pacemaker. Miraculously, despite being
deprived of oxygen for almost two hours, he’d suffered
no brain damage.
But his soccer career was over. In August 2012
Fabrice – who was born in the DRC and moved to
England as a child – officially announced his
retirement. He now spends his time visiting schools
to raise awareness about heart conditions. As he
learnt the hard way, cardiac arrest can happen to
even the healthiest of young hearts.
In November he paid an emotional return visit to
Spurs’ White Hart Lane stadium. ‘I wanted to go and
see where I fell down,’ he said. ‘I had to go and look
at that spot again. I felt better afterwards. For me,
that was closure.’
‘I’m just an ordinary dude who had a cardiac arrest,’
he recently told the Manchester Evening News. ‘It
happened to be televised around the world. I’m still
the same old Fabrice. I still sit around watching
movies and playing Call of Duty until 2 am. I’m no
different than any other 24-year-old. I just want to
enjoy my life and spend time with my family.
‘To be alive is more than I could wish for. Living,
breathing, being with my family… Nothing else matters.’
BELOW An emotional
Fabrice Muamba
waves to the crowd
before a Barclays
Premier League
match in
November
2012. This was
his first public
visit to White
Hart Lane
stadium
since his
cardiac
arrest.
CheCk in |
p h o t o e s s ay
laughter
is the
best
Medicine
Researchers at the mayo Clinic in the uS have
found scientific evidence that laughter is indeed
good for our health. in the short term, laughing
stimulates your heart, lungs and muscles, and
increases the endorphins released by your brain.
Long-term benefits include improving your
immune system and pain relief. We chat to four
local comedians who are doing their bit to keep
South africa healthy.
Compiled by Mandy Freeman Photographs ivok studio and Morné van Zyl
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a Funny one-liner?
‘i hate being bipolar.
it’s brilliant!’
alan coMMittie
What makes you laugh?
‘When Australia loses cricket
test matches! I like the wit
of Woody Allen as much
as the physical comedy
of Peter Sellers. And I love
laughing at the discomfort as
portrayed in “mockumentaries”
where tiny, real, everyday
moments are milked for all
their comic possibilities.’
What do you do when you’re
not being funny on stage?
‘Then I’m looking for it. I try
to write funny stuff and plan
funny shows. I also just relax,
which often means not talking
at all, watching mindless TV,
reading or just spending time
with friends – allowing them
to be funny instead.’
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CheCk in |
p h o t o e s s ay
a Funny one-liner?
‘“There is no need
To panic.”
John vlisMas
What makes you laugh?
‘Real life. it’s much funnier than
anything you could make up.
Bad comedy is often too forced –
great comedy just unfolds.
What do you do when you’re not
being funny on stage?
‘i’m a dad and run the production side
of my business. i’m also qualified to
train scuba divers. i try to spend as
much time as possible doing different,
non-comedy things. i think that helps
to keep my comedy interesting.’
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it gets me
every time.’
joey rasdien
What makes you laugh?
‘It’s the simple things, like
a one-year-old’s expression
when accidentally passing gas.’
What do you do when you’re not
being funny on stage?
‘Like anyone else, I enjoy
spending time with my
family and playing sport:
golf, cricket or soccer.’
a Funny one-liner?
‘Well, that’s like
asking a doctor,
what’s the worse
case of symptoms
he’s ever been
presented with, isn’t it?’
autumn 2013
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Mediclinic FaMily
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CheCk in |
p h o t o e s s ay
tshepo Mogale
What makes you laugh?
‘Guys who use complicated
political english to say
the simplest thing. People
with perms who sleep with
plastic bags on their heads.
The face wipe people do
when they get out of a pool.
People who sing along
to songs when wearing
headphones but who
don’t know the words
so they “remix” it…’
What do you do when
you’re not being funny
on stage?
‘i like to think i’m a normal
guy – i play sport, work and
just get on with life.’
a Funny one-liner?
‘FroM My accent people
can tell that i grew up
in the states.
the Free State…’
36 i
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CHECK IN |
NUTRITION
EGGS-TRAORDINARY!
