Category: 2016

Prenatal Surgery: Saving a baby’s life in utero

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In July 2015, Eunice and Nathi Motha finally became pregnant via in-vitro fertilisation and their joy at the news turned to pure elation when they found out they were pregnant with twins; a boy and a girl. After an uncomplicated pregnancy until 18 weeks, the couple readied themselves for the arrival of their babies. Sadly, however, the amniotic sac of the boy foetus ruptured and his leg protruded through the cervix. This made life in the womb for the boy unviable and the pregnancy needed to be terminated – or did it? According to gynaecologist obstetrician, Dr Deon Van der Merwe at Life Midmed Hospital, the girl foetus could be saved and the pregnancy for one of the twins could continue, the boy however, had to be removed from the uterus either vaginally or via caesarean birth.  

Not just another day at the hospital

It was the second time in 15 years that Dr van der Merwe performed an operation of this nature and he consulted with colleagues to gauge their informed opinions. “It is not an operation that is taken lightly as the dangers are immense; there is the risk of uterine rupture to carry the second twin to term after a caesarean at 19 weeks, there is also the risk of bleeding and sepsis and lastly, miscarriage, as the cervix was already dilated to 3 cm,” said Dr van der Merwe. “Even with all these risks, I had to help Eunice, as she had conceived under trying circumstances through IVF and she wouldn’t entertain me terminating the pregnancy.” 

Eunice relates how Dr van der Merwe explained the termination procedure and how she refused to listen to his words. She believes that after seeing their desperation and sadness in addition to her husband Nathi’s pleas to save one of the babies, he decided to do the work. “Even before Dr van der Merwe saw that my son’s leg was protruding through my cervix, I just knew something was wrong. For me his little leg kicking felt like a wriggling worm – a feeling I would never wish on anyone. It broke my heart to know that he would not make it,” says Eunice. “When they did the scan, I could still hear his heartbeat and I was so worried about if he would be hurt when the procedure was done; either vaginally or via caesarean. There was also no time for me to process all of these thoughts and we had to make the decision to save one baby or risk losing both babies… We chose to save our daughter.” The membranes were already ruptured for one week and the decision could not be delayed any longer. 

Emphasising that the operation was not an everyday procedure, Dr van der Merwe set to work, trying to remove the male foetus vaginally, but it was not possible and so a caesarean was performed. “We put the patient under general anaesthetic and after trying to remove the foetus through the cervix, which would not open enough, we knew the only way to save the second foetus’s life was to remove the first one via caesarean.” he said. 

Eunice remembers how she felt after the first operation. “I did not expect to have the burning sensation in my belly, as I assumed they would be able to remove him vaginally. I was denied pain medication so that they could do a scan after the operation was done to make sure my daughter was ok,” she says. “I knew I could endure anything for her well being, so that when I heard her heartbeat on the scan I was so happy, but it was also mixed with a deep sadness for the loss of my son, who I had never met, but who I had only felt – in my cervix. I still wish I had had the opportunity to see him with my own eyes, just to say goodbye – and that I was sorry.” 

A challenging caesarean section

Dr van der Merwe explained how the incision was made only after carefully ascertaining where the girl foetus’s placenta was. It was imperative not to accidentally rupture the amniotic sac of the second baby, as that would mean a complete termination of the pregnancy. “There would be no way to save the female baby if the membranes ruptured, so we had to be extremely careful. The incision was followed by removing the male infant with the ruptured sac and then putting the undamaged sac back into the the mother’s uterus to enable her to continue with the pregnancy,” he added. A stitch was also made around the cervix, as the pregnancy needed to continue – and because she had already dilated to 3 cm. “The risk of preterm labour of the other baby increased, as well as the chances of infection and so we had to be very cautious after the operation too. The longer the foetus could stay in the mother’s womb the better for it’s overall health and development,” said Dr van der Merwe. 

D-day for the girl twin to be born

Eunice’s pregnancy progressed to 35 weeks when she went into natural labour. She proceeded to go to the hospital immediately and underwent a second caesarean in the space of 17 weeks after her first caesarean. “The second caesarean was far less complicated; as the baby was ready to be born, although five weeks premature,” said Dr van der Merwe. “There was absolutely no way we could allow for an attempt at natural birth either, because of the danger of uterine rupture as a result of the very recent previous caesarean earlier in her pregnancy.” Eunice remembers meeting her daughter a day after she was born, as she was admitted to the neonatal unit for what became 13 long days after the birth. 

“After the caesarean, I was so confused and exhausted, so I slept a little while. On that same evening, I got up, had a shower and felt better. After getting dressed, I took a wheelchair up to see my baby girl… and I could not stop staring at her beautiful face,” says Eunice. “She was so amazing and just so beautiful and I will always be grateful to Dr van der Merwe who saved my baby’s life. My husband and I cannot be more thankful than we will always be to him. We named her Thembelihle, which means Good Hope; as she gave us hope when we almost lost everything.”

To dairy or not to dairy…

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Dairy does not agree with everyone, so how do you know if you’re lactose intolerant or if you have a milk allergy? 

