16 October 2008

Don't worry, be happy

We spend a lot of time worrying needlessly about our health. The good news is that a lot of the scare stories shouldn't be keeping you awake at night.

We spend a lot of time worrying needlessly about our health. Yes, there are things you should be doing to maintain optimum health, but a lot of the scare stories shouldn't be keeping you awake at night writes Helen Grange of Femina magazine.

A worldwide phenomenon of the 21st century is that we are living longer than ever before. Most life-threatening diseases are under control due to the huge advances in medical science. And with the advent of the internet, supplements and self-test kits, we've never had so much knowledge and power at our disposal.

Yet worrying is a condition that's on the rise. Shelton Kartun, director of the Anger & Stress Management Centre of SA, says South Africans – particularly those living in Gauteng – are suffering extraordinary stress due to crime, the increased cost of living, debt, high performance expectations, raising children and traffic congestion.

'South Africans are worried about the safety of their families and the future of their children. We are not only anxious about savage and petty crime, but are becoming increasingly fed up with corruption, lack of service delivery and rising costs,' he says.

Add to this our myriad health worries. But we're prone to blowing things out of proportion here. Aids and tuberculosis are by far the main killer diseases in South Africa but many of us tend to worry more about diseases such as cancer and contracting a disfiguring hospital infection.

Headline-grabbing illnesses such as drug-resistant tuberculosis further distract us from what we should really be paying more attention to; diseases that the Medical Research Council (MRC) label 'chronic diseases of lifestyle'. In their latest report, MRC researchers say chronic diseases (heart disease, diabetes, etc.) have been steadily increasing due to unhealthy lifestyles.

Veteran doctor Professor Harry Seftel puts it in his inimitable way: 'We need to be looking at the epidemic called sloth! Conditions such as obesity, diabetes and high blood pressure are all the products of this disease,' he says.

The urbanised black community is particularly vulnerable, he says, because they are exposed to the endemic diseases of underdevelopment, such as gastric enteritis, TB and pneumonia as well as these 'Western diseases of lifestyle'.

Stop worrying
To begin with, we need to stop worrying. Stress is a major contributor to coronary heart disease, as well as high blood pressure, alcoholism, overeating and a host of anxiety and mood disorders.

Remember that your emotions are inextricably linked to stress, so fretting about what might happen tomorrow will cause you anxiety but won't sort the problem out. The trick to beating stress lies in balancing your life and correcting bad lifestyle habits, says Kartun.

'Stop procrastinating. Plan your life better, eat healthier, cut down on coffee, alcohol and cigarettes, take up yoga or walking. Learn when and how to relax. See a stress counsellor if necessary. Keep reminding yourself that worrying achieves nothing and remember that there are always two ways of looking at things. The positive way is usually healthier and less stressful,' he says.

How to decipher scary headines
Newspapers tend to feature scary health stories that raise our anxiety levels, but the reality is that these diseases affect only a small percentage of our population.

Avian flu
Ordinary flu and respiratory illnesses are more threatening to our health than avian flu, the incidence of which is highest in Asia. It has been seen in other countries, including South Africa, but to date cases in this part of the world have been rare. The concern is that the strain of bird-flu virus known as H5N1, which is highly contagious and fatal in birds, will mutate into a human strain, which would make person-to-person transmission possible and trigger a human flu pandemic. For now, the chances of getting it are slim.

MRSA (methicillin-resistant staphylococcus aureus) bacteria
You've seen the alarming headlines about hospital 'superbugs', which are justifiably a cause of major concern to governments and health services all over the world. MRSA infections can range from boils to more severe infections of the bloodstream, lungs and other internal organs. It can cause life-threatening and disfiguring infections that can often only be treated with expensive, intravenous antibiotics.

Experts have been saying for years that poor hospital practices spread dangerous bacteria and many studies have shown that health-care workers, including doctors and nurses, often fail to wash their hands, which contributes to the spread of MRSA. The overuse of antibiotics is another factor that has been identified as a possible cause of its rapid spread.

According to Professor Robert Wilkinson, a professor of infectious diseases at Imperial College in London and an honorary associate professor at UCT, micro-organisms that are resistant to antibiotics are on the rise everywhere, but are 'very patchily documented' in South Africa.

Of greatest concern in this part of the world is multi-drug-resistant (MDR) and extreme-drug-resistant (XDR) TB, which Prof Wilkinson says often occurs because patients do not complete their course of treatment for TB.

He adds that about one percent of South Africa's population will contract TB every year, and in about 50 percent of these cases, patients will be HIV positive.

Drug-resistant TB
Multi-drug-resistant (MDR) and extreme-drug-resistant (XDR) TB hit the headlines last year when Cape Town's Brooklyn Chest Hospital legally prevented four patients afflicted with the disease from leaving the hospital.

Since then, conflicts continue to flare up over patients being 'locked up' for the duration of their treatment, while doctors and government officials scratch their heads over how to stop the spread of XDR-TB by these patients without denying them their individual freedom.

The initial outbreak of XDR-TB took place in the Tugela Ferry region of KwaZulu-Natal, where eight medical staff and more than 250 patients died in one hospital over three years. Patients not adhering to their drug regimens has been largely blamed, and cases continue to trickle into hospitals there every week.

Computer statistics show that this devastating trend seems set to continue unless steps are taken to prevent more infections.

Prof Wilkinson says XDR-TB now exists in every province in South Africa and is most prevalent among patients who are HIV-positive. 'This is a wake-up call. More effective TB controls need to be imposed in Southern Africa as a matter of urgency,' he says.