Here’s how to make a delicious and healthy
breakfast with eggs.
Recipes and styling Abigail Donnelly Photographs Jan Ras Nutritional information Irene Labuschagne
EGG-WHITE OMELETTE WITH SCRAMBLED-EGG FILLING,
SERVED WITH BABY SPINACH AND MUSHROOMS
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STUFFED EGGS WITH PEACH AND BASIL
AUTUMN 2013
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STUFFED EGGS WITH
PEACH AND BASIL
For the perfect poached egg
WHAT YOU NEED
Serves 2
500 ml water
1 T white vinegar
1 free-range egg
WHAT YOU NEED
4 free-range eggs, boiled and halved
1 T fat-free smooth cottage cheese
1 T chives, chopped
1 T parsley, chopped
½ red chilli, deseeded and finely chopped
Salt and freshly ground black pepper
1 ripe peach
¼ cucumber, thinly sliced
10 g fresh basil leaves
½ t red chilli, finely chopped
WHAT YOU DO
SPICY
KEDGEREE
WITH SOFTBOILED EGGS
AND TROUT
SPICY KEDGEREE WITH SOFTBOILED EGGS AND TROUT
Serves 2
½ red onion, thinly sliced
1 T red Thai curry paste
250 g brown rice, cooked
50 g mangetout, julienned
Freshly ground black pepper
150 g trout
2 free-range eggs, soft-boiled
2 spring onions, finely sliced
WHAT YOU NEED
Heat a non-stick pan over medium heat.
Brown the onion and then add curry paste,
cooking for one minute before adding the
rice and mangetout. Season with freshly
ground black pepper. Blanch the trout for
three minutes in a simmering pan of water,
then remove and allow to rest. Add the spicy
rice to a serving dish and flake the trout
over it. Top with the soft-boiled eggs and
garnish with spring onions.
Per serving
1 548 kJ
30,8 g
11,4 g
32,1 g
3,3 g
106 mg
2,84 g
3,86 g
2,94 g
285 mg
1 ½ t extra-virgin olive oil
75 g white button mushrooms, halved
100 g baby spinach
2 free-range eggs, separated
Salt and freshly ground black pepper
50 ml milk
2 T parsley, chopped
Preheat the oven to 180 °C. Heat ½ t olive
oil in a non-stick pan and fry the mushrooms
till brown and cooked. In a pot of simmering
water, blanch the baby spinach for about
20 seconds till wilted, then remove from
the heat and drain off any excess water.
Heat ½ t olive oil in a non-stick pan. Season
the egg yolks with salt and black pepper,
add the milk and whisk well before softscrambling. In a separate non-stick pan
heat ½ t olive oil. Whisk the egg whites
till soft-peak stage, season with salt and
pepper and add to the pan. Leave it on the
heat and brown the bottom of the omelette
slightly before finishing in the preheated
oven. Bake for two to three minutes
or till the egg has cooked. Fill it with
the scrambled egg yolks, browned
mushrooms and baby spinach, and
then fold. Garnish with parsley.
N U T R I T I O N TA B L E
WHAT YOU NEED
Energy
Protein
Total fat
Carbohydrates
Total dietary fibre
Sodium
Saturated fatty acids
Monounsaturated fatty acids
Polyunsaturated fatty acids
Cholesterol
Boiling water
1 free-range egg
WHAT TO DO
Bring the water to a boil before placing
the egg in it. Boil for exactly five minutes
before removing the egg and allowing it
to cool on its own before shelling it.
MEDICLINIC FAMILY
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AUTUMN 2013
N U T R I T I O N TA B L E
Energy
Protein
Total fat
Carbohydrates
Total dietary fibre
Sodium
Saturated fatty acids
Monounsaturated fatty acids
Polyunsaturated fatty acids
Cholesterol
WHAT TO DO
For the perfect soft-boiled egg
40 I
Remove the yolks from the boiled eggs
and add to a mixing bowl along with the
cottage cheese, chives, parsley and chilli,
season and mix well. Spoon the mixture
back into the halved eggs. Cut the peach
in half and remove the pip before slicing
into wedges. Arrange the eggs and peaches
on a serving dish, along with the cucumber
slices, and scatter with basil leaves. Garnish
with chilli.