Some favour dairy and others oppose it vehemently…  The Prevalence towards food allergies worldwide is increasing. Studies show an early introduction to food allergens – before six months – can increase the risk of developing food allergies and why recommendations suggest only introducing those foods after six months. We speak to two experts in the field of nutrition who shed light on the topic of lactose intolerance and milk allergy; registered dietician Marijke Pienaar at Life Robinson Hospital Randfontein and gastroenterologist, Dr Hilda Smith at Life Wilgeheuwel Hospital. 

Firstly, see an expert… 

“If you suspect you have a possible dairy sensitivity, see your doctor for a food allergy test,” says dietician Marijke Pienaar. “Both allergies and intolerances can be managed, but should not be done in isolation – and it is strongly advised to see your dietician to prevent any deficiencies or to properly treat the food allergy or intolerance. Do not eliminate any foods from your diet unless it has been clinically proven that you do have a milk allergy or milk intolerance by your doctor.” 

How are food allergies diagnosed?

No single test can be fully depended on in the diagnosis of food allergies, explains dietician Marijke Pienaar. Testing food allergies usually starts off by taking a detailed history of a patient’s diet and also allowing the patient to do 7-day detailed food and symptom record. “Once a food has been positively identified to cause allergic symptoms, a skin-prick test can be performed. The choice of allergens to be tested should be guided by the food and symptom record. Skin-prick tests are preferred as the initial test as its low cost, convenient and relatively accurate. After a food or allergen has positively reacted with the skin (meaning the skin will inflame where the allergen was added to the skin), a serum (blood) specific IgE test can be performed to positively diagnose the food allergy,” she says. “One could simply try by diagnosing food allergy by eliminating the allergen from the diet for a set period of time (usually between 2-6 weeks) followed by planned and intentional re-introduction, but this process can be lengthy and often results in unclear answers or diagnosis.”

What is lactose intolerance?

Lactose intolerance, also known as lactose malabsorption is the inability to fully digest the sugar lactose in milk products due to a lactase deficiency, explains Dr Smith, and symptoms include diarrhoea, gas, bloating, nausea and cramps. “Most patients can manage without giving up all dairy products. Lactase breaks down the the sugar in milk (lactose) to glucose and galactose for absorption in the small intestine,” she explains. 

SIDE BAR: Types of Lactose Intolerance, according to Dr SmithPrimary lactose intolerancePatient starts life with a normal amount of lactase and during childhood, the enzyme decreases as the diet changes from milk to solids. Production continues to decrease into adulthood – and if production decreases significantly, the patient will become symptomatic when consuming dairy products. Secondary lactose intoleranceIn this instance, there is a decreased lactase production by the small intestine after illness, such as celiac disease and Crohn’s disease. Once the disease is treated in the small bowel, then the lactase production usually recovers. Congenital or developmental lactose intoleranceHere, the patient is born with a complete absence of lactase, which is very rare. Premature infants may also present like this due to the immaturity of their gut –  as production most often develops in the third trimester of pregnancy. 

How can lactose intolerance be treated? 

“Sadly, we are unable to boost lactase production, but encourage patients to avoid discomfort and symptoms by decreasing their dairy intake and also adding enzyme products to assist with the breakdown of dairy in the gut,” says Dr Smith. “Limit dairy products by taking smaller servings and experimenting with different dairy-containing products and choosing lactose free products can really make a difference. Lactase enzyme tablets or drops can also help.” 

What is a milk allergy?

There are two main proteins in cow’s milk that can cause an allergic reaction and they are casein (found in the solid part of milk that curdles) and whey (found in the liquid part of milk that remains after the milk curdles.) The allergic reaction happens when the immune system identifies certain milk proteins as harmful and as a result triggers the release of immunoglobulin E antibodies to neutralise the protein allergen. “Symptoms can be mild to severe and you can break out in hives or experience wheezing or vomiting. Other symptoms also include a loose stool, often containing blood, diarrhoea, cramps, coughing, runny nose, itchy skin rashes, often around the mouth,” says Dr Smith. “Avoid milk-containing products, especially from the obvious sources like milk, butter, yoghurt, ice-cream and cheese.” 

SIDE BAR: No dairy? No problem! Here are some healthy calcium-rich foodsCalcium-fortified bread and cerealsCanned salmon and sardines with the bones Fortified orange juiceBeans, legumes, chickpeasRhubarbDark green leafy vegetables like spinach, kae, broccoli and okraDried figsSoy products and tofuAlmonds
Delicious milk alternatives to try…“The most important factor to look for when purchasing milk alternatives, is to choose milk alternatives that have been fortified with calcium. In terms of what milk alternative to use from a dietetic point of view, it does not matter, it’s all about individual preferences,” explains dietician Marijke Pienaar. 
Soy Milk – Soy milk is probably the most popular and recognisable alternative to cow’s milk. Like cow’s milk, soy milk is often fortified with calcium, Vitamin A, Vitamin D, riboflavin and often has the same protein amount as cow’s milk. It is therefore the most similar milk alternative to cow’s milk in terms of nutrition profile, but often patients complain of the “nutty” taste and not a favorite in terms of flavor.
Almond Milk – Almond milk contains a much lower amount of protein than dairy and soy milk, but people prefer the Almond milk above soy due to the sweet flavor and creamy texture that is similar to dairy milk. Most almond milks are fortified with calcium, but if not, almond milk is considered low in protein, vitamins, minerals and fatty acids present in dairy milk. Other common nut milks include cashew, hazelnut and walnut milk.
Rice milk – Rice milk is the most hypoallergenic of any of the milk alternatives, free from soy, gluten and nuts. Rice milk is high in carbohydrates but low in protein compared to dairy milk. Rice milk is quite thin and watery and not suited for use in cooking and baking and unfortunately if not fortified, low in calcium.
Coconut Milk – Due to the Banting craze, coconut milk became quite popular in the last couple of years. Coconut milk is relatively high in fat and therefore does appear to resemble in terms of texture closest to that of whole milk. Despite the similarities in texture, coconut milk does not have a nutritional profile comparative to that of cow’s milk. One serving (250ml) of coconut milk contains 80 calories, 1 g protein and 100 mg calcium, while 1 cup of 1% dairy milk contains 100 calories, 8 g protein and 300mg calcium.
Hemp Milk – Hemp milk is another good alternative for those allergic to soy, nuts and gluten and is made from hulled hemp seeds, water and (in most cases) sweeteners. It contains a good amount of protein and has an excellent fatty acid profile, but is relatively low in calcium, unless fortified.
Cow’s Milk alternatives for infantsBreastfeedingHypoallergenic formulasSoy-based formulas

