7 Ways to Keep Your Kidneys Healthy

Our kidneys belong to what we call our 'major' organs, as they perform work in our body that keeps us alive. We can live without a gall bladder, but we cannot survive without a liver, heart, lungs or kidneys. This is why it's so vitally important that we look after our kidneys, not only to prevent kidney disease but also to make sure they are always in good working order. So, let's have a look at what our kidneys do for us, what happens when they can't do these things anymore, and how to look after them.

What do our kidneys do for us?

The main job of our kidneys is to work together with our liver to process and remove toxins from our blood. In this case, 'toxins' aren't necessarily poisons. The term means anything that would be harmful to us if they stayed in our systems. So, it includes everything from certain ingredients in our food (like small traces of mercury in fish) to animal fat and alcohol. As blood flows through our kidneys, they remove these materials from the blood, thus ensuring that these don't enter any further into our bodies.

The kidneys also do a lot more for us. They help to control our blood pressure by regulating the amount of salt in our bloodstream and removing any harmful extra salts and minerals and help produce red blood cells. This is very important for overall body health, and particularly to keep your bones healthy. Our kidneys turn all these materials into a waste product that we eliminate, which we call urine.

Because they play all these roles, our kidneys have to be very strong. Problems develop when they aren't healthy enough to successfully process harmful materials. When this happens, our entire bodies begin to break down which could be fatal. This is why people who have severe kidney disease have to have regular 'dialysis', where their blood is routed through a machine that 'cleans' it in the same way that their kidneys would before it is pumped back into their bodies.

Where are your kidneys?

You'll find your kidneys, one on either side of your body, just below your rib cage towards the back of your abdomen. They are deep inside your body, to protect them from external damage because they are so important in keeping you alive. Each is about the size of an adult's fist.

What happens with kidney disease?

Kidneys can take such a battering if we don't look after them that they can no longer work as well as they should, and they can become diseased. In extreme cases, they can stop functioning completely, which we call a kidney (or renal) failure. Happily, we only need one kidney to survive, which means that we can afford to lose one if it becomes unhealthy.

So, what can happen to our kidneys? The main condition that we need to be careful of is known as Chronic Kidney Disease. Recent research has found that a major cause of this is obesity, which makes sense, because our kidneys are especially vulnerable to the things we eat, given their jobs in our bodies. In fact, our diets are so important to healthy kidneys that we are seeing an increase in kidney disease as a result of eating too much unhealthy fast food. It is estimated that15% of South Africans suffer from some kind of kidney disorder

The main culprits here are Type 2 diabetes and hypertension. They both have very serious effects on our kidneys, weakening them and breaking down their ability to function.

7 Ways to Keep Your Kidneys Healthy

Unless there is a kidney condition in the family that is passed down – and this is quite rare – kidney diseases are completely preventable. Here are 7 things that you can do every day to help make sure your kidneys are healthy and happy.

1. Live an active lifestyle and keep fit

When we're fit our blood pressure is lower, which means far less strain on our kidneys. It doesn't really matter what kind of exercise we do, but the best exercises for kidney health are cardiovascular ones, like cycling and running.

2. Control your blood sugar

Diabetes is closely linked to kidney damage, so it's very important to follow the guidelines that protect you against diabetes. This means not eating too much sugar, in any form whatsoever. Remember, there is a LOT of sugar in a takeaway hamburger, for example, so do some research to find out about better low sugar options.

3. Look after your blood pressure

High blood pressure damages the kidneys, so make sure you have yours checked regularly. Maintain good blood pressure by eating properly and exercising regularly.

4. Drink lots of healthy fluids

Water is critical for the kidneys to function properly. It makes sense if you think about it for a moment. Imagine a cup of water with a little bit of salt in it, and another cup full of salt with just enough water to make it moist. It's far easier to pour from the first cup than the second, because the more water you have, the more the salt is diluted. Our kidneys work in the same way.

5. Don't smoke

Smoking not only puts toxins into our blood that the kidneys need to then cleanse, but it also narrows the blood vessels, which interferes with blood flow through the kidneys. This means that it is more difficult to remove the toxins from the bloodstream.

6. Don't drink too much alcohol

As we said above, the kidneys are used to remove alcohol from the blood. If we drink too much, we damage our kidneys over the long term, because having to process too much alcohol places a serious amount of strain on our kidneys and liver.

7. Be careful of over-the-counter pills

All medication (particularly pills and capsules) need to be processed by the kidneys, and some of these medications can have a serious effect if you take them for too long. So, make sure you tell your doctor about all medications you're taking, and how much of them you're using.

For more information please contact:
Dr MM Mahlangu (Specialist Physician / Nephrologist)
MBBCh(Wits) Mmed Internal Medicine (UL) Cert of Nephrology (CMSA)
Zamokuhle Private Hospital
+27 (0) 11 923 7750
info@lenmed.co.za or info@sd-nephrologist.co.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Six Essential Tips for a Healthy Pregnancy

When you discover you are pregnant you will feel joyful and your natural instinct will be to protect your unborn child. If this is your first pregnancy, you may even get a lot of warranted and unwarranted advice from friends and family, which may overwhelm you. They mean well but whom do you listen to and how do you know what advice to follow? Especially when you hear stories about the things you should or should not do that can affect the health of your baby.

This article will help empower you to make the right decisions about your health during your pregnancy and therefore the health of your unborn child. All of the decisions you make about what you eat, how active you are and your lifestyle will ultimately determine how your baby grows inside you and how this precious little being will be born into life.

Here are the 6 most essential tips to a healthy pregnancy:

1. Don’t drink

Did you know that the experts are still not sure how much alcohol consumed will harm your unborn child? The safest bet is to avoid alcohol altogether throughout your pregnancy. What the experts do know is when you drink alcohol it passes from your bloodstream into the placenta and straight into your baby. The liver is one of the very last organs to develop in the foetus which means your baby is unable to process alcohol the same way as a fully formed adult. Too much alcohol going through your system can seriously harm your baby’s development.

2. Quit smoking

Cigarettes contain toxins which are harmful to the human body. When these toxins enter your bloodstream they deplete the only source of oxygen and nutrients your unborn baby needs to grow. No amount of cigarettes is safe for your baby because every puff you take is less oxygen for both of you. When you plan to fall pregnant, you should already try to quit smoking then so that by the time you conceive you are no longer a smoker.

3. Eat healthily

We have all heard of the saying that when you are pregnant you should eat for two. This simply isn’t true. During pregnancy you are only required to eat about 300 calories more a day than normal. This amounts to about as much as a small plate of healthy food. It is important to eat a healthy diet while you are trying to fall pregnant as well as during your pregnancy and while you are breastfeeding. Poor nutrition during pregnancy can result in poor foetal development and gaining too much weight can lead to gestational (pregnancy) diabetes, chronic backache and high blood pressure. During pregnancy a woman’s macronutrient (energy) and micronutrient (vitamins and minerals) needs increase so it is vital for you to be eating food which is nutritionally dense and contains all the right nutrients. Your doctor can guide you with regards to the food you should be eating.

4. Get active

Whoever tells you not exercise because you will harm the baby is wrong. Unless it is your doctor who is telling you not to exercise for good reason. If you are pregnant, you should be exercising around three times a week for 20 minutes. Research has shown that doing exercises during pregnancy results in a shorter labour and helps with symptoms of pregnancy like nausea and stiffness. It also helps you maintain a healthy weight plus you will feel stronger and fitter after giving birth. Don’t throw yourself into a vigorous exercise routine. Take it easy and consult with your doctor before you begin.

5. Rest up

You will feel exhausted during two of the three trimesters of your pregnancy. In the first trimester (1-3 months) hormonal changes can make you feel tired, as your placenta grows to accommodate the healthy development of your baby. During the second trimester (4-6 months) you will regain your energy. Then, in the third and last trimester (7-9 months) your fatigue will return and you will feel more tired than ever. To help you through the tired stages you should get a lot of rest and try to sleep more than usual. It is also important to eat small, nutritious meals more often during the day. Rest is also important during your pregnancy because once you have given birth you will be getting very little sleep for at least the first 3 to 6 months of parenthood.

6. Get regular checkups

Your antenatal care is vital for both you and your baby during your pregnancy. This means you must commit to regularly seeing your medical practitioner. This could be your doctor, a gynaecologist, or the maternity clinic at your nearest hospital. They know exactly what milestones to be aware of. They will also detect any problems early on and therefore help prevent any unnecessary traumas.

You should trust your doctor and listen to his or her sensible advice. Your doctor will guide you throughout your pregnancy and let you know what to expect along the way.

Your pregnancy should be something you enjoy because becoming a mother is one of the most important milestones in your life. By following the six tips we have discussed in this article you should be well on your way to a very healthy and problem-free pregnancy. This will in turn provide you with a strong, healthy and contented little bundle of joy at the end of your nine-month journey.

If you are planning to fall pregnant or think you are pregnant, contact your doctor today and make an appointment to discuss the next steps.

For more information please contact:
Dr N Maligavhada (Paediatrician/Pulmologist)
BSc (Univen) MBChB (Natal) DCH (SA) FCPaed (SA) Cert. Paed Pulmonology (SA)
Randfontein Private Hospital
+27 (11) 411 3089
info@lenmed.co.za or riatshikhetha@gmail.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Seven Lifestyle Factors That Will Benefit Your Health

It’s a fact, you cannot do much about your genetics but you can make some healthy lifestyle choices which will influence the longevity of your life and reduce your risk of getting sick. There are seven important lifestyle factors which will have a positive impact on your health and therefore increase your chances of living to a ripe old age.

The seven lifestyle factors are:

1. A healthy balanced diet

When you eat healthily and make sure your body is getting the right nutrition, you are providing it with a sustaining energy. You are also lowering your risk of getting serious lifestyle diseases, like heart disease, hypertension (high blood pressure), diabetes and cancers. A healthy and balanced diet will prevent you from becoming overweight and putting you at risk of getting any one of the above lifestyle diseases.

However, while you don’t want to gain too much unhealthy weight, you also shouldn’t follow fad diets. Three balanced meals a day with a healthy mid-morning and mid-afternoon snack will ensure you remain energised while providing your body with good nutrition.

2. Drinking lots of water

Did you know we can survive around 3 weeks without food yet we cannot go without water for more than 7 days? What this is telling us is that water is vital. We should be drinking eight glasses of pure water a day in order to keep hydrated and maintain good health. (Juices, cooldrinks and other beverages do not count as water.) Water aids healthy digestion, it keeps our cells hydrated and functioning properly, and it flushes toxins out of our bodies. It is thanks to water that our bodies are able to absorb vital nutrients from food.

3. Exercising regularly

All it takes is about 20 to 30 minutes of regular exercise on a daily basis to keep us fit and healthy. Finding something physical to do and committing to it will help reduce your heart rate and therefore decrease the risk of

cardiovascular disease. Exercising also strengthens muscles and therefore increases bone density, reducing the risk of you getting osteoporosis in your old age. It improves lung capacity and aids proper breathing. A big plus to doing regular exercise is it improves your mental health, reduces stress, helps you sleep better and improves your mood.