Serves 1
WHAT TO DO
Energy
Protein
Total fat
Carbohydrates
Total dietary fibre
Sodium
Saturated fatty acids
Monounsaturated fatty acids
Polyunsaturated fatty acids
Cholesterol
WHAT TO DO
EGG-WHITE OMELETTE WITH
SCRAMBLED-EGG FILLING,
SERVED WITH BABY SPINACH
AND MUSHROOMS
WHAT YOU NEED
N U T R I T I O N TA B L E
Bring the water to a gentle simmer
over medium heat. Add the vinegar and
use a whisk to create a whirlpool in the
centre. Crack and gently drop the egg
in the centre of the circulating water.
Don’t poke or fiddle with the egg; allow
the circulating water to hold it together.
Poach for three minutes or till the egg
white is fully cooked. Remove using
a slotted spoon.
QA
Per serving
1 453 kJ
27,4 g
20,6 g
8,3 g
5g
1 113 mg
5,09 g
10,29 g
2,39 g
464 mg
Per serving
1 096 kJ
15,9 g
11,7 g
16,1 g
4,1 g
928 mg
3,41 g
4,46 g
1,58 g
462 mg
Is it true that eggs are
high in cholesterol?
The South African Heart and Stroke
Foundation recommends: ‘Those
at risk, who have a family history of
high cholesterol, have established
atherosclerotic disease or are
suffering from type I or II diabetes,
should not consume more than
200 mg of cholesterol per day.’
So it’s not a good idea to cook
an egg every morning. However,
if you’re not at risk you can
happily enjoy an egg a day,
provided that it replaces a portion
of meat for the day and the rest
of your day’s dietary intake is
healthy and well balanced. Irene
Labuschagne adds: ‘The best
cooking methods for eggs are
to boil or poach them.’
NUTRITION
| CHECK IN
SWEET-POTATO CAKES WITH POACHED EGG, ASPARAGUS AND MUSTARD VINAIGRETTE
Serves 2
WHAT YOU NEED
2 sweet potatoes
2 T chickpea flour
½ red onion, grated
15 g fresh coriander leaves, chopped
Salt and freshly ground black pepper
1 T extra-virgin olive oil
75 g asparagus spears
2 free-range eggs, soft-poached
micro-herbs
DRESSING
1 t Dijon mustard
½ t honey
½ t white-wine vinegar
OATMEAL
AND PINEAPPLE
Salt and
freshly ground
black pepper
LOAF, SERVED
WITH FRESH
½ t extra-virgin
olive oil
FIGS AND RAW HONEY
Abigail Donnelly is Eat Out’s
editor and group food editor of
Woolworths TASTE magazine.
She’s won the Galliova Award for
Best Food Writer four times and appeared
as a guest judge on MasterChef SA.
Irene Labuschagne (RD SA) is a part-time
principal dietitian at the Nutrition Information
Centre of the University of Stellenbosch
(NICUS). She’s written several publications
and co-authored two chapters in a textbook.
Preheat the oven to 180 °C and roast the
sweet potatoes for 45 minutes till cooked.
Spoon the flesh into a mixing bowl with
the chickpea flour, onion and coriander,
season with salt and freshly ground black
pepper and then mix well. Mould into two
patties and allow to rest for five minutes.
Heat the olive oil in a non-stick pan and fry
the patties till golden. Blanch the asparagus
till just cooked and cut each spear into four
pieces. Plate each patty on a serving dish,
scattering the asparagus around it. Top the
patty with a soft-poached egg and season.
For the dressing, place the mustard, honey
and white-wine vinegar in a mixing bowl and
season. Whisk well while adding the olive oil.
Top the poached egg with micro-herbs and
drizzle with the dressing.