Read the labels! 

According to dietician Marijke Pienaar, The South African Food Labelling Regulations (under the Foodstuffs, Cosmetics and Disinfectants Act, No 54 of 1972)  requires that all packaged food products sold in South Africa that contain milk as an ingredient, must be listed in the ingredients as  ‘milk’ on the label and identified as an allergen in a separate part of the food label. “Read all product labels carefully before purchasing and consuming any item. It is part of the dietician’s education to teach patients what foods contain milk and how to read food labels properly,” she says. 

Got milk? I’ll have some goat’s milk, thank you!

Goat’s milk is believed to be more easily digestible and less allergenic than cow’s milk. The fat globules in goat’s milk are smaller than in cow’s milk resulting in an easier digestion process. Goat’s milk is also naturally homegenized, as opposed to cow’s milk, which must be homogenised in a factory. Another plus is that goat’s milk contains about 10% less lactose than cow’s milk and is easier to digest for those suffering with a lactose intolerance. Goat’s milk is high in potassium, a micronutrient lacking in cow’s milk. 

Yoga: Good for the mind, body and soul

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Show aging the door as you slip into your comfy yoga pants and into a yogic posture to ensure your longevity.

We all know the feeling… losing keys, forgetting names of people, places and familiar-on-the-tip-of-your-tongue words… Unnerving as it is, we all get to that point, sometimes as young as forty. A recent pilot study, which involved participants over the age of 50, explored the relationship between performance on memory tests before and after a yoga session. Results of the study showed a significant improvement in memory and levels of depression in the older adults who took part. It also showed that yoga was as effective as other memory enhancement training techniques and had additional physical benefits. Good news for our aging brains and bodies – and some might argue, good news for the soul! Biokineticist Mark Stevens, a stones throw from Life The Glynnwood Hospital and Hatha and prenatal yoga instructor Deevya Vasson Lalla share their insights into the over 5000-year-old ancient art of yoga as a form of physical exercise with multiple benefits. 

Yoga is so much more than just exercise

“The combination of breath work, stretches and relaxation techniques practiced on a regular basis helps the body move out of survival mode which has many positive side effects on your health,” says yoga instructor Deevya. “You may notice a change in your state of mind, the lowering of high blood pressure, improvements in your posture with ease of movement and increased strength and flexibility.” Not only that, yoga assists with brain function and the ability to focus, enhancing concentration and memory, explains biokineticist, Mark. “Participating in regular physical activity definitely has a positive effect on the neuromuscular link between one’s brain and muscular system. From a movement disorder point of view, practicing certain movements, improving flexibility and strength, challenging balance and proprioception and correcting gait are vital in maintaining one’s independence and improving quality of life,” he says. “Exercises to help improve the neuromuscular link between one’s brain and feet can be as simple (not always that easy for some) as doing toe taps and calf raises or balancing on one leg. Often the more active one is, the slower the rate of decline in muscle strength, flexibility and proprioception as one gets older.” 

What do I need to get started?
“You don’t need much to get started with your yoga practice, but it does help to find a good teacher at a venue close to home, so that it is easy and convenient to attend a class,” says Deevya. “You need a willingness to try, a good attitude, comfortable pants and t-shirt and a soft surface to do your poses on. If you don’t have a yoga mat, don’t let that stop you – a carpet will work just fine.” Biokineticist Mark adds that it is also important to ensure that if you have had a previous injury, that you first check with your physiotherapist or doctor that you may engage in the exercise of your choice. “This is determined on an individual basis – and the important thing is that you engage in some form of physical activity. Enter a race,  book a yoga session, commit to doing something physical. It doesn’t have to be too big or daring or expensive. Find a partner, friend or family member to join you and motivate each other to start. Set a goal and write it down. Tell your partner, friend or family member what your goal is and commit to it. It could be walking your first 5km race, losing 5kg, entering a cycle challenge or attending at least one exercise session a week for the next three months,” he says. “Consistency is key and don’t quit too soon. Unfortunately there are no quick fixes and improving one’s fitness, flexibility or strength does take time, persistence and perseverance.”