4. Plenty of sleep

A full night’s sleep is vital as it gives your body some time to regenerate and recharge. You should be getting no less than seven hours of sleep per night because your body needs this amount of time to take care of its metabolic functions, like repairing damaged cells, recharging tired old cells and getting rid of toxins. Consistent lack of sleep can have quite a serious effect on your physical and mental health and wellbeing.

5. Not smoking

If you want to increase your lifespan and decrease your risk of getting serious illnesses, you should never start smoking and, if you are a smoker, you should quit now. Constant exposure to the nicotine in tobacco can cause coronary artery disease, peptic ulcer disease, esophageal reflux, hypertension, fetal illnesses, delayed wound healing, and cancers, and can significantly shorten your lifespan.

6. Reducing alcohol consumption

If you are consuming a moderate amount of alcohol - about one drink a day - you have nothing to worry about. However, drinking more than this can lead to health issues, such as a higher risk of heart disease, some cancers (liver cancer in particular), high blood pressure and stroke. Alcohol can be addictive and if you have a drinking problem you are at a higher risk of having accidents, being violent and even having suicidal thoughts.

7. Keep a check on mental and physical health

As a rule of thumb, you should see your doctor for checkups at least every two to three years if you are under 50, and once a year if you are 50 or over. It is a good idea to have an open and honest relationship with your doctor as he or she will help you navigate your health journey through life. Remember that most diseases can be cured if they are detected at an early stage. This applies to your mental health, too.

Lenmed offers highly qualified doctors who are fully equipped to give you a full health assessment. Find a doctor in your area easily on our website.

For more information please contact:
John Nderitu, Clinical Dietician/Diabetes Educator
BSc Food Nutrition & Dietetics (Egert-Ke), MA Medical Sociology (UoN-Ke), PG Diploma in Diabetes (USW-UK)
Bokamoso Private Hospital
+26 (7) 369 4784
Info@Lenmed.co.za or John.Nderitu@bokamosohospital.org or john.nderit@gmail.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.


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The Truth about Postpartum Depression

After the birth of a baby, many mothers experience the ‘baby blues’, a short period of feeling sad or tearful, which can be triggered by hormonal changes after giving birth. Sleep deprivation and anxiety, especially in first time mothers, may add to these feelings. It is a conflicting time; joy, excitement, anxiety and fear. Add to that the baby blues and mothers can feel overwhelmed.

While the baby blues include mood swings, crying spells, anxiety and difficulty sleeping and begin two to three days after the birth, they only last about two weeks.

When the feeling of sadness is more severe and lasts longer it is known as postpartum depression. There is also an extreme mood disorder which may develop after childbirth – postpartum psychosis.

Postpartum depression is not a character flaw

The most important thing to remember is that postpartum depression is not a character flaw or a weakness. There could be genetic factors, or physical or emotional causes. Factors such as sleep deprivation, personality disorder, complications during birth or pregnancy, a young maternal age, high sensitivity to hormonal change, or psychiatric illness can play a role.

Giving birth is not the only major change you have gone through. Having a baby to take care of is a huge emotional upheaval. It can be overwhelming and as many babies need almost constant attention, sleep may be hard to come by. As a result, you may be struggling to handle even minor problems. Added to that, you may be concerned about how to take care of a baby. Your body doesn’t recover immediately and so you may not feel as attractive as before you were pregnant. You have may feel you have lost control of your life, even of your own identity.

The difference between baby blues, postpartum depression and postpartum psychosis

1. Baby Blues

The baby blues usually occur for a few days after birth to a week or two. Mothers may suffer from mood swings, anxiety, irritability, reduced concentration, trouble sleeping, tearfulness, lack of appetite, and sadness or feeling overwhelmed.


Fortunately the baby blues usually fade on their own within a few days to one to two weeks. Mothers are advised to get as much rest as they can, accept help from family and friends, connect with other new moms, create time to take care of themselves and avoid alcohol and recreational drugs, which can make mood swings worse.

2. Postpartum Depression

Symptoms may emerge either during pregnancy or the first few weeks after birth to as long as a year after birth. Red flags to watch out for are excessive feelings of fatigue, irritability, anger, sadness, guilt, worthlessness or inadequacy. You may struggle to concentrate, think clearly or make decisions; you may lose interest in former pleasures and activities, or want to withdraw from family and friends. Thoughts of harming yourself or your baby or recurrent thoughts of death or suicide are serious warning signals. Sleep disorders, eating disorders and excessive weeping are also common symptoms.


The good news is that with appropriate treatment, most mothers recover from postpartum depression. It is often treated with psychotherapy or medication, or both.

It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through therapy, you can find better ways to cope with your feelings, solve problems, set realistic goals and respond to situations in a positive way. Sometimes family or relationship therapy also helps.

Your doctor may recommend an antidepressant that can be used during breast-feeding with little risk of side effects for your baby. But be sure to work with your doctor to understand the potential risks and benefits of specific medications.

In some cases, postpartum depression can continue, becoming chronic depression. It's therefore very important to continue treatment after you begin to feel better as stopping treatment too soon may lead to a relapse.

3. Postpartum Psychosis

This condition can develop within the first week after delivery and can become an ongoing problem, with some patients developing bipolar disorder or schizophrenia.

Symptoms can include paranoia, excessive energy and agitation, confusion and disorientation, sleep disturbances, attempts to harm yourself or your baby, difficulty bonding with your baby, poor concentration, obsessive thoughts about your baby, or hallucinations and delusions.


Postpartum psychosis could lead to life-threatening thoughts or behaviours and needs immediate treatment. Patients with postpartum psychosis will need long term specialist medical care.

Treatment may include hospital admission and require a combination of medications to control the symptoms. Other interventions, such as electroconvulsive therapy (ECT), can also be successful in reducing the symptoms.

A mother who experiences this condition will need to work with her doctor to deal with the challenges of breastfeeding and possible separation from her baby.

You do not have to struggle alone

If you think you may have postpartum depression, make an appointment with your doctor immediately. With prompt treatment you will be able to manage your symptoms.

If you feel you, or someone you know, may be suffering from the baby blues, postpartum depression and especially if you suspect postpartum psychosis, please make an appointment with your doctor immediately.

For more information, contact:
Dr Mathabethe Sebei (Psychiatrist)
MBChB Medunsa (2001), FC Psych (2011)
Randfontein Private Hospital
+27 (11) 411 3024
info@lenmed.co.za or sebeij@hotmail.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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What is Cancer and Why Do We Get It?

Cancer seems to be such a dreaded disease that we don't even like to hear the word. So we usually don't think about it and hope it doesn't happen to us. Like anything, though, the more we understand about cancer, the less scary it becomes – and the more we realise how much we can actually do to lower the risk and possibly even cure it. So let's take a simple look at what cancer is, what we think can cause it, and the easy things we can do in our lives to avoid getting it.

What is cancer?

Cancer is really just a change in the normal healthy cells in our bodies that makes them grow differently, or out of control or in the wrong place. Of course there are many different types of cancer, but this is basically what happens. It might be a mole that changes colour, or a strange lump that appears – this is simply the result of something having gone wrong with our usually healthy tissue.

This can happen anywhere in our bodies, and it can happen to any of us, whether we are male or female, young or old, rich or poor. That's partly why cancer is so frightening – it seems to strike randomly. However, as you'll see when you read on, the occurrence is not as random as we think and we can do many things to reduce our risk of getting it. Medical scientists are also constantly making breakthroughs in the ways that we treat cancer, and more people are recovering from it than ever before.

How does cancer start?

Our body is constantly refreshing itself. Old cells die and we grow new ones to replace them. That's why our skin stays healthy – old skin cells fall off revealing a freshly grown layer. Unfortunately, sometimes, for reasons we still don't fully understand, changes (mutations) take place in the DNA of cells. In other words, something goes wrong with the 'instructions' that our cells use to replace themselves, and abnormal cells are produced. A cell that should have been healthy emerges with a built-in fault: it might grow too fast, be the wrong type of cell for that part of the body, or grow somewhere else where it isn't supposed to appear. These are what we call cancerous cells.

How do cancer tumours grow?

This problem gets worse when these cells move to other parts of the body. This is why cancer spreads. The medical term for this is "metastasis", but all it really means is that the cancer cells travel through our bloodstream or lymph system, and then form new abnormal growths elsewhere. This is how breast cancer can spread to our lungs or other organs, and create tumours in other areas of our body.

When cancerous cells multiply they can form clusters of cells which form tumours. Some tumours eventually become malignant which means they can seriously damage your health. If not successfully treated, malignant tumours are likely to cause death.

Doctors divide cancer growth into different stages, depending on how serious it is and how much it has spread or not. Stages 1 and 2 usually mean that the cancer has been found quite early, and hasn't started to spread. Stages 3 and 4 mean that the cancer has started to spread and has now appeared in other places too.

What causes cancer?

While doctors don't yet fully understand what causes cancer in our bodies, the good news is that they are learning more every day, and have already identified things that can make a difference in whether we get it or not. These are known as 'risk factors'.

Naturally, one of the 'causes' of cancer is our genes. The potential to develop cancer can be passed on from one generation to another, as you can inherit certain genes from your parents - which is why you are more likely to get breast cancer if your mother had it.

By now we also know about some of the big threats that we should avoid to help us reduce our risk of getting cancer, like smoking, alcohol consumption, going out in harsh sunlight without sunscreen, and being exposed to cancer causing (carcinogenic) chemicals. There are also lots of less obvious things that can cause cancer.

Luckily we can all learn the right changes we can make to our lives to minimise our risk of getting cancer in the future. Also, fortunately, cancer is not infectious and cannot be passed on from one person to another. In other words, you can’t ‘catch’ cancer from someone else who already has it. (Although, as mentioned earlier, you can inherit genes from your parents that may make you more susceptible to the disease.)

How can we lower our cancer risk?

While cancer has now become a preventable disease in many ways, we still don't have control over the genetic aspect (only about 5-10% of cancers are genetic), so to a certain extent we are at the mercy of our genes. Cancer can appear no matter how healthily we live, unfortunately. That said, there are many things we can do to reduce our risk from other cancer risks, and this may even stop cancer genes from becoming active.

1. Don't smoke or use tobacco products

Smoke damages our cells and can turn healthy ones cancerous. Regular smoking of cigarettes, cigars or pipes places us at high risk. You should also avoid other tobacco products, like hookah pipes and snuff, as the tobacco itself contains chemicals that can cause cancer. Even smoked and processed meats contain contaminants that could cause cancer at some time in the future, if consumed excessively.

2. Be very careful of the sun

Skin cancers can be caused by exposure to sunlight. As our climate has changed due to global warming, the ozone layer in the atmosphere that protects us from harmful ultraviolet rays from the sun has become too thin. This means that if we expose ourselves too much to direct sunlight it’s much easier to get skin cancer than in the past. We should always protect exposed areas of our bodies with a sunscreen that has an SPF value of at least 20 UV protection factor whenever we go out into direct sunlight. Making this a part of our daily lives can substantially lower the risk of skin cancer. Sunscreen must be applied at least 20 minutes prior to going out into the sun. It also needs to be re-applied at least every 2 hours and more often when perspiring or swimming.

3. Live a healthy lifestyle

Cancer is also linked to unhealthy ways of living that weaken our defences against it, or directly cause it. We should try to avoid being overweight and eating too much sugar, and we should avoid drinking alcohol (there is no safe level of alcohol consumption). Keeping ourselves physically fit through regular exercise is also very beneficial.

