Helping a friend through illness

What to say when your BFF is seriously ill

“I’m so sorry you’re sick: I want you to know that I will never try to sell you some random treatment I read about on the internet.”

When Emily McDowell had cancer, she was amazed by the ridiculous things people said to her. Now in remission, she is designing her own range of ‘get well’ cards. The above is a quote from one of these.

When people are ill with what seems to be an incurable illness, they don’t know how to respond and what to say. I know this because I was diagnosed with Lupus 12 years ago, and for the first couple of months, I walked around in a dwaal. I opened my medical books and read frantically. While some gave the impression that this wasn’t really serious and could be easily managed with medication and life-style changes, others gave a prognosis of doom and gloom, inevitable complications and imminent death. I put my medical books aside and ignored Dr Google.

Over the years, I’ve learned to keep my mouth shut and my feelings under my hat when I’m in the public eye. This because, as Emily discovered, people say such ridiculous things!

Either they’re fundi’s who know all about your illness, then go on to tell you all the gory details about somebody they knew who suffered for years. Thanks. Or they’re promoting some amazing product that healed their best-friends-brother-in-law and you-would-be-a-fool-not-to-try-it. Some people even give you a run-down of what you should and shouldn’t be doing and contradict the treatment you’re getting from a qualified specialist at the hospital. The best is when people tell you to do something about your religion and how to pep-up your spiritual life and believe (that you will get better) – because quite clearly you don’t!

You also get people who cross-question you like you’re at an inquisition. How do you feel and what did the doctor say and how did this happen and will they get it? Oh boy! It just makes you want to run away!

Your best friend has phoned to tell you she has been diagnosed with breast cancer.

• Keep quiet and let her talk
• Make a lunch-date
• Offer to go to the hospital with her
• Buy her bubble-bath
• Offer to look after her children so she can go to the hairdresser
• Bake her a batch of biscuits
• Offer to help with the shopping or go shopping together
• Make her a meal
• Make her laugh
• Go to a movie or babysit so she can go on a date with her man
• Send her short, encouraging SMS messages
• Be there for her.

Don’t avoid your BFF because you don’t know what to say. Don’t pretend that the diagnosis doesn’t exist  – talk about it. Don’t tell her about somebody who recovered miraculously and how amazing they were and never complained. Don’t offer to take her to church – let this be something she does on her own when she’s ready.

What I learned was that the most unexpected people came out of the woods and were there for me when I needed them. People that I had been working closely with for years dropped me like a piece of hot shit. To them, I had become useless and redundant. They no longer needed me. Not one word of caring or sympathy. Amazing. Please don’t make this mistake. It hurts.

Serious illness can bring out the best or the worst in people. Luckily, I found a whole new bunch of friends, I discovered another way of helping to support our family financially by writing and using my gift of music and handcrafts. My hospital visits are an education and I meet the most amazing people – many of whom are a lot worse off than I am, yet they don’t blame God (or their parents) for doing this to them!

So, pick up the phone and speak to the friend you have been avoiding because you don’t know what to say to him/her. Quote Emily if you like. 

Talking to your daughter about her first period

When your daughter has her first period

Can you remember your first period? How many women, I wonder, remember this day as special? It certainly wasn’t for me – my mother gave me a packet of pads and that was it! After that, I kept my period secret. Especially at school (and I went to an all-girls school!). Periods were called ‘the curse’ or ‘that time of the month’ (I think they still are). I never understood them and couldn’t cope with the pain, the mess and the inconvenience. Mostly I felt ashamed. My skin broke-out in blotches and pimples, I felt wet, smelly and uncomfortable. I was irritable and lost all self-confidence at ‘that’ time of the month.

This changed when I studied to be a midwife. For the first time I learned about something called ovulation and its link with menstruation. I learned to understand periods and how to cope with them. I could buy my own pads. I started using tampons.

Now that your little girl is starting to show signs of puberty – attitude, growth-spurts, sprouting hair and developing breasts – it’s only fair to psyche yourself (and her) up for ‘the talk’! Remember, she’s not interested in the wherewithal about sex and or having a lecture about what not to do. She’s a millennial remember, so she’s only interested in herself: what’s going to happen to her and what she can do about it.

Periods start about two years after the first signs of puberty. The first symptoms of a period are vaginal changes and ‘panty-wetness’. Girls will notice white patches that may become mucousy, and change from brown to pink before her period starts. Learning to recognise these subtle hints and body changes will teach your daughter to understand her body and uniqueness as a woman. It will help her as she grows older because she will learn confidence when she feels in control of her body – especially when it comes to contraceptive choices, pregnancy and birth, breastfeeding and finally, menopause.

At this early stage, don’t worry about talking about sperm and boys etc – unless, of course, she asks. Tell her about her eggs – called ova – and show her a picture of the ovaries where they have been waiting since she before she was born. Not many women realise this and that their eggs age, just like they do. By the time a woman is 30, her eggs are getting ‘old’! Women also don’t realise that it’s the egg that dominates her menstrual cycle and controls her hormones – mostly oestrogen during the first half of the cycle (just after a period), and progesterone during the second half of her cycle, after ovulation, which is about two weeks before her next period starts.

Explain to your daughter that periods come in cycles – that are, on average, about 28 days – which is a few days short of a month. This means that she shouldn’t expect her period to start on the same date every month. A cycle is calculated from the first day of one period to the first day of the next period and it’s normal for dates to vary. When a cycle is shorter, her period will start earlier and if her cycle is longer, her period will start later. It’s as simple as that.