<Sidebar> Yoga instructor Deevya shares her top five yoga practices to get you startedSukhasana – Easy Pose
Benefits: Opens the hips, lengthens the spine and prepares the body for concentration and meditation.
Method: Sit on the floor with your legs crossed at your shins and the spine elongated. If you struggle to sit up without rounding the upper body or your knees lift up above your hips then sitting on a pillow and against the wall will make this pose more comfortable. Alternate Nostril Breathing
Benefits: Helps balance the body and mind, strengthens the lungs and helps clean the lymphatic system. Method: Sit in easy pose or on a chair. Place your thumb and ring finger on either side of your nose. Press your thumb down on the right nostril and breathe out gently through the left nostril. Now breathe in from the left nostril and then press the left nostril gently with the ring finger. Removing the right thumb from the right nostril, breathe out from the right. Breathe in from the right nostril and exhale from the left. Continue for a few rounds keeping the breath smooth and relaxed. Standing Forward Bend
Benefits: A great stretch for the hamstrings, glutes and spine. Your head is also below the heart so you are getting the benefits of doing an inversion – it calms the brain, reduces stress and anxiety and relieves headaches and sinus. A great one to do before bed or when waking up in the morning.
Method: Stand with your feet hip width apart, hinge from your hips all the way down and rest your hands on the floor next to your feet. Keep the knees soft if straight legs is uncomfortable and rest the hands on a block or pillow if it doesn’t reach the floor. Don’t forget to breath and just allow the body to relax and release. Alternatively hold onto your elbows. Cat Cow
Benefits: Relieves any tightness in the muscles of your back and keeps the spine healthy and flexible. Method: Come onto hands and knees with hands underneath the shoulders, palms flat and knees underneath the hips. Keep a neutral spine and as you inhale lift the head and push the chest through the arms, arching the spine. Exhale and round the spine, tuck the chin, and tuck the tailbone. Close your eyes and try to synchronise the breath with the movement as you do a few rounds.Supine Spinal Twist
Benefits: This pose releases the lower back, helps to open your chest and shoulders, relieves any upper back tension and elongates the muscles of the spine.
Method: Lie on your back and hug your knees into your chest. Take the arms out in line with your shoulders and take both knees over to the left side, resting knees and feet on the floor. Slowly breathe as you relax the right shoulder to the ground and look over the right hand. If you struggle to get the knees to the floor, try putting a pillow between your knees. Hold for a few breaths and repeat on the other side looking over the opposite hand.
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My grandmother: the yoga aunty to all who knew her
“My grandmother Jasoda ‘Bhikibhen’ Keshav, otherwise known as ‘masi’ (‘aunty’ in Gujarati) to her many regular yoga students, taught in Rylands in Cape Town for 49 years. She started her yoga classes in the early sixties making the decision to dedicate her life to sharing the gift of yoga with other women, never charging them for attending. The classes started small, once a week on a Saturday morning, but soon grew to twice a week, including a Wednesday morning as word spread. Before she died at the age of 84 she had taught hundreds of women and stayed active until her last days. One could often hear her say; ‘one day when I am not here, you girls must remember what I taught you’, alongside the motto, which became the motto of many – ‘watch your thoughts… be the observer and you will conquer the mind and its illusions.’ I believe that yoga was her life – and she inspired so many women to use yoga to nourish their bodies and minds. She was the sharpest, wittiest woman I knew and I miss her quick tongue and soft hands. She was testament to the fact that yoga keeps you healthy, fit and living mindfully.” – Rekha Chavda granddaughter to Jasoda ‘Bhikibhen’ Keshav. 

For more information and to find a yoga instructor near you, visit http://za.greendock.com/directory/yoga/studios.html for a directory of practitioners. 

Get kids moving

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Unplug yourself from social media, get your trainers on and get the kids moving. 

There are 20-million children in South Africa and of those, 60 percent attend under-resourced schools, which often means they have little, limited or no access to physical education. Physical activity is vital for a child’s development and lays the foundation for a healthy and active life. In South Africa, every school-going child should access at least 90 minutes of physical activity per week, within the prescribed school curriculum. However, since physical education was removed from the school curriculum in 1999, children have become more sedentary, opting to spend free time connected to the internet, where it is accessible, exercising no more than their thumbs on small screens. South African children have poor physical activity levels, according to the 2014 Healthy Active Kids South Africa Report Card and as adult South Africans, we have a responsibility to inspire our youngsters to move more for better health and longevity. Charlene Yared-West speaks to the experts for some inspiring and fun ways to get kids moving… 

A bleak future without exercise

Dr Claire Nicholson, founder of the Move-It, Moving it Matters™ Programme points out a sad trajectory into adult life for children who do not exercise. “Without change, we can expect to see obese adults with life spans shorter than their parents,” she says. Dr Nicholson heads the programme Move-It, Moving it Matters™ (movingmatters.co.za), a healthy, active living initiative and one of its funding partners is Life Healthcare, which is committed to quality supporting interventions. It continues to gain momentum and respect locally, nationally and internationally and is a powerful educational suite of Programmes which stimulate positive engagements in activity, for life. The programme is currently in the hands of 20,000 children in Public schools across South Africa. “Our aim is to educate adults and children about the immense value of physical activity and to make it a fun alternative so that they go out there and just do it!” she explains. 