4. Look after you mind

These days we understand that our minds have a significant effect on our bodies and our health, and can cause all kinds of illnesses. For example, too much stress can lead to immune system failure, which makes us sick. So it’s very important to do some sort of activity that keeps the mind calm and healthy, like yoga or meditation or some other sort of spiritual activity.

5. Eat sensibly

Our modern lifestyles have made us quite dependent on what we call 'fast food'. This food can be very unhealthy, because of its ingredients and the way it is prepared. It usually has far too much sugar, is highly processed, and contains chemicals that we would prefer to not have in our food. Instead of eating a takeaway, follow a sensible diet of basic fresh food, including plenty of fruit and vegetables. Try to avoid too much sugar and artificial ingredients.

So remember: You can reduce your risk of cancer

As you can now see, although cancer is one of the scariest diseases, we can do a lot to reduce our risk and ensure that we live long, healthy lives. As long as we follow these really simple guidelines for living, we have a good chance of being cancer-free, and enjoying happier, healthier lives at the same time.  

With grateful thanks to the Cancer Association of South Africa (CANSA) for sharing their cancer research with the Lenmed Health Group. Visit CANSA to learn how each of us has the power to take action for a cancer-free world. www.cansa.org.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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6 Ways to Lose Your Holiday Weight Properly

The Festive Season is over and you may feel your waistline is as well. All is not lost however. In fact, now that we are at the beginning of the year, it is a good time to begin a new diet. By ‘diet’, we mean a healthy lifestyle eating plan. You may have tried one of the numerous crash diets that are popular. Cabbage soup anyone?

Do crash diets work? Yes, but only because you are cutting back on calories. Once the diet is over, you are so hungry you eat more than you should and are in danger of not only putting the original weight back on, but also extra weight.

Because you haven’t made any lifestyle changes you tend to crave food even more while you are on a crash diet. A proper, healthy diet doesn’t leave you hungry.

You probably want to get straight into what you should be eating and what you shouldn’t, but for long-term success there are some things you need to put in place first.

Here are 6 ways to lose weight properly and keep it off

1. Change your perspective

If you are carrying weight that is unhealthy the first thing you need to do is change your perspective. What is really keeping you from losing weight? Very few personal challenges are insurmountable. You need a strategy to help you change those habits and attitudes which have held you back in the past. It is important to remember that even though you may have an occasional setback, you can start again the next day. Building a new, healthy lifestyle could mean it may take longer to lose the weight, but this time you will keep it off and be healthy as well as slimmer.

2. Find your inner motivation

Most people try crash diets instead of implementing long-term, healthy lifestyle changes for the wrong reasons. They have the wrong motivation. The question to ask yourself is why do you want to lose weight? To fit into skinny jeans, to attract someone, to have people tell you how thin you are, or – and this is the only reason that matters - to be healthy?

No one can make you lose weight, but it’s important to have people who will encourage you when the going gets tough. The right kind of positive encouragement is important. The right people will offer accountability, help you create healthy menus and help you develop a healthier lifestyle.

Encourage yourself and keep yourself accountable by having regular weigh-ins, and record your diet and exercise progress in a journal. Remember, this is not about recording calories, but rather about recording the healthy meals you have. Recording calories can lead to the slippery slope of anorexia.

When you feel your motivation is slipping, remember this, losing even 5 percent of your weight can help lower your risk for chronic health problems, such as heart disease and Type 2 diabetes.

4. Set realistic goals

Realistic goals for weight loss are important. Losing 0.5 to 1 kilogram a week is a good place to start. To achieve that, you generally need to burn 500 to 1,000 calories more than you consume each day. The best way to accomplish your goal is with a healthy diet and regular physical activity.

When you are setting goals, there are two things to bear in mind: your ultimate result and how you are going to achieve it. For example, your goal could be to lose 5 kilograms. Walking every day for 30 minutes is an example of how you could do that.

If you need assistance in deciding what is ‘realistic’ for your age and weight, ask your doctor for help.

5. Enjoy healthier foods

You may be overweight for a number of reasons. Two of those could be eating too much food or eating the wrong food. If your calorie intake is higher than it should be then your new diet should consist of fewer calories. If you are eating the wrong food, replace it with the right food. Neither of these mean you should be giving up taste, satisfaction or even ease of meal preparation. Shortly after you have made the switch you will find unhealthy food is something you no longer crave and, in fact, you no longer enjoy it either.

Get your weight loss started with these tips:

  • Eat at least four servings of vegetables and three servings of fruits daily. An easy way to eat the required fruits is to blend them with yoghurt and add nuts for a great breakfast smoothie.

  • Replace refined grains with whole grains. Or cut them out altogether.

  • Use modest amounts of healthy fats, such as olive oil, avocados, nuts, butter and nut butters.

  • Cut out sugar completely. Cinnamon is a good substitute, especially in your coffee.

  • Choose low-fat dairy products, lean meat and poultry in limited amounts.

6. Get active, stay active

Regular physical activity plus a healthy diet will not only help you lose weight faster, but will make you healthier and happier as well.

Exercise boosts your mood by releasing cortisol and endorphins, strengthens your cardiovascular system, reduces your blood pressure and maintains your weight loss. While your new diet can be, and should be taken up immediately, your exercise program needs to be planned carefully and built up slowly. If you leap into a heavy routine too quickly, you may injure yourself. Steady aerobic exercise is a good way to start, for example, brisk walking, such as 30 minutes three days a week. Take the stairs instead of the elevator, park at the far end of the parking-lot when shopping, walk the dog twice a day. People who have regular exercise and maintain a healthy weight are generally happier than those who do not. What better motivation for a healthy lifestyle change than that?

If you need help with planning a new lifestyle diet or an exercise program contact your doctor for advice.

For more information please contact:
Lorisha Singh RD (SA)
BSC Med (Hon) Diet, IPPN UWA, PGPN Boston University of Medicine | Consultant Clinical Dietician
Shifa Private Hospital
+27 (0) 31 240 5000
Ethekwini Hospital & Heart Centre (Suite 10)
+27 (0) 31 581 2411
info@lenmed.co.za or admin@lorishasingh.co.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis

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Back to School | Healthy Nutrition for Children

Food habits start from early childhood. If you feed your baby, toddler or child sugary drinks, crisps and sweets they will be eating and drinking them as adults. If you keep their diet free of junk food and only give them healthy food as babies you will be setting them up for a healthy life right from the start.

But, what should you feed your child and how much should you give them? For a new parent this can be a minefield. Especially when they start going to school. There, their level of activity will probably rise and they will need to be concentrating and learning at far higher intensities than previously. They will need more stamina, the ability to think and reason more clearly, all while still growing.

Then, there is puberty. If you think about it, children’s minds and bodies have so much going on inside it is no wonder they are so reluctant to get up in the mornings.

The best guide your children can have in terms of diet is you. You cannot expect your child to enthusiastically eat broccoli if you refuse to touch it. Nor can you expect your child to drink water if all you drink are sugar-laden energy drinks. Avoid giving your child sweet, fizzy drinks, energy drinks or low-calorie drinks as all these are laden with sugar.

A growing body needs the right nutrients, vitamins, minerals, proteins, carbohydrates and fat, all of which are the fuel required in order to develop correctly. Not only that, but they need these elements in different amounts at different ages.

Nutritious and nutrient-dense foods to include in your child’s diet, unless they are allergic to any of them are:

Lean meat and poultry, eggs, beans, peas, soy products, unsalted nuts and seeds.
Lunchbox possibilities: Chicken drumsticks, lamb sausages, hard-boiled eggs, snap-beans, small packet of nuts.


A variety of fresh fruit. Try to avoid shop-bought fruit juices as these have added sugar in them and usually all the fibre has been removed. Instead, make your own fruit juices and leave the fibre in. Dried fruit’s sugars are concentrated so limit the amount of those. One quarter cup of dried fruit is the same as one cup of fresh fruit.
Lunchbox possibilities: Apple, pear, banana, dates, diced coconut, orange, naartjie, pineapple cubes, mango cubes, strawberries, blueberries, a small avocado or avocado chunks – do not forget to drench these in lemon juice or they will go brown.


The bane of every child’s life. Introduce them to your child’s diet as early as possible. Fresh, organic vegetables are best. You don’t need a large property to grow your own as most vegetables grow well in pots. Have a good mix of colours – green, dark green, purple, red, orange, yellow and white. Have leafy, starchy and bean varieties as well.
Lunchbox possibilities: Romaine lettuce, blanched red, yellow or orange pepper strips, small radish, baby tomatoes, broccoli florets, cauliflower florets, carrot slices, cucumber cubes as well as a small tub of hummus they can use as a dip.


If you can’t cut out grains rather choose whole grains like oatmeal instead of sugary breakfast cereals. Instead of pasta and rice rather have quinoa, brown or wild rice. And if you must eat bread rather have whole-wheat or rye bread.
Lunchbox possibilities: Rye bread, chicken and salad sandwich; Rye bread, tuna and mayo sandwich; Rye bread, sardine and mayo sandwich. Avoid shop-bought sardines in tomato sauce as the sauce can be high in sugar and salt.


For good bone health and development include milk, sugar-free yoghurt, cheese, butter and fortified soy beverages in your child’s diet.
Lunchbox possibilities: Chunks of cheese, a small tub of sugar-free yoghurt - add fresh fruit like strawberries and blueberries. Do not give your child yoghurts with fruit already added as these contain large quantities of sugar and preservatives.

Foods and drinks to avoid

Additives including sugar

Sugar occurs naturally in fruit and milk. It is the added sugar that your child needs to avoid. Sugars like refined white sugar, brown sugar, corn sweetener, corn syrup, honey etc.

Saturated and Trans fats

Fat is both good and bad for you. It all depends on the fat in question. Fats to avoid are trans fats, also known as hydrogenated or partially hydrogenated fats. The best fats are those which provide essential fatty acids and vitamin E. These include olive oil, butter, nuts, avocados and oily fish such as sardines.

Unhealthy snacks

Children are born with a sweet-tooth and while it is impossible to stop them from having sweets, cakes and other unhealthy foods all the time, the trick is to not have them at home or to use them as treats. Seen as treats, these unhealthy foods become desirable and make it that much harder to keep your child on the path to a healthy life. Unhealthy snacks include most breads and specifically white bread, candy, cake, breakfast cereals – these are laden with sugar and salt, low-cocoa content chocolate like milk chocolate, biscuits, syrup, honey, doughnuts, ice cream, jam, jelly, molasses, muffins, pancakes, pizza, pudding and waffles.

Packaged or processed foods

Avoid packaged or processed foods as these carry hidden sugar and salt which may not be listed on the label. Another processed food to avoid is processed cheese. Yes, those already sliced cheeses do make it easier when making your child’s sandwiches but they are not healthy.

Keeping your child on a healthy diet may mean a complete revamp of your own diet. If you need help in creating a diet plan to suit you and your family, contact your doctor and set up an appointment today.