N U T R I T I O N TA B L E
Per serving
Energy
Protein
Total fat
Carbohydrates
Total dietary fibre
Sodium
Saturated fatty acids
Monounsaturated fatty acids
Polyunsaturated fatty acids
Cholesterol
1 386 kJ
14,6 g
15,8 g
27 g
5,6 g
757 mg
3,05 g
9,09 g
2,04 g
233 mg
Last thoughts
SWEET-POTATO CAKES WITH
POACHED EGG, ASPARAGUS
AND MUSTARD VINAIGRETTE
AS
UP
TR
U IMNNG 22001132
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MEDICLINICFAMILY
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II 41
41
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JUST A MINUTE
G
ME TIME
Compiled by Ellen Cameron
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
CLASSIC SUDOKU
Complete the grid by filling in the numbers 1 to 9.
A number may not repeat in any row or column,
nor in any of the demarcated 3 x 3 cell groups.
9
1
4
2
7
5
9
9
5
6
2
3
3
3
6
7
2
9
SEPIA
BRAND
TAPER
STORE
CAMEL
7
2
3
2
9
2
SPASM
1
8
8
9
RESIN
6
9
4
Fit the following five-letter words into the grid
so that five words run horizontally and the
remaining two run vertically (as indicated by
the shaded columns):
8
5
5
5
8
CROSSWORD
7 4
4
5
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................................................................
MUSIC TO MY EARS
Each of the six groups of letters represents a sevenletter word related to music. Each group, however,
is missing the same letter. Decipher the missing
letter and unscramble the musical words.
1
2
3
6
5
T R
M
U
T
E
R A
S
4 O NO
4
5
6
O S
C
E
M
O
?
I
O
C
O
C
L
3
42 I
MEDICLINIC FAMILY
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AUTUMN 2013
G P 1
A
B
E
I
E E
L
D 2
R
U
Create one enclosed shape by filling in the sides of the cells. Each number
in a cell indicates the number of sides that are filled in. The example on the
right shows how this works.
1
1
2
2
3
3
1
2
2
1
3
1
3
2 1
2
2
3
1
1
2
1
3
1
1
0 1
3
1
3
1
3
3
3
1
0 1
0 1
2
3
2
3
1
1
2
1
2
3
2 3
2
1
2
2
3
1
1
2
2
2
3
0 2
2
2 3
2
2
2
2
2
3 1
2
3
TRAFFIC COUNT
2
2
3
1
1
0
2
2
2
0 2
2
1
3
2
2
1
0 1
1
1
3
1
3
3
2
3 1
2 3
1
3
2
2 3
0 1
1
0 1
3
2 1
1
1
2
3
2
2
2
2
2
1
2
3
2
1
3
2
2
3
2
BOXED IN
TRAFFIC COUNT
On a stretch of gridlocked highway, a traffic count reveals the number
of vehicles in summarised form:
5. Trumpet
4. Soprano
buses + trucks = 25
3. Piccolo
trucks + cars = 23
6. Compose
cars + buses = 28
3
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
2
2
(13 cars, 15 buses and 10 trucks)
3
Total = 38 vehicles
2
CROSSED OUT
0
SOLUTIONS
R
E
M
O
C O N T R O L
E
BOXED IN
2. Prelude
1. Bagpipe
The missing letter is P.
MUSIC TO MY EARS
What is the total number of vehicles on this particular section of
the highway?
7. Resin
6. Taper
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
5. Brand
4. Sepia
CROSSED OUT
3. Spasm
2. Camel
Place these letters into the grid to create the name of a common
household device.
1. Store
CROSSWORD
7
9
8 7 6
8 5
1
6 9
8
5 3
2 4 7
7 8
5
4 6 2
9
1
3
3
1
2
5
4
7
2 4 6
1
9 3
3 6 9
5
7
4 2
1
8
1
7 4
6 9 8
3
5 2
4 2 3
9
1
5
7
8 6
2 4
8
1
3 9
7
6 5
CLASSIC SUDOKU
PHOTOGRAPHS iStockphoto
6 8
2 4
T
1
HINT:
3 5 9
C N O R E T O L M E O T R
AUTUMN 2013
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CheCk OUT |
S TA R N O M I N AT I O N S
STAr noMinations
We celebrate outstanding Mediclinic staFF.
noMinate your star and tell us Why.