Make exercise fun and meaningful
Show your kids you care and give them the gift of your time when you set out for physical activity, explains Tracy Clifford Statt, hypnosis practitioner for the motivational exercise programme Hypnocize.co.za. “The fun factor is very important and children prefer short bursts of activity. Also, avoid nagging and negative language and be sensitive to insecurities like being overweight, or uncoordinated. Choose appropriate activities which won’t embarrass the participants,” she says. “It is also very helpful to set daily goals  for activity with your children – begin with short 10 minute bursts and work up to 30 minute play sessions.” 

Encouragement and support are key

Mr Kiruben Naicker, biokineticist at Life Mount Edgecombe Hospital in KwaZulu Natal notes that he is seeing more children with from obesity in his practice, from as young as seven or eight years old. “Parents often think their children will grow out of their baby-fat… until they see that children have in fact grown into obesity. Obese kids often become obese adults unless a lifestyle change is made,” he says. “Children need good examples to follow, encouragement and support – and parents play a big role in this. Whether it is washing the car together on a Sunday afternoon, taking a walk on the beach or showing them it’s a healthier choice to take the stairs instead of the lift are all good ways of imparting the importance of movement. Choose age appropriate activities and the sky’s the limit!” 

Be interested in their interests

“Children should be overjoyed by their own joy – and parents should partake in that joy by showing an interest in their children’s interests,” says Dr Nicholson. “So, even if that interest is in building Legos, parents should get onto the floor and play with their children. This can be built upon and taken outdoors where it can become a more physical activity, like building with bricks for example. Pay attention to what they are drawn to for clues into what they possibly would enjoy.”  

Invest in their lives

According to Andrew Wyllie, Personal Trainer and owner at personalsublime.co.za, encouraging movement in children is an investment in their lives. “Exercise builds confidence, encourages teamwork and social skills, helps build physical development and maturity, and also inspires creativity,” he says. “The bottom line is that children need to discover and explore that side of  their own development and be in awe of their amazingly agile and strong bodies.” 

<Sidebar> You don’t need a gym membership to move – explains Naicker. “Always ask yourself the question ‘how can I get my child to be more active?” Here are some ideas to get you started…

  • Play catch in the backyard. 
  • Go riding a bike together.
  • Take a morning family stroll  in nature.
  • Grab a towel and go to the beach. 
  • Take the stairs instead of a lift.
  • Take a walk instead of a drive.
  • Ban Technology for a day – then be ready to engage children in an activity like Twister.
  • Go for a swim as a family.
  •  Take it outside – indoor activity is sweaty and stifling.
  • Plan for Rainy Days – a novel activity like blowing up balloons and chasing them around the room.

Technology to heal your heart

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Novalis Tx leading the way in cancer treatment on the African continent 

Life Healthcare Vincent Pallotti Hospital in Cape Town has just made substantial upgrades to its successful “first for Africa” multimillion-Rand Novalis Tx  radiotherapy equipment, otherwise known as Novalis Radiosurgery, which allows for faster and more accurate targeting and treatment of previously untreatable tumours. Charlene Yared-West finds out more and meets the team behind the technology. 


Can cancer really be beaten?
Cancer has become so common as more and more people are diagnosed with some form of the disease. Sadly, we are all programmed to think it could never happen to us or to someone we love, but then it does… A family member, a friend or a colleague. The question we want answered then is; can cancer be beaten? Research from the University College of London School of Pharmacy projects that worldwide, cancer is expected to reach 26-million new diagnoses and 17-million deaths by 2030, however, because of the new therapies, pharmaceuticals and technologies that are constantly being developed, like the Novalis Tx equipment, many forms of cancer could be eradicated for most age groups by the year 2050.

 Last year, it was reported that over 1-million patient treatments worldwide had been performed with the Novalis Tx machine, since it was created in 2003, calculated at an estimate of 200-thousand treatments per year. Studies have shown that one out of every two cancer patients can benefit from Novalis Radiosurgery, which is good news for people diagnosed with various forms of cancer. “I believe that this machine offers top-end technology which allows us to treat our patients with a high degree of accuracy and due to its high output can also minimise treatment times,” says Dr Rainer Fröhling, Radiation and Clinical Oncologist at Life Healthcare Vincent Pallotti Hospital in Cape Town. “It allows us to target cancers in sensitive areas and minimise side effects and in conjunction with other treatment modalities, offers the chance of better outcomes to our patients.”

Novalis Radiosurgery: Saving lives without the need for scalpels
The Novalis Tx has been in operation since 2003 in selected countries around the world and was launched in South Africa at Life Healthcare Vincent Pallotti in  December 2013, ten years after its inception. It is a non-invasive radiotherapy which uses state-of-the-art high-tech systems to destroy cancer anywhere in the body in short 20-minute sessions, without the need for surgical incisions or serious operations. 

So, how does it work?
The machine with it sleek design, rotates around the patient from every angle, delivering the radiation beams where needed onto the body. The team of attending medical professionals including oncologists, a medical physicist and  radiotherapists  manage and guide the Novalis Tx skillfully, obtaining the necessary information about the tumour during the treatment. 

“The Novalis Tx is used to treat both malignant and benign conditions. In simplest terms, it produces radiation in the form of photons and electrons used in radiotherapy, which cause damage to the structure of a tumour cell which causes the tumour cells to die and for the tumour to shrink – and this can be seen in follow-up scans,” explains Dr Fröhling. “The Novalis Tx produces the radiation which then enters the patient from the outside and targets the tumour on the inside of the patient. The machine has technology to make its treatment as accurate as possible and has an array of imaging tools to ensure precision.” 