For more information please contact:
Lorisha Singh RD (SA)
BSC Med (Hon) Diet, IPPN UWA, PGPN Boston University of Medicine | Consultant Clinical Dietician
Shifa Private Hospital
+27 (0) 31 240 5000
Ethekwini Hospital & Heart Centre (Suite 10)
+27 (0) 31 581 2411
info@lenmed.co.za or admin@lorishasingh.co.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis

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Dealing with Depression During the Festive Season

Stress and depression can disrupt your holidays and hurt your health. If you are single and have no family, the stress and depression comes in a different form to those who are not single and do have family. Both are difficult and can become debilitating.

The holiday season can be extremely difficult for people suffering from depression. Loneliness, sadness and anger can intensify severely when one feels excluded from happy families, shared love, festivities, meals and gifts.

Alternatively the stress of social and family commitments can also be a trigger for depression. We are expected to fit in lots of parties, dinners and business lunches, which can be overwhelming. Also, we may be under pressure to spend lavishly on gifts, decorations and vast amounts of food, resulting in a financial burden that could take months to recover from. For those who go away on holiday there is the added stress of planning, shopping and packing, not to mention the cost of the holiday and the exertions of travelling.

Both scenarios can cause deep unhappiness; there are those who will yearn for the experience of happy family and friends and those who will long for peace and quiet. This longing for something seemingly out of reach is what drives the slide into depression, stress, and often anger.

Other factors that can contribute to holiday depression

  • Associating the holidays with unresolved family issues or a painful childhood.
  • Facing the loss of a loved one with whom you have previously shared the holidays.
  • Having unrealistic expectations of family and friends.
  • Being away from family and friends.
  • Coping with changes in family obligations, particularly after a recent marriage or divorce.
  • Feeling isolated from others.
  • Ignoring feelings of sadness, loneliness, or depression in an effort to maintain "holiday cheer."
  • Having an expectation that you "should" feel good.
  • Reflecting on losses or disappointments over the past year.
  • Drinking more alcohol, which is often more readily available during the holidays, as alcohol often will make depression worse.

Whether you are alone or are wall-to-wall with guests, being realistic and planning ahead, as well as seeking support, can help ward off stress and depression. The result may surprise you as you may end up enjoying the festive season more than you imagined.

Tips to prevent holiday stress and depression for singles

If the festive season has taken a toll on you before, putting in measures to prevent that will help. And, it is best to take positive action before you find yourself stressed and depressed as it is much harder to pull yourself out at that point.

  • Reflect. If you are a person of faith, take time to reflect on the spiritual significance of the holidays.
  • Have an adventure. Try something new; cooking courses, a new craft, join a hiking club, learn to play bridge, or join an amateur dramatics club, for example.
  • Have a party. Spend time with people you care about. Do not wait for them to invite you. You invite them. Do not leave it till the last minute. Calendars fill up quickly over the festive season.
  • Volunteer your time to help others. Spending time with those in need can help you feel less isolated.
  • Journal gratefulness. Try to appreciate the good things you have now instead of focusing on the past. Write a list of different things you are grateful for every day for the holiday season.
  • Get inspired. Read inspirational or interesting material. The holiday season is a great time to learn and expand your knowledge and to get inspired. Don’t wait for others to inspire you, find your own inspiration.
  • Stay active. Get out. Go for a walk. Window shop. Visit a market or a fair or even a town you have never been to before.
  • Acknowledge your feelings. It is normal to feel sadness and grief if someone close to you has recently died or you cannot be with loved ones. It is good to take time to cry or express your feelings.
  • Identify someone to talk to. If you know you suffer from depression during the holidays, look for someone in advance that you know will be available, is a good listener and will be able to talk you through the hard times.
  • Get help if you need it. Don't be embarrassed to ask for help any time of the year.
  • Be wise. If you are on medication, take it as prescribed. If you do not, you will open yourself up to physical and mental complications.

Tips to prevent holiday stress and depression for people with families

Do not let the holidays become something you dread. Work out what your holiday triggers are now, such as financial pressures or personal demands, so you can combat them before they become more intense.

  • Set aside differences. Try to accept family members and friends as they are, even if they do not live up to all of your expectations. Set aside grievances until a more appropriate time for discussion. And be understanding if others get upset or distressed when something goes awry. Chances are they're feeling the effects of holiday stress and depression, too.
  • Create new traditions. As families, and finances change, shrink or grow, traditions and rituals often change as well. Variety is a good thing, explore it more. Ask your family which traditions are most important to them and see how you can simplify them, or recreate them in a new way.
  • Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you cannot participate in every event. If it is not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time.
  • Share the load. Ask for volunteers, include the kids, for food preparation and dish washing and tidying up after the party, lunch or dinner. Take the time you need to finish tasks that are important to you. Don't try to complete everything at once.
  • Do not go overboard on cooking. Give each person, including kids, a day for which they have to plan the family activity. Plan your menus and then make your shopping list. That'll help prevent last-minute scrambling to buy forgotten ingredients. It will also prevent you buying food items you do not need. Ask others to bring their favourite dishes. Cook and freeze foods ahead of time.
  • Plan ahead. Plan, plan, plan. Diarise specific days for shopping, baking, visiting friends and other activities.But remember; do not spend all of your time planning activities for your family. You might end up feeling drained and unappreciated and they may have ideas of what they want to do.
  • Appreciate your family’s uniqueness. Avoid comparing yourself with what other families are doing or buying.
  • Gift yourself with a debt-free new year by not spending beyond what you can afford. Do not fall into the trap of taking a bank loan to cover the costs of the festive season.
  • Ask people what they want. It saves hours of time, and money, trying to get something they may not like.
  • Spend no more than an agreed specified low amount.
  • Give homemade gifts.
  • Donate to a charity.
  • Be realistic. The holidays do not have to be perfect or just like last year or like the festivities of your childhood. Part of being realistic is to be open to something new and different. Make a list what you expect from yourself and your family during the holidays. Hidden within these expectations you might find your potential holiday stress points. Write down what you can change to prevent or defuse stress. Having fun is realistic.
  • Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Try an alternative idea with regard to presents:
  • Don't abandon healthy habits. Two traditions that should be abandoned are over eating or drinking, especially alcohol and starving yourself in order to eat more at Festive Season meals and parties. Not only is it bad for your health but overindulgence can add to your stress and guilt. Do not stop your exercise program. If you don’t have one, start one today.

Here are some other suggestions:

  • Have a healthy snack before holiday feasts so you do not go overboard on snacks or drinks.
  • Get plenty of sleep.
  • Take a breather. Make some time for yourself. Rest when your body tells you to. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm. Stop and enjoy the fruits of your labour. Do things you enjoy.
  • Take time to reflect. Reflect on the good times you had in the past as a family. You can do this on your own or make it a family event. Reflecting on past good times is likely to trigger positive feelings and build on your positive memories.
  • Use time in different ways. Visit friends after the holidays instead of trying to cram everything into a few short days. Travel outside of the rush hours. If you are travelling long distance do it over a couple of days rather than all at once. Remember to stop and rest every two hours. Take a more scenic route.
  • Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional.

For more information please contact:
Dr MJ Ndhlovu
PhD (Cons Psy) UNISA, Msoc. Sc (Clin Psy) (UNW) | Clinical and Consulting Psychologist
Zamokuhle Private Hospital
+27 (0) 11 923 7785
info@lenmed.co.za or mjndhlovu@yahoo.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Frequently Asked Questions about Skin Cancer

Q: What is skin cancer?

A: Simply put, skin cancer is a tumour or growth of abnormal cells in our skin. The most common types of skin cancers are basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Of the three, malignant melanomas are the most dangerous and more likely to spread.

Q: What causes skin cancer?

A: Most skin cancers are caused by exposure to the ultraviolet (UV) radiation in sunlight and in tanning beds. But there are parts of the skin not exposed to sunlight which also develop skin cancer. These skin cancers may be formed by exposure to toxic substances or by having a weakened immune system.

Q: What would increase the risk of getting skin cancer?

A: The most common factors that could increase your risk of developing skin cancer are:

  • Fair skin. Anyone can get skin cancer. However, having fair skin greatly increases your chances. If you have blond or red hair, light-coloured eyes, and you freckle or sunburn easily, you're more likely to develop skin cancer than a darker skinned person.
  • A history of sunburns. Having had one or more blistering sunburns especially as a child or a teenager, increases your risk of developing skin cancer as an adult. However, sunburn at any age is also a factor.
  • Excessive sun exposure. Here is what most people don’t know - a tan is your skin's injury response to excessive UV radiation. If you spend a lot of time in the sun, without protective clothing or sunscreen you may develop skin cancer. Tanning beds are a high-risk factor, especially for malignant melanoma.
  • Sunny or high-altitude climates. You are more at risk if you live in a sunny, warm climate and at a higher elevation than people living in colder climates with much less sunshine.
  • Moles. People who have many moles or abnormal moles which look irregular and generally larger, are more likely to develop skin cancer. Pay close attention to your moles, check them regularly. If they change or worry you, visit your doctor as soon as possible.
  • Precancerous skin lesions. A skin lesion is a part of the skin that has an abnormal growth or appearance compared to the skin around it - rough, scaly patches varying in colour from brown to dark pink. Known as actinic keratosis, they are usually found on sun damaged skin on fair-skinned people and usually on their face, head and hands. They can increase your risk of developing skin cancer.
  • A family history of skin cancer. If anyone in your family has had skin cancer, you need to be extra careful to always wear sun-screen and wear protective clothing.
  • A personal history of skin cancer. If you developed skin cancer once, you are at risk of developing it again.
  • A weakened immune system. Having a weakened immune system increases your chances of developing skin cancer. People living with HIV/AIDS and those taking immunosuppressant drugs after an organ transplant are at greater risk.
  • Exposure to radiation. If you received radiation treatment for skin conditions like eczema and acne, you may have an increased risk of developing basal cell carcinoma.
  • Exposure to toxic substances. Exposure to certain substances, such as arsenic, may increase your risk of skin cancer.

Q: What are the signs of skin cancer?

A: Different types of skin cancer share some of the same signs, which is why it is important to have your doctor look at anything suspicious as quickly as possible. Skin cancers can appear as moles, scaly patches, open sores or raised bumps. Here are some signs to look for:

Squamous Cell Carcinoma

Squamous cells lie just below the surface. They are your skin's inner lining. While squamous cell carcinoma usually occurs on areas of your body, such as your face, ears and hands which are exposed to the sun most frequently, people with darker skin are more likely to develop squamous cell carcinoma on areas not often exposed to the sun. Squamous cell carcinoma may appear as:

  • A firm, red nodule
  • A flat lesion with a scaly, crusted surface
  • A flat, scaly red patch (may look similar to a skin rash)
  • A small, smooth, shiny or waxy bump (bumps may bleed or develop a crust)
  • A red or brown scaly skin patch

Basal Cell Carcinoma

Basal cells, which produce new skin cells, sit beneath the squamous cells. Basal cell carcinoma usually occurs in sun-exposed areas of your body, such as your neck or face. Basal cell carcinoma may appear as:

  • A pearly or waxy bump
  • A flat, flesh-coloured or brown scar-like lesion
  • A flat, scaly red patch
  • A small, smooth, shiny or waxy bump (bumps may bleed or develop a crust)
  • A patch with large blood vessels (may look like a birthmark)
  • A brown or black raised bump
  • A lesion with rolled edges and a central ulcer

Malignant Melanoma

While Melanoma can develop anywhere on your body, it most often appears on the face or the trunk of affected men, and most often develops on the lower legs of women. It can occur on skin that hasn't been exposed to the sun, otherwise normal skin or in an existing mole. In darker skin tones, melanoma occurs more often on the palms or soles, or under the fingernails or toenails.