Email mediclinic@newmediapub.co.za or write to Family magazine, Po Box 440,
Green Point, 8051.
With coMpliMents
coMpassion and care
I’d like to congratulate you on the compassionate nursing staff at Mediclinic
louis leipoldt. My daughter, Inge, was admitted for a procedure. Needless to say,
I was one nervous mom! They were fantastic and worked with confidence and
efficiency. I want to commend nursing auxiliary Magdalene Raphael for helping
me so much with Inge.
Annelise Strauss
AR
ST
F THE
O
MONTH
Thank you is not sufficient here, but
professional nurse Miemie Baan at
Mediclinic sandton deserves our
compliments and appreciation for
taking such special care of my husband
earlier this year. We appreciated her
professionalism and friendliness at all
times. Miemie and the rest of the team
are shining stars – they always do their
best and make a difference in difficult times!
Heidi van Nieuwenhuizen
DID YOU KNOW?
Mediclinic louis leipoldt
is one of the oldest and
best-known private
hospitals in the
Western cape and offers
a panoramic view of
table Mountain.
professional nurse Mimie baan
regte engele
outstanding help
Ek het nou selfs nog meer respek vir
verpleegpersoneel nadat my dogtertjie
vroeg in Februarie ’n naweek lank in
die pediatriese afdeling by Mediclinic
durbanville was. Baie dankie aan Kim
Johnson, Cindy Bakker, Jo-Anne Smuts
en Sakkie Isaacs: ek was baie gestres maar
die manier waarop hulle ons hanteer het,
het my soveel beter laat voel. Boonop was
hulle professioneel, mooi gegrimeer en
uiters netjies. Ek wil opreg dankie sê vir
hul absoluut fantastiese diens. Hulle was
soos regte engele. Laastens ook net ’n
dankie aan George Mentoor – dis te
pragtig hoe hy almal op hulle gemak laat
voel en die kleingoed so mooi hanteer.
Baie dankie!
Helena van der Merwe
I’d like to nominate Christine Williams
from Unit D at Mediclinic panorama.
She was a breath of fresh air after
a long day of surgery. She was loving
and caring as only a true nurse could
be; she is my star. Thank you, Mediclinic,
for the exceptional service.
Judy Hendra
Baie dankie aan die personeel by die
noodsentrum by Mediclinic potchefstroom,
en meer spesifiek Daniel Ntshewula, vir sy
flinke, vriendelike diens. Ons seun Dewan is
onlangs daar opgeneem terwyl hy by sy oupa
en ouma gekuier het, so dit was stresvol vir
ons as ouers aangesien ons nie self by hom
kon wees nie. Ons wil ons dank betuig aan die
betrokke personeel wat hom bygestaan het.
Julle is puik!
Neels en Lizélle Olivier
enrolled nurse christine Williams
ontvangsadministrateur daniel ntshewula
44 i
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AUTUMN 2013
Family reserves the right to edit star nomination submissions as we deem necessary.
potch is puik!
nursing auxiliary Magdalene raphael
CHECK OUT |
M Y H O S P I TA L
YOUR HOSPITAL STAY
MADE EASY
1
IT’S BEST TO
COMPLETE THE
PRE-ADMISSION
PROCESS
BEFOREHAND.
+ Visit our website at
www.mediclinic.co.za.
Click on ‘Patients’ to
access and complete the
pre-admission form online.
+ Or you can download and
print the pre-admission form
from the website. Click on
‘Patients’ to download the
form. Complete the form and
fax it to the relevant hospital.
The fax numbers are listed
on the website.
2
ON
ARRIVAL
AT THE
HOSPITAL…
+ Make sure you have your
ID and medical-aid card.
+ Go straight to the admissions
desk. If you completed a
pre-admission form online,
you will have to confirm
your details and sign to
confirm that you accept
the conditions of admission.
+ If you have not completed
a pre-admission form, our
staff will assist you.
3
YOU
CAN
NOW
SETTLE IN.
+ After the paperwork has
been completed, a porter
will take you to the
nursing unit.
+ A nursing practitioner will
take down your medical
history and brief you on
the procedure and what
you can expect at each
step of the process.