The machine is so smart, says Dr Fröhling, that it can take into account the patient’s breathing, so as to focus the radiation beam on the tumour only, while minimising the radiation dose to the normal tissues around the tumour. “These highly focused treatments are particularly useful for brain tumours, as well as those found in the lung, pancreas, spine and liver, where one has to be extremely careful not to damage surrounding tissues – and where surgery would be very difficult,” he says. Dr Fröhling adds that the machine is linked to sophisticated software to plan the treatment, assess the dose and positioning of the radiation in the patient and deliver the radiation with a high degree of accuracy. 

How does it compare to other cancer therapies?
Besides its acute precision to the millimetre, normal tissues are increasingly spared of radiation damage and this can therefore also lower the side effects of the treatments and the Novalis  TX shapes the radiation beam precisely to match the tumour or lesion. Conventional radiotherapy also usually takes place over an extended time frame of between two and six weeks, whereas Novalis Radiosurgery is much shorter and can be done in as little as one treatment in certain cases. “I do believe that the technology available to us with the Novalis Tx allows for highly accurate radiotherapy and, in the correct indication, this accuracy is clinically relevant,” says Quinton Africa, Lead Therapist at the Novalis Tx unit at Life Healthcare Vincent Pallotti Hospital, Cape Town. “Chemotherapy and surgery maintain a vital role in the successful treatment of many cancers and all available treatment options should be accessible to our patients to maximise their results. Radiotherapy on certain brain tumours may lower the extent or eliminate the need for surgery and so, decrease surgery-related death.” The cost of treatment with the Novalis Tx is more than conventional radiotherapy but with the correct motivation for the correct indication it is considered by most medical aids. Eligibility for radiosurgery depends on the type and location of the tumour and the extent of the patient’s disease and is determined on a case by case basis. 

Minimal side effects
Novalis Radiosurgery does not require anaesthesia and usually, there is no scarring and very little risk of infection when compared to conventional surgery, explains Mr Africa. “You might however experience a headache, dizziness and fatigue immediately after treatment, so it would be advisable to arrange for transport home after the treatment,” he says. 

Meet the team behind Novalis Tx Radiosurgery at Life Healthcare Vincent Pallotti Hospital
The specialised Oncology Centre at Life Healthcare Vincent Pallotti hospital embodies a multidisciplinary  team approach to cancer care – a distinction the unit is very proud of. Patients are treated by a team of oncologists,  radiotherapists,  medical physicists, nurses, surgeons, psychologists and other cancer specialists that work together for a truly multidisciplinary approach to cancer treatment in a modern, convenient and comfortable setting. One member of the treatment team,  radiotherapist,  Lesle Campbell, explains that it is her responsibility to deliver accurate treatment and ensure that patients are informed, happy and well cared for. “I respect the fact that I am helping patients at a very difficult time in their lives. I am able to listen, encourage and support as well as actively partake in helping them overcome cancer,” she says. “I also love that my job is technically challenging and that each day brings a new challenge. It is not an easy career path , but a rewarding one.” Another staff member,  radiotherapist, Jamie-Lee van Niekerk ensures that treatment given on the Novalis Tx is administered with minimal discomfort for patients. “It is amazing to see how technology has changed the landscape of cancer care,”  she  says. “It is a very fast-paced job that advances and changes all the time. This is part of why I love what I do.”  Radiotherapist, Lucinda Oosthuizen, also part of the team explains that a large part of her role is to listen to the stories of the families she sees. “We have to inform the families about treatment and the side effects – we really do build strong relationships with our patients,” she says. “The gratitude most patients display for the role we have played in their lives and their treatment journey and seeing their condition improve is rewarding and fruitful.”

<TEAM PHOTO WITH CAPTION DETAILING NAMES AND ROLES OF EACH TEAM MEMBER TO WORK ON THE NOVALIS TX – PIC TO COME ON MONDAY.>

<Sidebar> Novalis Tx equipment to be rolled out in Pietermaritzburg later this year
Hopelands Cancer Centre has the largest group of specialist oncologists in Kwazulu-Natal, caring for patients with cancer across the province. “After its successful launch in Cape Town, we are excited to be able to offer access to this unparalleled treatment equipment to our patients at what will be only the second Novalis Tx facility on the continent,” says Dr Ziad Seedat, Radiation and Clinical Oncologist at Hopelands Cancer Centre in Kwazulu-Natal. “Life Healthcare is currently assembling a talented and experienced team to operate the equipment and achieve the highest levels of service quality for patients. Our doctors have been training in Germany over the past three years to improve our skills and make maximum use of capabilities of the new equipment. In conjunction with our surgical colleagues, this facility will allow for curative therapy of tumours that cannot be completely removed safely.The speed and precision of this machine in targeting both malignant and benign tumours in intra- and extracranial locations is beyond compare.”
<Sidebar> Other treatable conditions with Novalis Radiosurgery
According to Dr Fröhling, the machine can be used to treat malignancies, benign tumours and some non-cancerous conditions, included in the list below. “We are finding new ways of using the technology to treat various conditions all the time, the sky is the limit,” he says. “The patients who entrust us with their care are our daily motivation. Working with a team of dedicated  radiotherapists, planners, a physicist and oncologists allows us to get the best out of our equipment for our patients.” Some of the conditions that can potentially be treated include;Malignant brain tumours ( metastasis from other cancers, primary brain tumours, tumours of the skull )Benign tumours of the brain and in the head and neck area ( meningiomas, acoustic schwannomas, pituitary adenomas),  Functional pain conditions ( trigeminal neuralgia)Blood vessel malformations ( arterio-venous malformations)tumours involving the occular structurestumours close to the spine where radiation dose to the nerves/ spinal cord needs to be minimisedMalignant tumours of the pancreasLiver tumours such as metastasis Lung tumours – primary lung cancers and metastasis 