Melanoma signs include:

  • A large brownish spot with darker speckles
  • A mole that changes in colour, size or feel or that bleeds
  • A small lesion (an area of skin that looks different to the skin around it) with an irregular border and portions that appear red, white, blue or blue-black
  • Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus
  • A new mole
  • A mole that is getting bigger
  • A mole that changes colour or shape
  • A mole that bleeds
  • A mole that itches or causes pain
  • A mole with an uneven border or shape

Q: Who is most at risk for skin cancer?

A: The following people are most at risk for skin cancer:

  • People with a lot of freckles
  • People who get sunburned
  • People with a family history of skin cancer
  • People with light skin
  • People with blue/green eyes

Q: How can I tell if I have skin cancer?

A: If you have a mole or other skin lesion that is causing you concern, show it to your health care provider. After examining your skin, she may remove the mole or bump herself or may ask you to see another doctor. The removed tissue will be sent to a laboratory and when the results, positive or negative, are back your doctor will contact you.

Q: How is skin cancer treated?

A: Where your skin cancer begins determines its type and your treatment options. Treatments include removal by your doctor, cryotherapy – freezing, electrodesiccation and curettage - scraping and burning, radiation therapy, and Moh’s surgery or wide local excision. The earlier skin cancer is removed, the better are your chances for a full recovery.

Q: Can skin cancer be prevented?

A: Yes, in many cases, skin cancer can be prevented. The best way to protect yourself is to avoid too much sun. You can do this by following these tips:

  • Avoid the sun during the middle of the day, 10am to 4pm, and don't spend long periods of time in direct sunlight.
  • Wear sunscreen year-round. Remember that cloudy or overcast days are as dangerous as hot, sunny ones. Use broad spectrum sunscreens with a SPF of 30, preferably higher - ideally SPF 50, which protect against the sun’s UV-A and UV-B burning and tanning rays. Apply the sunscreen 30 minutes before you go outside and then reapply every 2 hours. More if you’re swimming or perspiring. Be generous in your application and put it on all exposed skin, including your lips, the tips of your ears, and the backs of your hands and neck.
  • Use a lip balm with sunscreen at all times.
  • Wear protective clothing. Sunscreens don't provide great but not complete protection from UV rays. Wear preferably dark, tightly woven, long-sleeved shirts and pants to protect your arms and legs. Wear a broad-brimmed hat, which provides more protection than a baseball cap does. A brimmed hat protects your face, ears and neck.
  • Wear sunglasses to protect your eyes. Look for brands that block both types of UV radiation.
  • Avoid tanning beds. Lights used in tanning beds emit UV rays and can increase your risk of skin cancer.
  • Some common prescription and over-the-counter drugs, including antibiotics, can make your skin more sensitive to sunlight. Check with your doctor or pharmacist.
  • Check your skin regularly and report changes to your doctor. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks.
  • Check your entire body carefully, even the nooks and crannies. You may need to use a mirror.
  • Show any changing mole to your doctor, the earlier, the better.

If you have any concerns about any moles or other sun-related skin concerns, contact your doctor as soon as possible.

For more information please contact:
Dr F Spruyt (Plastic & Reconstructive Surgeon)
MBChB (UFS) FCS (SA) Plastic Surgery | MMED Plastic and Reconstructive Surgery (UFS)
Royal Hospital & Heart Centre
Tel: +27 (0) 53 045 0580
info@lenmed.co.za or info@drfritsspruyt.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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The Truth about AIDS

Here are the four most important things you need to know about HIV and AIDS:

  • AIDS and HIV are not the same thing.
  • HIV is the human immunodeficiency virus.
  • AIDS is Acquired immunodeficiency syndrome.
  • Having HIV does not mean you have AIDS.

As flu is the result of the influenza virus so AIDS is the result of the HIV virus. In both cases, the flu and AIDS are the resulting diseases. Although AIDS is a chronic, potentially life-threatening condition, most people with it die of other diseases, such as tuberculosis or pneumonia. Simply put, the HIV virus attacks the body, destroying the body's immune system, and causes AIDS, and AIDS leaves the patient with few defences against other diseases to which they succumb.

If HIV is a virus, how do I catch it?

HIV is a sexually transmitted infection. As it infects the blood cells it can also be spread by contact with contaminated blood. If infected blood is present in any situation where contact with it allows the blood to enter your system the chances are high you will contract HIV. Scenarios include, but are not limited to, sex of any description, mouth-to-mouth contact (if there are open sores), from mother to child during pregnancy, childbirth or breast-feeding. The chances of anyone contracting AIDS from a blood transfusion nowadays is virtually impossible because there are extremely strict blood screening protocols in place.

How do I know I have HIV or AIDS?

There are three stages of HIV. The first, and most contagious stage, often goes unnoticed as it can resemble flu. Taken on their own, each of these symptoms does not mean you have HIV or AIDS. It is the combination of them which will alert your doctor to the possibility.

Primary infection (Acute HIV)

Within weeks to a month a person will develop flu-like symptoms which may last a few weeks.

Symptoms include:

  • Fever
  • Headache
  • Muscle aches and joint pain
  • Rash
  • Sore throat and painful mouth sores
  • Swollen lymph glands, mainly on the neck

Clinical latent infection (Chronic HIV)

Symptoms include:

  • Persistent swelling of lymph nodes.
  • Symptomatic HIV infection
  • Symptoms include:
  • Fever
  • Fatigue
  • Swollen lymph nodes
  • Diarrhoea
  • Weight loss
  • Oral yeast infection (thrush)
  • Shingles (herpes zoster)
  • Other infections, cancers, etc.

Progression to AIDS

Untreated, HIV becomes AIDS in about 7 to 10 years.

Symptoms include:

  • Soaking night sweats
  • Recurring fever
  • Chronic diarrhoea
  • Persistent white spots or unusual lesions on tongue or in mouth
  • Persistent, unexplained fatigue
  • Weight loss
  • Skin rashes or bumps
  • Symptoms of other infections and cancers

If you have any concerns, please contact your doctor immediately.

Is HIV and AIDS really an epidemic, or is it now under control?

According to the most recent stats, more than 36.9 million people worldwide are living with HIV. Disturbingly, only 75% of those know their status, and frighteningly, 1.8 million children under 15 years' of age have the virus (2017 Global HIV Statistics: UNAIDS).

Without medication, it may take years before HIV weakens your immune system to the point where you have AIDS. The disease typically progresses to AIDS in about 7 to 10 years, if left untreated.

There is still no cure for HIV. That is the bad news.

Is there any good news?

Better medical treatments are available, and these if taken correctly, people with HIV are able to live longer and with a better quality of life. There are a variety of drugs, used in combination, which can control the virus. Each class of anti-HIV drugs blocks the virus in different ways. To avoid creating strains of HIV that are resistant to single drugs, researchers have found it best to combine at least three drugs from two classes. HIV treatment regimens may involve taking multiple pills at specific times every day for the rest of your life. There has been some indication that a good diet and regular exercise also plays a role in improving one's immune system.

HIV treatment should reduce your viral load (the amount of virus in your system) to the point where it is undetectable. It is important to note though that does not mean your HIV is gone. It simply means a test has not been developed yet which is sensitive enough to detect the dormant HIV. It is almost impossible to transmit it to others when your viral load is undetectable.

It is important that all adults, sexually active or not, be screened regularly for HIV, so that those who are infected can learn their status and make the proper, responsible decisions for their lives. It also enables them to be treated for HIV as soon as possible.

A long, healthy life with HIV can be achieved, and knowing your status and being on treatment will enable you to significantly decrease your chances of transmitting the virus to someone else.

For more information please contact:
Dr S Mashamaite (General Practitioner, Special Interest: HIV)
MBChB (Natal), MPH (Unisa), Dip HIV Man (CMSA)
Zamokuhle Private Hospital
Tel: +27 (0) 11 923 7751/2
Email: info@lenmed.co.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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The Truth about Immunisation

What is immunisation?

According to the World Health Organisation (WHO), a vaccine is a biological preparation which improves one's immunity to a particular disease. A vaccine typically contains an agent resembling the disease-causing microorganism. It is often made from weakened or dead forms of the microbe, its toxins or one of its surface proteins. This agent, when injected into a person, stimulates the body's immune system to recognize the agent as foreign, destroy it, and 'remember' it. That way, if that person is subsequently exposed to the disease, the immune system can more easily recognize and destroy these microorganisms.

A vaccine is administered via a vaccination. The person being vaccinated is now immunised against a disease. Without the vaccination, the disease could make that person seriously ill, if not be potentially lethal.

Because vaccinations have done such a good job of keeping people, especially children, healthy, it could be argued that the current generation has forgotten how serious those diseases actually are.

What happened before vaccinations?

Measles, polio, whooping cough, diphtheria and many other illnesses that vaccinations now prevent used to ravage the world. For example, each year, between 1936 and 1945 in the United States alone, 767 000 people, most of whom could have been children, caught diphtheria, paralytic polio, measles, and whooping cough. Four thousand children died every year from whooping cough alone. The difference that vaccinations made is clear when one considers that in 2014, only 13 children died.

With Polio, also known as poliomyelitis, 1 in 200 infections leads to irreversible paralysis. Up to 10% of these children die.

How did vaccinations help?

Before 1988, an estimated 350 000 cases of Polio were reported each year. In 2017, there were only twenty-two. Thanks to vaccinations, these number have decreased over time. Without a vaccination, this contagious disease could spring up again; some estimations are that the number of infected people could rise rapidly once more to 200 000 a year in only 10 years.

It is also thanks to vaccinations that smallpox has been eradicated worldwide. Before vaccinations for smallpox were developed, it caused tens of millions of deaths.

How do we know vaccinations work?

After vaccinations began to be administered the number of people who contracted a deadly illness plummeted, as did the number of deaths. Since people have begun refusing vaccinations, there have been new outbreaks of diseases - most recently, chicken pox. Another worldwide epidemic putting millions of people and children at risk can be avoided - but only with the help of vaccinations.

What difference does it make if I refuse a vaccination?

Your refusal to be vaccinated may easily result in the deaths of other people. You, or your child, may contract a preventable disease - remember they are all highly contagious. You won't know you are sick for a few days. If you come into contact, during that time with other people who have not been vaccinated, whether by choice, or because they are too young to be vaccinated, or they can't be vaccinated as they have a poor immune system, or a damaged immune system due to another illness they have contracted, like multiple sclerosis, these people will get sick. Some of them may die.

The autism debate

There has been a lot of debate recently concerning immunisation and autism. There is no credible evidence, despite the intense medical research which has investigated the claim, that immunisation causes autism.

The rumor began with a small study, of only 40 patients, published by a physician. The study was very small with just over 40 patients. The article was later found to be fraudulent. It was retracted by the journal that published it. Several other studies proved the findings to be wrong and the physician's medical licence was revoked.