+ It is advisable to send any
valuables, such as cellphones
or wallets, home with the
person who brought you
to the hospital.
IT’S A GOOD IDEA TO...
Visit the hospital pre-admission
centre. Staff can advise you on:
+ the procedure and/or
the treatment related to
your admission.
+ the financial aspects of your
hospitalisation, including how
to obtain pre-authorisation from
your medical aid.
+ the amount of cover authorised
by your medical aid and any
exclusion of benefits that
applies to you.
MEDICLINIC HOSPITAL CARE – ON YOUR DOORSTEP OR ON THE MOVE
Visit www.mediclinicinfohub.co.za or www.facebook.com/MediclinicSouthernAfrica
GAUTENG
Mediclinic Emfuleni
016 950 8000
Mediclinic Gynaecological
Hospital 012 400 8700
Mediclinic Heart Hospital
012 440 0200
Mediclinic Kloof
012 367 4000
Mediclinic Legae
012 797 8000
Mediclinic Medforum
012 317 6700
Mediclinic Morningside
011 282 5000
Mediclinic Muelmed
012 440 0600
Mediclinic Sandton
011 709 2000
Mediclinic Vereeniging
016 440 5000
Wits Donald Gordon
Medical Centre
011 356 6000
KWAZULU-NATAL
Mediclinic Howick
033 330 2456
Mediclinic Newcastle
034 317 0000
Mediclinic Pietermaritzburg
033 845 3700
Mediclinic Victoria
032 944 5061/2/3/4
LIMPOPO
Marapong Private Hospital
014 768 2380
Mediclinic Limpopo
015 290 3600
Mediclinic Thabazimbi
014 777 2097
Mediclinic Tzaneen
015 306 8500
MPUMALANGA
Mediclinic Barberton
013 712 4279
Mediclinic Ermelo
017 801 2600
Mediclinic Highveld
017 638 8000
Mediclinic Nelspruit
013 759 0500
Mediclinic Secunda
017 631 1772
NAMIBIA
Mediclinic Otjiwarongo
00264 67 30 3734
Mediclinic Swakopmund
00264 64 41 2200
Mediclinic Windhoek
00264 61 43 31000
NORTHERN CAPE
Mediclinic Kathu
053 723 3231
Mediclinic Kimberley
053 838 1111
Mediclinic Upington
054 338 8900
NORTH WEST
Mediclinic Brits
012 252 8000
Mediclinic Potchefstroom
018 293 7000
FREE STATE
Mediclinic Bloemfontein
051 404 6666
Mediclinic Hoogland
058 307 2000
Mediclinic Welkom
057 916 5555
WESTERN CAPE
Mediclinic Cape Gate
021 983 5600
Mediclinic Cape Town
021 464 5500
Mediclinic Constantiaberg
021 799 2911
Mediclinic Durbanville
021 980 2100
Mediclinic Geneva
044 873 6200
AUTUMN 2013
Mediclinic George
044 803 2000
Mediclinic Hermanus
028 313 0168
Mediclinic Klein Karoo
044 272 0111
Mediclinic Louis Leipoldt
021 957 6000
Mediclinic Milnerton
021 529 9000
Mediclinic Paarl
021 807 8000
Mediclinic Panorama
021 938 2111
Mediclinic Plettenberg Bay
044 501 5100
Mediclinic Stellenbosch
021 861 2000
Mediclinic Strand
021 854 7663
Mediclinic Vergelegen
021 850 9000
Mediclinic Worcester
023 348 1500
I
MEDICLINIC FAMILY
I 47
CHECK OUT |
B E F O R E YO U G O
THE LESSONS
AFRICA HAS TAUGHT ME
I
am Dutch by birth and South
African by choice. I came to
South Africa on 6 April 1990,
338 years after fellow Dutchman
Jan van Riebeeck did the same,
except that I arrived by train
with R250 in my pocket. The
African light amazed me and
I instantly understood the power
of this continent – of how it gets
into one’s soul.