Everybody’s talking about… Sitting

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Sit, stand or move? How can you overcome physical inactivity in your everyday life?  

Research shows that people who sit for eleven or more hours a day are 40% more likely to die over the next three years, whether they are physically active or not. Movement is a vital nutrient for health. Considering your levels of stress, increasing workload sitting at your desk and the amount of exercise you do, this can be a frightening statistic… so how can you avoid this risk? Charlene Yared-West speaks to the experts to find out more about how to sit less and live longer… 

Let’s start at the very beginning…

A sedentary lifestyle is rewarded and cultivated in our society from a very young age, explains Adele Pudney, physiotherapist from ADK Physio & Hydrotherapy (wellspringcentre.co.za). Babies are often overprotected and kept ‘safe’ to the extent that it lowers their natural and necessary exploration of the environment, she says. “The baby then grows into a child and at school is forced to sit for long hours behind a school desk. Now add to this poor alignment and ergonomics and these little bodies grow into the patterns that are adopted for extended periods, which don’t have good health outcomes.The World Health Organisation recommends at least 150 minutes of exercise a week, in the face of the statistic that adults typically spend 90% of their leisure time sitting down.” 

Sitting on your health problems

Obesity, high blood pressure, excess body fat, abnormal cholesterol levels, cardiovascular disease, type 2 diabetes, hypertension, cancer, non-alchoholic fatty-liver disease and even depression are some of the health problems which result from a sedentary lifestyle, says Mr Zeno Rossouw, physiotherapist based at Life Orthopaedic Hospital at Vincent Pallotti. “In my scope of practice I have seen clients who take for granted their access to information and education and have a lack of commitment to their overall health,” he says. He adds that people can only control that which is in their capability, such as ensuring a healthy diet, adequate exercise, not smoking and avoiding alcohol. Australian research shows that the average office worker only spends 73 minutes of their daily life walking – not sitting – and so in 73 minutes all their cooking, walking and any exercise they may get is done, adds Dr Greg Venning, author and chiropractor at Peak Chiropractic in Cape Town (capetownchiro.com). “We are genetically wired to love movement. It triggers the reward pathways deep in our brain and should make us want to move more, but modern sedentary living disconnects us from that primal joy. Movement of the body, especially the spine, acts like a windmill that generates stimulation and energy for the brain and every moment we spend sitting we’re robbed of that stimulation,” he says. 

Hit the pause button – and move!

A central problem is the structural damage that sitting causes that leads to nerve damage, organ dysfunction, muscle tightness, pain, fatigue and a whole host of problems, says Dr Venning. “Getting moving again will limit future damage and there will be some damage that your body cannot undo on it’s own. You can get a good idea of that damage by testing your relaxed posture,” he says. “If you slump, then there are problems that need assessed and addressed. Your body should hold you up effortlessly and you should not need to hold your body up.” Liesl Way, physiotherapist at Life Westville Hospital suggests these simple changes to interrupt long periods of sitting, which can make all the difference. 

  • Regular movement at your desk: Set an alarm every for 30 minutes as a reminder to pause and move for 2 to 5 minutes. This time should include marching on the spot, walking, stretching the neck, lower back, shoulders out of the slouch position (called reverse postures). While sitting, squeeze buttocks, pump ankles, march legs, bend straighten knees under the desks. 
  • Maintain a good posture: While sitting or standing, maintain good postural habits.
  • Regular daily exercise: 30 minutes, five times a week. 
  • Choose differently: Choose to take the stairs and not the lift, take a walk to a colleague’s desk instead of sending them an email, get up and walk to collect a file, instead of rolling your chair to fetch it. Have a walking meeting instead of a sitting one. Stand while reading. Park further away from the workplace to walk further. Have two work stations; one for sitting and one for standing and do different aspects of your job at these stations. 
  • Don’t be a couch potato: Instead of fast forwarding the TV ads, exercise while they are on!
<SIDEBAR>Before you sit down… rather stand, or better yet, try a treadmill desk!Standing workstations and treadmill desks have become more popular over the years. Experts agree that they have their benefits, but they also have their downsides. In everything, balance is key. “When using a standing workstation, blood can pool in the legs and put strain on the feet and legs, which can lead to plantar fasciitis and knee, hip and back problems. You will have to build up your standing tolerance slowly by listening to your body,” explains Adele. “If your body starts aching, change your position and make sure you wear comfortable, well supporting shoes, as high heels will not be kind to your feet.” Dr Venning suggests making a game out of it, which will encourage movement amongst employees. “Put penalties in place for every time you’re caught not standing for a phone call. Standing workstations are a great idea if they are managed well,” he says. Zeno points out that  treadmill desks could improve attention and memory after the user has stopped walking. “The constant slow pace will add to energy levels, soothing of joints and muscles thereby having a positive impact on the health of the employee,” he says. 