The latest research, published in The Journal of the American Medical Association, is based on a study of about 95 000 children with older siblings, some of whom had autism spectrum disorder (ASD). According to Dr Bryan King from the University of Washington and the Seattle Children's Hospital in the US, "The only conclusion that can be drawn from the study is that there is no signal to suggest a relationship between MMR and the development of autism in children." He adds that a dozen studies have now shown that the age of onset of ASD does not differ between vaccinated and unvaccinated children.

The confusion comes in because children are vaccinated at around the same time that autism is diagnosed. But they are not related.

Contact a healthcare professional at your nearest Lenmed Hospital. We will be happy to give you the information you need, in order to make an informed decision about your own health and that of your children.

For more information please contact:
Dr N Maligavhada (Paediatrician/Pulmologist)
BSc (Univen) MBChB (Natal) DCH (SA) FCPaed (SA) Cert.Paed Pulmonology (SA)
Randfontein Private Hospital
+27 (0)11 411 3089
Info@lenmed.co.za or riatshikhetha@gmail.com

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Type 2 Diabetes Mellitus: What You Need to Know and How to Manage it.

By Dr Ryan Ramdass

November is Diabetes Awareness Month and the 14th November is World Diabetes Day.

Diabetes mellitus is a group of physiological dysfunctions characterized by hyperglycemia (elevated blood sugar) resulting directly from insulin resistance, inadequate insulin secretion, or excessive glucagon secretion. Type 1 diabetes (T1D) is an autoimmune disorder leading to the destruction of pancreatic beta-cells. Type 2 diabetes (T2D), which is much more common, is primarily a problem of progressively impaired glucose regulation due to a combination of dysfunctional pancreatic beta cells and insulin resistance.

The classification of Diabetes Mellitus extends far beyond Type 1 and Type 2, but Type 2 diabetes is by far the most common and is the focus of this article. The International Diabetes Federation estimates that we had 2.3 million Diabetics in South Africa with an expected growth rate of persons diagnosed with T2D of 126% by 2040. In 2015, there were more than 321 000 deaths in Africa attributable to diabetes, most occurring in young people (below age 60) and more commonly in men. Globally, 5 million people die of diabetes each year, about 1 person every 6 seconds. Worryingly, the diabetes epidemic parallels that of the obesity epidemic, itself being a significant risk factor for T2D.

Our understanding of this complex condition has come a long way in recent years with an enormous amount of research leading to insights of the disorder, its complications, how to manage its complications, as well as a more recent emphasis on how to prevent it.

T2D for me is about patient education. A successful diabetic is one who understands their condition, is empowered to self-manage and, has the support of their family and healthcare team.

So why do we treat diabetes? Diabetes is treated to relieve a person of the symptoms of high blood sugar levels (fatigue, excessive thirst and hunger, frequent passing of urine) and to reduce infections for example. But more importantly, we treat diabetes to reduce complications which are classified into microvascular or small vessel (eye disease, kidney disease, nerve dysfunction) and macrovascular or large vessel (stroke, myocardial infarction and peripheral vascular disease).

To mitigate these complications implies addressing multiple targets such as aiming for specific sugar levels, HbA1c targets, cholesterol levels, blood pressure targets and reducing abdominal obesity. These complications need to be actively screened for by your doctor and will necessitate a thorough history and examination with the performance of an ECG, eye and foot examinations with blood tests at regular intervals to name but a few.

The fundamentals of therapy are diet, exercise and medications, and of course to stop smoking. Diet and exercise therapy alone may not be sufficient in treating diabetes as they do not adequately address the physiologic dysregulation mentioned above and importantly may not address the complications such as heart, eye and kidney disease which may be undiagnosed in a patient with diabetes.

Diet is more than merely avoiding junk foods and carbohydrate-laden meals. It is about healthy eating choices, regular meals and modest portion sizes. Specialized 'diabetic' foods are often very expensive and for the preserve of only a few people afflicted with diabetes. Proper education by a dietician and diabetic nurse educator regarding food, its preparation and habits of eating are more valuable than spending money on exotic foodstuffs.

Exercise as a therapy is well-proven to reduce the burden of diabetes by lowering blood sugar levels and blood pressure, reducing body fat and maintaining a healthy heart. Thirty minutes a day (150 minutes a week) of moderate intensity exercise is recommended by local and international guidelines. Some examples are brisk walking, swimming, aerobics, dancing, bicycle riding etc. There is a plethora of data that even starting an exercise program has significant benefits even if the target duration of exercise is not achieved. A diabetic should always consult their doctor before beginning an exercise program. A Biokineticist is a health practitioner who may assist a diabetic with developing a sustainable exercise program based around resources and physical limitations.

As I had mentioned earlier, the successful diabetic requires the support of their family. To successfully implement healthy food choices and eating habits, the whole family needs to participate. It is often fruitless to have one member of the family change to a healthy diet while everyone else continues as before. Remember, besides being common in our population, T2D has a strong genetic risk. It stands to reason then that the whole family makes a change towards healthy eating and good exercise habits. It goes a long way towards disease prevention.

Medical therapies play a central role in diabetic management and vary from the well-established drug metformin to sulphonylureas and insulin. In recent years, many more classes of medications with unique actions and advantages have become available in South Africa. Examples include DPP4 inhibitors, GLP-1 analogues and SGLT2 inhibitors as well as a plethora of newer insulins. Each diabetic requires a personalized approach as they have different requirements, targets and resources necessitating a unique and frequently reviewed prescription. Some of the newer agents focus on weight loss and have cardiovascular advantages for example, but they may not be appropriate or tolerable for all patients. Sexual health and mental health aspects of a diabetic are often overlooked and these need due attention from your doctor or specialist.

So who should be tested for diabetes? All overweight adults at any age if they have at least one other risk factor for diabetes (a family history of T2D, Polycystic Ovarian Syndrome, physical inactivity, race, presence of hypertension etc). In the absence of these risk factors, all other adults are screened from age 45. The preferred screening test for high-risk individuals is the oral glucose tolerance test as it is more sensitive and is the only method for detecting pre-diabetes. Point of care tests such as random testing with a glucometer are not recommended as they may miss a diabetic or pre-diabetic or even a person at risk and there are often no guidelines for follow-up given in this context.

To conclude, Type 2 Diabetes can be prevented. The US Diabetes Prevention Program and the Finnish Diabetes Prevention Study both demonstrated that diabetes can be prevented in at-risk persons with sustained lifestyle and dietary interventions. The emphasis is not on fad diets, crash weight loss programs or unproven substances. It is on recognized eating plans and sustainable exercise programs.

If you have any concerns please consult your doctor or specialist for more information.

For more information please contact:
Dr R Ramdass (Specialist Physician with special interests in Type 2 Diabetes and Antimicrobial Stewardship)
Head of Ethekwini Hospital and Heart Centre's Physician Advisory Board and the KZN Antimicrobial Stewardship
+27 (0) 31 581 2573
info@lenmed.co.za or physician@drs.ehhc.co.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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The Truth about Malaria

Malaria is a tropical disease caused by a parasite "Plasmodium", and is transmitted by the bite of infected mosquitoes. It takes only one bite from an infected mosquito to become infected. If not treated promptly with effective medicines, malaria can be fatal by infecting and destroying red blood cells and by clogging the capillaries that carry blood to the brain or other vital organs.

With about 660,000 deaths registered each year, about 400,000 are from Sub Saharan Africa alone, the prevention, diagnosis and treatment of malaria have been given priority in many countries around the world. There are four types of human malaria: Plasmodium vivax, P. malariae, P. ovale and P. falciparum. P. vivax and P. falciparum are the most common forms. Falciparum malaria is the most frequent and deadly form, especially in Sub Sahara Africa

What are the symptoms of malaria?

Common symptoms include:

  • High Fever - over 38 Degrees Celsius
  • Chills
  • Sweating
  • Headache
  • Vomiting
  • Muscle and body pains
  • Weakness
  • Joint pains
  • A cough
  • Jaundice
  • diarrhoea 

More severe symptoms include:

  • Bleeding
  • Haematuria
  • Pallor
  • Strokes
  • Chest pain (angina or heart attack)
  • Cerebral malaria (coma, convulsions, neck rigidity, neurological signs etc.)
  • Death.

Once you get malaria, sometimes in severe cases, some of the symptoms can linger for months.

How do I get malaria?

More than 3000 mosquito species have been identified in both the Arctic and subtropics. They are categorized into 39 different genera. The mosquito responsible for transmitting malaria is the female Anopheles Genus. The female feeds mainly (dusk to dawn) on an infected person to nourish her eggs, the parasite reproduces and develop, then when she bites another person the parasites in her salivary glands then pass to the non-infected person. These parasites move through your system to your liver. Here, they grow and when they reach maturity they leave your liver and slipping into your blood stream, infect your red blood cells, where they continue to multiply causing the blood cells to burst releasing more parasites into the blood stream to infect more blood cells. This is when people typically develop symptoms.

Are there other ways malaria can be transmitted?

Malaria is transmitted mainly by mosquitos. Contracting it via blood transfusions and sharing of needles is rare. Mother-to-child transmission only happens at birth when the parasite passes through the placenta to the child. However during pregnancy a mother with malaria can have serious complications which can affect her and the unborn child. Malaria cannot be transmitted directly from one person to another.

Even a small puddle of still water can be a breeding ground for hundreds of mosquitos.

It is a dreadful disease and scientists are trying to develop a vaccine to prevent it. Malaria has become practically resistant to preventative medications so the situation is urgent. In the meantime, world health officials as well as concerned charities and individuals are trying to reduce the numbers of people catching malaria by distributing bed nets.

Who is most at risk?

Travellers from countries with no malaria, young children and infants, and pregnant women and their unborn children are most vulnerable to contracting malaria especially if they live in African countries south of the Sahara Desert, the Asian subcontinent, the Solomon Islands, Papua New Guinea and Haiti. Other contributing factors to the widespread occurrence of malaria is lack of knowledge, and little or no access to health care.

Malaria, especially the variety found in the tropical parts of Africa, can be fatal. In fact, 90% of all deaths caused by malaria are thought to occur in Africa. The most distressing thing is that the virus in most common in children under the age of 5.

It is important to prevent malaria at all costs, which means keeping mosquitos away from people. Here are some things we can do to prevent and stop the spread of malaria.

  • Sweeping away puddles. Mosquitos can breed even in birdbaths. Make sure you either sweep away the water or, if it is an ornamental pool, make sure it is kept clean and free of mosquito larvae.
  • Taking medication: The use of prophylactic medication when travelling to countries or regions in a country known to have malaria.
  • Sleeping under a net. Bed nets, particularly those treated with human-friendly insecticide, are especially recommended for pregnant women and young children. A fan is also a good idea as it blows the mosquitos away. Spiders, lizards and geckos eat mosquitos so do not be too keen to chase them out of the house.
  • Covering your skin. Wear pants and long-sleeved shirts especially during dawn and dusk when mosquitos are out in force.
  • Spraying clothing and skin. Make sure the products you use are safe for contact with your skin.

Mosquitos are not only responsible for malaria. They also transmit viruses including Dengue Fever, Yellow Fever, the West Nile Virus and the Zika virus. Combined with malaria these viruses have been estimated to kill over a million people and as many as a billion suffer from brain damage, blindness, serious illness and debilitating pain.