I discovered many things
I had never seen or experienced
before. I encountered the culture
of the braai; the South African
love affair with sweet food;
chutney, witblits and even
mampoer (and boy, was I sick
for two days after that one). I discovered
gem squash with butter and salt, and
I still love it, although I’ve learnt that it’s
better to pierce the squash before boiling
it. I got to know the yellow brick and the
red ball in the supermarket dairy section –
so-called cheddar and gouda cheese.
I even met Peppermint Crisp and its
cousin, the fridge tart.
A bit of a culinary culture shock, really.
But I settled into it, for anything new
is exciting.
The greatest revelation of all? My love for
food and cooking became an obsession and
eventually my career. Southern Africa, with
its abundance of incredible produce, is the
source of my inspiration. It has also been
my education. And this is what I have learnt.
Africa has taught me integrity and
honesty. It’s about cooking what is grown
here and now, using the best available
produce and honouring the farmer. For
me, honesty is not about mentioning the
trendy name of some feedlot where the
beef comes from. I am talking about real
food and honest products. That’s where it
starts. Then we get creative. Then we play.
Africa has taught me to be unique.
Just as every region has its own special
48 I
MEDICLINIC FAMILY
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AUTUMN 2013
flavours, history and culture, so do I speak
my own culinary language. I have been
able to create my own path while at
Le Quartier. I will never forget going
on an eating splurge in London once,
when four restaurants all served their
own version of corn cakes with foie gras.
Tell me, how exciting is that?
Africa has taught me to stay excited at
all times. It is possible to reinvent, to push
forward, to recreate, to improve constantly,
powered by the enthusiasm of the people
around me. Both in my kitchen and outside
it, there’s an infectious creative energy that
feeds me. I feel it when I discover produce
I’ve never known before, or when each
season deliver its own bounty. I don’t want
strawberries all year round. I want them
when they taste real.
Africa has also taught me how to fight.
I fight for what I believe in, whether it’s the
freshest, the biggest, the smallest. I fight
for the right level of service and, especially,
against inferiority. But I don’t do so
unreasonably, for this goes hand in hand
with honesty and integrity. I will fight
against injustice and I will fight for my staff.
Africa has taught me humility and how
to share. Creating fantastic food and
experiences for our guests takes on
a deeper meaning when balanced with
feeding the needy. Life is tough for so
many around us. We can’t do our job
with blinkers on. At Le Quartier we cook
lunch for 120 children every school day.
Guests donate money when we tell them
the story. Some also knit scarves and
mittens for winter every year. Last year
we held a fundraising dinner in The
Netherlands and raised almost R1-million.
Unbelievable! Now we are also funding
breakfast for another 770 children in
two local schools. You see, anything
is possible when everybody chips in.
If anything, Africa has taught me
to be resourceful. Ons maak ’n plan.
On my culinary missions, I’ve learnt to
travel the less obvious roads, to conduct
research and find inspiring indigenous
ingredients. One of them is the !nara oil
from Namibia. It’s a nutty, fruity oil pressed
from seeds of a melon-like fruit that grows
in the desert, just beautiful with fish.
Then there’s Baleni salt, which local
women harvest from a hot spring in the
Lowveld using ancient traditional methods.
It is a sacred site where salt has been
harvested for the past 2 000 years. I also
keep my eyes open for the red num-num
fruit when I drive around Franschhoek.
I love its tartness. And what about buchu,
the amazing sour fig, varkkos, surings,
mebos, sorghum? I can go on for hours.
What we have here is so special. Yes,
every continent, every land, every person
has baggage. So do we. But, gosh, when
I open my eyes in the morning and see
the African light, I thank my lucky stars
that, through my chosen career, I can
conquer it all right here.
This is an extract from the speech Margot
Janse delivered at the Eat Out Conference
2012 in Cape Town the day before winning
the Eat Out 2012 Chef of the Year award.
ILLUSTRATION Sean Robertson
The award-winning executive chef of The Tasting Room at
Le Quartier Français hotel in Franschhoek, Margot Janse,
was born and educated in The Netherlands but she came
of age personally and professionally in South Africa.
Here, she pays tribute to her adoptive homeland.
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