What the fitness experts want you to know…

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It’s time for me-time this month, and here’s some sound expert advice to help get you moving for better health and fitness.

Sometimes, becoming fit and healthy is easier said than done – and for many, seems like an insurmountable challenge in their life. According to the World Health Organization, obesity has more than doubled since 1980 and in 2014, more than 1.9-billion adults were overweight. One of the best ways to avoid becoming a statistic is prioritise your health and wellness, which encompasses better nutrition, more movement and improving your fitness levels. Charlene Yared-West speaks to the experts to find out more about what you should and shouldn’t be doing to get fit – and stay fit. 

Just move!

Movement can happen in the gym or it can be tickle fights, sex, a walk on the beach, playing sport and anything that gets you moving, explains Dr Greg Venning, author and chiropractor at Peak Chiropractic in Cape Town  (capetownchiro.com). “Fitness has at least ten different components to it and human beings do best when they have competence in each of these ten. They are; strength, speed, endurance, stamina, power, accuracy, mobility, co-ordination, balance and agility,” he says. “How each person archives these is going to be personalised, as there is no single path to fitness. Find the things you love and approach them playfully and practice them for mastery. That will accelerate your short-term results as well and give you long-term staying power.” Adele Pudney, physiotherapist from ADK Physio & Hydrotherapy (wellspringcentre.co.za) agrees. “You must learn to love yourself and the movement you’re doing to be successful in maintaining your exercise goals. Be kind to yourself and reward yourself for small improvements,” she says. “See it as a journey; there will be times of great enthusiasm and other moments of total disinterest – and have ways to cope with both ends of the spectrum.” 

Movement for health

“Quit exercise. Workouts suck. Practice and play with movement and rediscover the joy in it,” says Dr Venning. He recommends moving for at least five minutes a day, which, as you start to enjoy the movement, will expand over time. “You require three types of movement for health; move moderately everyday, move heavy things one to three times a week and move fast, one to two times a week. Avoid long, repetitive cardio workouts, they aren’t as good for you as you think,” says Dr Venning. Zeno Rossouw, physiotherapist based at Life Orthopaedic Hospital at Vincent Pallotti agrees and points out that 30 minutes of daily exercise can reduce both weight and BMI almost as much as a 60 minute workout. “Be time efficient and rethink the value of a warm up. It is crucial to prepare your muscles for the activity they are about to endure,” he says. “It also helps to choose an exercise that will keep your mind guessing, like cross training. Each new and different workout can target different muscle groups, which reduce the risk of injury, boost energy levels and keep boredom at bay.” Dr Venning adds that a short duration (less than 20 minutes) of high intensity intermittent training can help you to get all the benefits of cardio in a fraction of the time. “Avoid moving weights around if you can’t move your own body weight around well. Start small and do something you enjoy doing,” he says. 

Are there shortcuts to fitness freedom?

The experts concur: there is no easy way – and no shortcuts, but you can still have fun anyway!Liesl Way, physiotherapist at Life Westville Hospital says that consistency and discipline are key in the beginning of your path to fitness. “Start with simple activities that you enjoy and realise that fitness is built over time – and not overnight, so don’t binge exercise. Doing so will make you lose your motivation and possibly cause injury – and you will feel awful (physically and emotionally) if you exercise beyond your current fitness level,” she says. Exercise creates opportunity to meet new people, it leads to a sense of well being, can combat feelings of depression, increases energy levels, can reduce insomnia and can be a very enjoyable part of your day, adds Liesl. 

<SIDEBAR> What you should be avoiding on your journey to fitness?Having a cheat meal after a good workout.Procrastinating when to start your routine.Focusing on the end goal. It becomes overwhelming and prevents us from moving forward.Making excuses as to why you shouldn’t workout.Setting unrealistic goals and time frames.Continuing with an unhealthy diet. A balanced, healthy diet is important for joint and muscle health.Starving yourself in an attempt to speed up the weight loss.Ignoring the value of adequate rest and stretching before and after exercise.
<SIDEBAR> Top tips for getting fitStart small and make steady daily improvements.Use positive and realistic affirmations and pictures to motivate yourself.Take part in outdoor exercise … Fresh air, scenery like a trail run or mountainbiking can boost your energy levels.Tracking your activity is also a very useful exercise, whether it’s a fitness diary or a high-tech app on your smartphone.Grab a workout partner, but also someone that will challenge you and thereby increase how long and hard you workout.Enlisting the help of a personal trainer could help to motivate you. They can supervise and ensure that your technique is flawless preventing injuries and ensuring good results.Nutrition has a major role to play, as people have heard that the six pack is made in the kitchen and not at the gym. People should consider keeping a food diary to track how certain meals impact their performance.Sleep is also a vital aspect of a healthy balanced lifestyle. Ensuring that we have between 6-8 hours will also help boost our fitness levels. A post workout cool down can leave the individual with the notion that the workout wasn’t as tough as they originally expected. A better mindset for getting back to the gym the next day. Performing static stretches whereby a 20-30 second hold is best.Love yourself enough to take care of yourself.