If you have any concerns, please make an appointment with your doctor before travelling to areas where high concentrations of mosquitos are known and where malaria is prevalent, or if you are showing symptoms of malaria.

For more information please contact:
Dr S Silvester,  MD
Emergency Room Physician, ER Manager
Maputo Private Hospital
+258 214 88 600

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Diabetes is a Lifestyle Disease

Did you know? Diabetes is one of the leading causes of blindness. It also leads to kidney failure, heart attacks, stroke, and lower limb amputation. Type 2 diabetes is fast becoming a common lifestyle disease and is indicative of the environment we live in today. We live fast, eat badly and barely exercise.

About Diabetes

Glucose is vital to us. It is a sugar found in foods containing carbohydrates and is also made in the liver. It provides our muscle and tissue-cells with a much-needed source of energy. It also helps fuel our brain. Diabetes affects the way our bodies use blood glucose, and occurs when the body is resistant to insulin due to factors like weight-gain or when the pancreas does not produce enough insulin to move the glucose into the cells for energy.

Diabetes has grown exponentially since the 1990s. So much so that in 1991 the IDF (International Diabetes Foundation) and WHO (World Health Organization) designated the 14th November as World Diabetes day, to raise awareness of the disease, how it affects people, and how it can be prevented.

There are various types of diabetes. But, one thing is certain, no matter what type of diabetes a person has, it leads to excess sugar in the blood. Too much sugar leads to very serious health issues.

The most chronic diabetes conditions are Type 1 and Type 2. They aren't reversible but can be managed through medical care and a healthy lifestyle plus diet.

The only reversible forms of diabetes are prediabetes and gestational diabetes. With prediabetes your blood sugars are quite high but not high enough to be classified as diabetes. Gestational diabetes occurs during pregnancy, usually during the third and final trimesters, and is generally resolved after the baby is born.

What is the difference between Type 1 and Type 2 diabetes?

Type 1 usually makes an appearance during childhood and requires regular insulin injections to manage blood sugar levels. Type 2 is a disease brought on in our adult years – generally more common in people over 40. Although genetic factors can play a role, it is also directly linked to our unhealthy lifestyles, bad diets and lack of exercise. Fortunately, by seeking medical care, Type 1 and Type 2 diabetes can be managed very well with medication and by making healthy adjustments to our lifestyle.

Symptoms of diabetes

Your symptoms can vary based on how elevated your blood glucose is. If you have Type 2 diabetes, prediabetes or gestational diabetes, you may not even experience initial symptoms, which is why the disease is so dangerous. Have your blood glucose levels checked once a year if you are overweight or diabetes runs in your family. With Type 1 diabetes, symptoms can occur quickly and severely.

Here are the 10 most common symptoms of Type 1 and Type 2 diabetes:

  1. Frequent urination
  2. Feeling hungry all the time
  3. Abnormally thirsty
  4. Sudden and unexplained weight loss
  5. Tired all the time
  6. Irritable
  7. Blurry vision
  8. Sores that heal slowly
  9. Frequent gum, skin and vaginal infections
  10. A urine test will show a presence of ketones – they occur when there isn't enough insulin in your blood

When should you seek medical attention?

You should see your doctor if you or a loved one notice any of the symptoms shown above, if you have already been diagnosed with diabetes or if you are concerned. Fortunately, if diabetes is diagnosed early on and managed properly, you can live a healthy life. Don't let your blood sugars get out of control. By living healthily, eating a balanced diet and being aware of diabetes, you and your loved ones lower your risk of getting the disease. If you are diagnosed you will need to keep a close eye on your blood glucose levels and your doctor will insist on regular check-ups.

If you have any concerns, please make an appointment with your doctor as soon as possible.

For more information please contact:
Dr S Mashamaite (General Practitioner)
MBChB (Natal), MPH (Unisa), Dip HIV Man (CMSA)
Zamokuhle Private Hospital
(011) 923-7751/2

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Why Washing Your Hands is Effective

The quickest way to spread germs and disease is through physical contact. Not only by touching other people but from everything with which you come in contact. Having come into contact with germs you can infect others and even infect yourself by touching your eyes, nose or mouth. Knowing how and when to wash your hands properly is important.

When to wash your hands

Wash your hands whenever they are clearly dirty.

Preparing food is one of the most important times to have clean hands. Even if the food you're preparing is going to be cooked, it is important to wash your hands before and after preparing food.

If you use contact lenses you need clean hands when you put them in your eyes and taking them out.

Wash your hands after blowing your nose, sneezing or coughing, as well as after using the toilet, changing a nappy or doing housework, and especially after handling garbage of any kind.

If you are caring for someone who is sick, treating wounds – and that includes even when putting a plaster on a scraped knee, it is important to have clean hands. Germs pass even more quickly through an open wound.

Which is the best soap to use?

Regular brands of soap are as effective at fighting germs as antibacterial soaps. Using antibacterial soaps may result in antimicrobial agent resistant bacteria. It really is best to use ordinary soap. Be wary of any product including liquid, foam and gel hand soaps, bar soaps, and body washes which contain triclosan and triclocarban.

When soap and water are not available, 60% alcohol-based hand sanitizers are a good alternative. Carrying an alcohol-based sanitizer in your handbag or pocket means you will never have to worry about washing your hands when you are not near bathroom facilities. It is also safe for children, but always supervise young children and store the product out of reach when it is not in use as swallowing the sanitizer can cause alcohol poisoning.

There is an art to using a hand sanitizer. Ensure you have enough of the product on the palm of your hands to wet your hands completely. Rub your hands together so the product covers all the surfaces of your hands, up to your wrists. Keep rubbing until your hands are dry.

The right way to wash your hands correctly

Although alcohol-based sanitizers are a good alternative, it is always best to wash your hands with soap and water. It is also important to do it right.

To begin with, wet your hands with either warm or cold running water. Apply the soap. It doesn't matter if it comes in bar, liquid or powder soap form. Lather your hands well and, for a minimum of twenty seconds, rub them vigorously, palm to palm, back of hands, wrists, between your fingers and under fingernails. After that, make sure you rinse your hands well and dry them on a clean towel.
Keep yourself and others healthy by developing a habit of washing your hands correctly and at the right times.

For more information Please contact:
Dr F Amod
(Infectious Disease Specialist)
MBchB(UKZN), FCPATH (Micro), FCP(med), Dip(HIV Micro)
Shifa Private Hospital
+27 (0) 31 240 5260
Info@lenmed.co.za or Amodf@mweb.co.za 

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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Lenmed High Blood Pressure Quiz

How much do you really know about high blood pressure? Here's a short 'TRUE or FALSE' quiz to find out.

  1. High blood pressure is a result of your heart beating too fast. True or False?
  2. High blood pressure is caused by eating too much spicy food. True or False?
  3. High blood pressure is known as the 'silent killer' because some people don't know they have it. True or False?
  4. High blood pressure makes you cough blood. True or False?
  5. High blood pressure only affects white people True or False?
  6. High blood pressure only affects old people. True or False?
  7. High Blood pressure only affects people who are overweight. True or False?
  8. Children never suffer from high blood pressure. True or False?
  9. Only people who have a bad temper suffer from high blood pressure. True or False?
  10. People who are physically fit don't suffer from high blood pressure. True or False?
  11. In South Africa, high blood pressure is responsible for 1 in 2 strokes. True or False?
  12. In South Africa, high blood pressure is responsible for 2 in 5 heart attacks. True or False?
  13. In South Africa, 1 in 3 adults live with high blood pressure. True or False?
  14. Lifestyle changes alone can reverse high blood pressure. True or False?
  15. Only medication can control high blood pressure. True or False?
  16. You only need to take high blood pressure medication for a short time. True or False?

Here are the answers:

1. False     2. False       3. True       4. False
5. False     6. False       7. False      8. False
9. False     10. False     11. True    12. True
13. True    14. False     15. False    16. False

So, how did you do?

Are you an expert on high blood pressure or have you realised that what you know may be nothing more than myth? If you are concerned that you may have high blood pressure please make an appointment with your doctor today.

For information please contact:
Dr T Kathawaroo
(Specialist Physician)
MBBCh (Wits), FCP (SA)
Daxina Private Hospital
Tel: +27 87 087 0644

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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The Truth about High Blood Pressure

High blood pressure, or hypertension, is the underlying cause of 1 in every 2 strokes and 2 in every 5 heart attacks. It is a sobering fact and yet so many people do not take high blood pressure seriously, probably because it rarely has symptoms. Without visible signs, almost half of the people who have it are completely unaware of it.

How do I know I have high blood pressure if there are no real symptoms?

High blood pressure rarely has symptoms but that's not to say it has none. There are definite visible symptoms and when you experience these you need to seek medical advice without delay. Facial flushing, headaches, nausea, nose bleeds, sleepiness, visual disturbances and vomiting and are all symptoms of extremely high blood pressure. As we said earlier, because of the lethal nature of high blood pressure, it is best not to wait until you experience these symptoms. At this stage, an appointment with a doctor is vital.

The best advice we can give you is to have your blood pressure checked at least once a year.

There is a very good reason for this. Anyone can develop high blood pressure. It is not dependant on age, gender, fitness or lifestyle.

It is true that it becomes more likely you will develop high blood pressure as you age, but it is not wise to assume that because you are in your twenties that you won't have it. As we've said, to be on the safe side, have your blood pressure checked once a year.

How is blood pressure measured?

There are 2 measurements that you need to be aware of when it comes to blood pressure; systolic and diastolic. Systolic measures the pressure of your heart's contractions, while diastolic measures the pressure of the heart while it is resting between beats. The measurement is given as the systolic over the diastolic.

High blood pressure occurs when both readings are consistently higher than normal.

If your blood pressure is 140 over 90 you need to see a doctor and begin making lifestyle changes immediately. While lifestyle changes may be enough, your doctor may also prescribe medication for you. High blood pressure medication needs to be taken regularly for it to work and it will, more than likely, have to be taken on a permanent basis. It is not a quick fix solution and should not be treated as such.
If you have any concerns, please make an appointment with your doctor as soon as possible.

For more information please contact:
Dr T Kathawaroo (Specialist Physician)
MBBCh (Wits), FCP (SA)
Daxina Private Hospital
Tel: +27 (0) 87 087 0644

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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The Truth about Lifestyle and Heart Disease

Heart disease is on the rise and the statistics are alarming. According to the heart and stroke foundations of South Africa, 225 South Africans are killed by Heart disease daily. It seems an obvious thing to say but, if your heart cannot function properly your risk of having heart disease or even a stroke is significantly higher. No heart, no life. Above all else, 80% of all heart disease conditions can be prevented. Taking care of your heart is vital for life. Taking care of your health should be the first step in preventing heart disease and stroke. But how do you ensure your heart is healthy and operating at its best? Your lifestyle plays the biggest part. And that means diet and exercise.

You cannot be a couch potato, consuming fatty, deep-fried foods and sugary drinks all the time and expect to have a healthy heart. In fact, if your lifestyle is unhealthy, you are putting your heart under great strain and you can become overweight very quickly. On the other hand, you don't need to be a tri-athlete to have a healthy heart. What you do need is to eat correctly and exercise.