Wi-Fi and cellphone radiation
Research continues into the effects of cellphones on the human brain, but any dangers have yet to be proved, notwithstanding Australian neurosurgeon Dr Vini Khurana's latest study conclusion that there is a link between cellphone usage and certain brain tumours. As for Wi-Fi, the World Health Organisation has concluded that there are 'no adverse health effects from low-level, long-term Wi-Fi exposure'.

For now, the benefits seem to outweigh the potential risks. Think of the stress you're avoiding by being able to call your friend when you can't find her at your designated meeting spot, or how many medical emergencies have been timeously attended to due to the presence of cellphone technology.

Last year there were eight reported human deaths due to rabies infections in KwaZulu-Natal, where the disease is most prevalent. This year, four people have died from contracting rabies.

Rabies experts and veterinary doctors say the disease is on the increase; last year vets in KwaZulu-Natal had to put down 463 animals (mainly dogs and cats) that were suffering from rabies, the highest number of recorded cases in the province's history – but the Department of Health is of the opinion that the prevalence of this disease can't be labelled an 'outbreak'.

What you should be worrying about…
The rules of a healthier life are by now clichéd: a balanced, nutritious diet; exercise; not smoking; and drinking alcohol in moderation are key to keeping your body and mind in shape.

Follow these guidelines to reduce your risk of heart disease, stroke, cancer and diabetes, which can all lead to an early grave.

At the same time, watch out for anything that is persistent and attend to it, such as lumps in your breasts. Other things to keep an eye on are moles that change shape or colour, noticeable weight loss or gain, aches and pains that aren't accounted for and that hang around, a change in thirst or appetite, changes in bladder habits and an onset of breathlessness or chest pain.

Aids kills between 900 and 1 000 people a day in South Africa, and a striking proportion of this statistic is made up of young adult women, according to the MRC's Chronic Diseases of Lifestyle report. Close to eight million African women are HIV positive, compared with 10 million women worldwide. Women are more vulnerable to Aids because of their biological make-up, and even more so in African communities because of social and economic inequalities.

Being in a relationship or married offers no protection: 80% of new HIV infections in women worldwide occur in marriages or long-term relationships with primary partners. The answer to its spread is well-known – condomise or, if a relationship is sound, go for testing before taking the plunge.

A whopping 90% of the million annual malaria deaths in the world are recorded in Africa south of the Sahara. About 300 million clinical cases of malaria occur annually: that is five times as many as combined cases of TB, Aids, measles and leprosy. Malaria kills more than three African babies every minute and, even worse, the drug chloroquine is losing its effectiveness against the disease. In some parts of Africa malaria is resistant to the four leading front-line drugs.

Malaria quickly rebounded after the mass insecticide-spraying campaigns of the 1950s and 1960s and today malaria-endemic areas include South Africa's Kruger National Park, Mpumalanga, Limpopo and northern KwaZulu-Natal, though it is far more virulent in countries north of us, such as Mozambique, Angola, Kenya (near its coast), the Democratic Republic of Congo and Malawi.

Your weight
The Medical Research Council reports that 29% of men and 56% of women in South Africa are overweight or obese. Perhaps the most alarming fact is that 17% of children under the age of nine are overweight and studies show that they are highly likely to become overweight adults.

Obesity can lead to dozens of health problems, including some forms of cancer, diabetes, coronary heart disease, hypertension, osteoarthritis and psychological trauma.

The simple truth is that bad habits – way too much of the wrong types of foods and not enough sweat – are killing us.

Pay attention to your waist measurement as well as your body mass index. A waist measurement of over 81cm means you're at a higher risk of health problems.

Your gynae health
Despite campaigns such as Lovelife, sexually transmitted infections (STIs) such as chlamydia, all of which enjoy a deadly alliance with Aids, are continually on the rise in South Africa. Early treatment is essential to prevent complications, which include sterility. Look out for symptoms such as an unusual discharge, bleeding and pain during sex. Go for a Pap smear every year and if you're single, never have intercourse without using a condom.

Your periods
Noticeable changes in your periods – if they stop, get heavier or become highly irregular – should be checked. Don't panic. Serious gynaecological problems are rare, but the sooner they're detected the sooner they can be sorted.

Your heart
About 130 heart attacks and 240 strokes occur daily, according to the Heart and Stroke Foundation of Southern Africa. And take note, smoking doubles your risk of having a stroke and increases your risk of a heart attack by two to three times. Sensible lifestyle habits are essential to staving off ticker troubles, including maintaining your ideal body weight, exercising and drinking alcohol in moderation.

Your bowel and bladder habits
An estimated that one in four South Africans will develop cancer in their lifetime, and the third most common cancer in women is colorectal cancer. Women have a one in 131 lifetime risk of developing it, according to CANSA. But it's very treatable in the early stages. If you notice bleeding or changes in your bowel habits, see a doctor immediately. The same applies to your bladder. Blood in your urine might indicate a kidney disorder and excessive urination can be an indicator of diabetes.

Your moles
Skin cancer in South Africa mainly affects lighter-skinned people whose skin isn't geared to harsh sunlight. Melanoma is one of the most prevalent cancers in this sector of the population, along with breast and cervical cancer. Slather on that sunscreen and be vigilant about any changes to moles.

Your breasts and cervix
Every year 5 600 new cases of breast cancer are diagnosed in South Africa. At a one in 27 lifetime risk, it is the number one cancer that affects women. Cervical cancer is the second most common, with a lifetime risk of one in 31. Early detection is imperative to beat them both. Get to know your breasts and check for lumps regularly. And don't miss out on your routine Pap smears.

(This is an edited extract of a feature that appeared in Femina magazine, September 2008 issue. For more fascinating features like this, see the current issue of Femina, on sale now.)


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