Your weight affects your heart

Did you know, being overweight puts you at a 50% higher risk of having heart disease? Being overweight means your heart has to work much harder to get blood to every part of your body. If you are overweight, not only is the chances of having heart disease higher, but you can also develop diabetes, hypercholesterolemia or high blood pressure. You need to be the right weight for your height and age. This is done by calculating your Body Mass Index (BMI). Have a chat with your doctor or dietician about what your ideal weight and your BMI should be.

How does my diet affect my heart?

To start with, when we say, 'diet', we do not mean a crash diet over a couple of weeks. We mean your eating lifestyle. According to studies, the Mediterranean Diet is considered to be the best dietary guidelines to follow for a healthy heart and lifestyle. It consists of a large intake of fresh fruits and vegetables, predominately white meat like fish and chicken. It includes healthy fats like olive oil, nuts, and seeds. The Mediterranean diet is also considered to be high in soluble fiber with focus on whole wheat carbohydrates, beans, peas and lentils. This is the preferred diet to follow not only when one has heart disease, but also considered safe to be used by diabetic, liver disease or renal failure patients.

Your diet affects more than just the roll around your tummy. It affects everything in your body; your weight, your hormones, your organs and the way they function. Getting off the couch and being more active improves your emotional well-being as well.

Healthy food choices does not mean you will be missing out on tasty and delicious meals. Instead, embrace the change. Discovering new foods and new ways of cooking can be both exciting and healthy at the same time. You might be surprised at how delicious healthy food is.

Here are 7 tips for a healthy heart diet

1. Choose good fats over bad fats
Not all fat is bad for you. The good fats are not only tastier, but indeed good for your heart and healthy. Bad fats are considered to be fats known as saturated and trans fatty acids. These fats are well known to build up in the blood and can cause high cholesterol or even blockages within the arteries which could lead to heart disease or strokes.
Mono- and Polysaturated fats are considered to be healthy fats and can be found in olive, sunflower, or canola oil, margarines, tree nuts, seeds, peanuts, peanut butter and fatty fish such as salmon, tuna, herring, trout and sardines. These fats have been proven over the years to keep your heart healthy and can help prevent heart disease. It is therefore important to remember to never cut out all fats from your diet. Healthy fats are also known by the terms of Omega 3 or Omega 6 fatty acids. These fats have many functions in the body and they include decreasing inflammation, keeping arteries soft and maintain the health of your eyes, brain and joint health. Omega 3 and Omega 6 fatty acids cannot be produced by the body. It is essential to eat these foods to obtain the benefits they provide. Guidelines have shown that you must at least consume fish twice a week and rather use olive oil when cooking or preparing foods. Remember to never deep-fat fry any foods.

It's also important to remember, that even a very large consumption of good fats can also be unhealthy. Use all fats in moderation.

2. Choose complex carbohydrates high in soluble fiber
Refined carbohydrates like white bread, cake, cupcakes, biscuits, pies, noodles, vetkoek, crisps are not good for your heart. These foods not only contain a large amount of bad fat, and calories contributing to weight gain. They are also very easily digested and can leave one feeling hungry very quickly or maybe even craving something sweet. Complex carbohydrates high in soluble fiber, have a very low GI, which means the food digests very slowly, making you feel fuller for longer and can curb prevent energy levels dipping during the day. Complex carbohydrates also contain fiber which has been shown to help protect your heart against heart disease. The preferred starches to eat would be brown or whole wheat bread, rice, pasta, potatoes and sweet potatoes (with the skin), fruits and vegetables, beans peas and lentils, whole grain cereals and whole grain crackers. Always remember to use these foods in moderation, as once again, even a large intake of these foods can also be unhealthy and lead to weight gain.

3. Increase your veggie and fruit intake
Enjoy a variety of fruit and vegetables on a daily basis. The national recommendations is 5 fruits and vegetables in our daily diet. They not only contain a large amount of vitamins and minerals which keep the heart healthy, but also contain lots of fiber and anti-oxidants to help protect your heart from disease and stroke. If you struggle to include these foods in your diet, start off by replacing your snacks with a fresh fruit or try and add a fruit to your breakfast by either cutting it into your cereal in the morning or adding it to your yoghurt and muesli. For supper, try to pack at least half of your plate with vegetables or salad.

4. Choose lean and fresh proteins
White meat like fatty fish, chicken and eggs have been proven to be better for your heart. The Heart and Stroke Foundation suggests that out of the 7 days a week, at least 4 days must consist of the consumption of white meat. If one does choose red meat, please choose lean cut of meat and avoid processed meats. It is also important to remember, that when you do prepare your meat to choose preparations methods that involve very little oil and no deep fat frying. Braaing, grilling, stir-frying, boiling, steaming your meat is considered to be the healthiest options. Meat should be eaten in moderation. The human digestive system is not equipped to manage large quantities of animal protein and an excess can cause severe damage to your kidneys

5. Beans are best
Beans, lentils and peas are an excellent substitute for meat. They are packed with fibre, anti-oxidants, low in fat and high quality protein. They are also considerably cheaper than meat with the same benefits (if not more) than meat. Start including these foods by adding a tin of beans when preparing stews, curries, pasta or one pot dishes.

6. To lose fat, go low fat
When choosing dairy products remember to either choose low fat or fat free dairy products like low fat (2%) or fat free milk, low fat yoghurt or sugar free yoghurt, low fat cheeses like mozzarella, fetta, reduced fat gouda and cheddar, low fat cheese wedges and low fat cottage cheese.

7. Drink more, drink less
Keep well hydrated with at least 8 glasses of fluid per day. Water is considered the best of all the fluids to drink as your body needs water in order to function correctly. Every cell in your body requires fluid. Instead of soft drinks which have large quantities of sugar or fruit juices, rather sip on water, sugar free soft drinks or sugar free cordials. You can add freshly cut lemon, mint, cucumber, apples or lemon juice to the water to give it a nice fresh flavor.

Your heart is a muscle, make it stronger

Exercise builds muscle, including your heart. A strong heart pumps less times per minute but pushes out more blood with each pump. More blood means more oxygen being pushed around your body. Your body needs oxygen to function efficiently.

Exercise also lowers blood pressure, reducing the risk of heart disease and levels of the bad cholesterol known as LDL. LDL is known to build up inside the blood and can clog your arteries causing hardening of arteries, narrowing of arteries or can even cause complete blockages. The end result is most possibly a heart attack or a stroke.

When we exercise, our bodies require more energy to function and as an effect, the body can use cholesterol (bad or good) for energy production. Exercise helps reduce cholesterol which in return with helps prevent heart disease. It is also important to remember that the heart is a muscle and if you exercise, you also strengthen your heart muscle so, it pumps better and harder and help prevent cardio vascular disease. The end result - a healthier, more active, fitter and leaner you. Exercise, combined with a healthy diet, speeds up weight loss.

If I want a healthy heart which exercise should I be doing and how often?

Walking, cycling, dancing, jogging, running and swimming are all great aerobic exercises. And aerobic is the best kind of exercise for your heart, as it makes your heart work harder, burning calories to get oxygen to your body. For a healthy active lifestyle it is recommended that you do either 45min of vigorous activity 3 times a week or a minimum of 20min moderate activity 5 times a week.

For more information or if you are unsure about what kind of diet and exercise you should be on, make an appointment with your doctor today.

For more information please contact:
Dr M Pienaar
B.Sc Diet (UKZN) PG.Dip (UKZN)
Randfontein Private Hospital
+27 (0) 72 392 3020

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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How to Beat Bullying

Facts about bullying

Bullying can be defined as a need to repeatedly hurt someone verbally or physically. Bullies usually resort to this behaviour as a way to feel powerful or superior to the person they are victimising.

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The Truth about Breast Cancer

The first thing you should know is that both men and women can suffer from breast cancer. It is the most common cancer diagnosed in white and coloured women in South Africa, and the second most common in black women.

Breast cancer can be frightening, but there is good news. Firstly, breast cancer is not always fatal. There has been a substantial increase into funding for research. As a result, survival rates have not only increased, but are doing so steadily. The increase in research has led to diagnostic advances, earlier detection, and a better understanding of breast cancer.

What is breast cancer, exactly?

Very simply, it is cancer, also known as a malignancy, formed by an abnormal and uncontrolled growth and multiplication of cells in the breast. These cells divide more rapidly than healthy cells. In other words they grow more quickly. As they grow, they form a lump or mass. Cells may spread – metastasize - through your breast to your lymph nodes or to other parts of your body. Which is why early detection is paramount. Survival rates are higher after an early diagnosis, it is important to check your breasts regularly and know what you are looking for.

What signs or symptoms should I look for?

If, during your regular examination of your breasts, you find any of these symptoms, please contact your doctor as soon as possible.


  • A breast lump or thickening that feels different from the surrounding tissue
  • A change in the size, shape or appearance of your breast
  • Changes to the skin over your breast, such as dimpling
  • Redness or pitting of the skin over your breast, like the skin of an orange


  • A newly inverted nipple
  • Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
  • Here are some of the factors that could be a factor in developing breast cancer. Please don't be alarmed - you may have all these factors present in your life and never develop the disease.
  • Being female.
  • Increasing age.
  • A personal history of breast conditions.
  • A personal history of breast cancer.
  • Radiation exposure.
  • Obesity.
  • Beginning your period younger than 12 years old.
  • Beginning menopause at an older age.
  • Having your first child any time after 30 years of age.
  • Having never been pregnant.
  • Postmenopausal hormone therapy. The risk of breast cancer decreases when women stop taking these medications.
  • Drinking alcohol.

Can I do anything to reduce my chances of getting breast cancer?

Yes! The most important thing is doing regular self-examinations of your breasts. This won't prevent breast cancer, but it will help you understand the normal changes your breasts go through and help you identify any unusual signs and symptoms as soon as possible.

Ask your doctor about breast cancer screening. Breast cancer screening exams and tests, such as clinical breast exams and mammograms should never be neglected. Together, you and your doctor can decide which strategies are best for you. The rule of thumb is to have a mammogram once you reach 35 years of age and then one every 5 years after that.

Drink alcohol in moderation, if at all. If you do drink, limit the amount of alcohol to no more than one a day.

Exercise 5 - 6 days of the week, choose a healthy diet and maintain a healthy weight. Thirty minutes of brisk exercise on most days of the week keep you healthy and fit. It also helps keep your weight down and excess weight can cause problems. Remember that the number of calories expended in exercise must be more than the number of calories consumed. The Mediterranean diet, supplemented with extra-virgin olive oil and mixed nuts, may reduce the risk of breast cancer as it focuses mostly on plant-based foods - fruits and vegetables, whole grains, legumes, and nuts, olive oil over butter, and fish instead of red meat.

Limit postmenopausal hormone therapy. You may suffer from symptoms of menopause which make taking HRT necessary. Make sure your doctor has explained both the risks and benefits of HRT (Hormone Replacement Therapy) as combination drugs may increase the risk of breast cancer.

While this is a frightening subject, remember – knowledge is power.

If you have any concerns whatsoever about the health of your breasts, whether you are a man or a woman, please do not hesitate to contact your nearest Lenmed Hospital and make an appointment with our healthcare professionals today.

For more information please contact:
Dr PWJ Reyneke (General Surgeon)
MMed (Chir) Pret (1985), LKC (SA) (1985), MB CHB PRET (1977)
Royal Hospital and Heart Centre
+27 (0) 53 045 0464

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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