A little more about ovulation. A period starts about two weeks after ovulation. If your daughter ovulates earlier, her cycle will be shorter – and her period will start sooner than she expected. When ovulation is delayed (and this can be up to three months in the first two years of having periods) she may think that she has ‘skipped’ a period – but the reality is she is having a very l-o-n-g cycle. During the first two years of periods, cycles will vary from short to long, from heavy to light, sometimes even with ‘spotting’ in-between. Your daughter needs to know this so that she doesn’t stress that there is something wrong with her. Please don’t put your daughter on the contraceptive pill to ‘regulate’ her periods. Give her body, hormones, life-style, diet and health a chance to sort this out naturally. Interfering by introducing synthetic hormones at this early stage may cause more complications than solutions.

For more information about periods, ovulation and cycles, go to the kotex website: www.kotex.co.za or link with Kotex on the side pannel. 

     

Babies and children / winter ailments

Coughs, colds and flu in babies and children

Here in the southern hemisphere, Easter is more about autumn leaves, avocado-pears and oranges than daffodils, bunnies and chickens. While the northern hemisphere celebrates the coming of warmer days and longer nights, we’re taking out our winter woollies and putting the duvets back onto our beds.

Winter is also the season of flu, coughs and colds. It takes just one person infected with a virus to unwittingly spread it to family, friends, colleagues and just about everyone he comes into contact with. The elderly, pregnant women, people with poor resistance, children and babies are particularly vulnerable. This week’s blog is about vulnerable children and babies and respiratory tract infections.

The nose, mouth and throat are the first line of defence when it comes to fighting microbes. Microscopic tuberculosis spores, fungi, viruses, bacteria and parasites are everywhere – in the air we breathe, on surfaces we touch and the people we mix with. The fine hairs inside the nose filter the biggest of these. When they’re particularly irritating, they make us sneeze. The mucous lining of the mouth, nose and throat is our second line of defence. This moist, slippery surface contains a fluid that is able to protect the body from invading micro-organisms.

When a virus or bacteria manage to bypass these defences, babies and children can come down with an upper or lower respiratory tract infection.

An upper respiratory tract infection begins with rhinitis, or runny nose caused by a virus. This infection can spread up the nose into the sinuses causing sinusitis. A middle ear infection can be bacterial or viral and is mostly spread from the nose and through the eustachian tube (this connects the middle ear to the top of the nose called the nasopharynx) to the middle ear. Tonsillitis and pharyngitis are bacterial upper respiratory tract infections.

Lower respiratory tract infections spread downwards into the chest and are mostly viral. These begin with laryngotracheal-bronchitis and tracheobronchitis that can become bronchitis.

The greatest concern about these infections is that upper respiratory tract infections in very small babies and young children can spread to the brain and become meningitis or encephalitis. In severe cases this can cause life-long complications. Severe lower respiratory tract infections can become pneumonia.

What to look out for when your baby/child is sick:

• Before your baby/child shows typical symptoms, they will be just plain miserable and clingy, reluctant to play and eat.
• They may look flushed or very pale with a temperature of 38°C or more
• Your baby/child may be thirsty but not hungry. If they’re coughing and are very ‘mucousy’ they may vomit their feeds
• Because they’re drinking less, babies will wet fewer nappies. Children will use the toilet less often. This is a sign of dehydration.
• A baby’s cry will tell you that s/he is not well. It becomes a whimper rather than a loud lusty cry
• Lack of feeding and a fever will make your baby/child listless, limp and lethargic
• Coughing may get worse. If your baby/child has an ear infection, s/he will rub the infected ear
• Some infections cause a rash.

 These symptoms are good reason to take your baby/child to the doctor, especially if they are becoming dehydrated.

What should you do when your child is ill:

Take him/her to the doctor. An antibiotic will only be prescribed if the infection is bacterial. Viral infections cannot be cured with an antibiotic.

• Make sure you give your child the correct dose of medicine at the right time and at the intervals that they’ve been prescribed
• Treat the symptoms i.e. give your child medicine for a fever regularly. While the fever persists, give your baby/child a tepid (not cold) bath and keep him/her very lightly dressed. Give them rehydrate in small doses very often until they can tolerate liquids. Give them easy-to-swallow and digest food like jelly and soup.
• Leave them to sleep undisturbed while their body heals
• Nebulising and physiotherapy helps with lower respiratory tract infections

If the symptoms persist, or get worse, please take your baby/child back to the doctor.

Luckily, babies and small children are exceptionally resilient and recover remarkably quickly. Keep them healthy this winter with lots of vitamin C – found in just about every fruit available. Keep them warmly dressed (especially in the early morning and late evening when they are being fetched from crèche or nursery school), and if they’re picky-eaters, give them a good multivitamin (ask your pharmacist to recommend a brand with a combination of vitamins and minerals made specially for children).    

How to avoid listeriosis food poisoning

Listeriosis and pregnancy

There has been a Listeriosis bacterial food-poisoning outbreak in South Africa recently (more especially in Gauteng where I live). This has highlighted the need for vigilant quality control by health inspectors (the outbreak began in two cold-meat and hot-dog sausage factories), scrupulous cleanliness where food is processed and in supermarket delicatessens, alertness by the public (especially those who are immune-compromised) and kitchen hygiene.

I contacted a doctor, dietitian, laboratory and NICD (National Institute for Communicable Diseases) for more information.  This is what I learned.

NICD:  

Unlike most germs, Listeria bacteria grow and spread in cold temperatures – including cold storage and your fridge. Bacteria can spread inside and outside food packaging and contaminate other food in the fridge and kitchen surfaces.

People are advised to:

• Keep kitchens, fridges and working surfaces scrupulously clean. Wash your hands before working with food. Wash fruit and veggies. Scrub chopping boards after use. Soak dishcloths and kitchen towels in bleach (e.g. Jik)
• Keep the fridge temperature below 4°C and the freezer at -18°C

The more bacteria are allowed to multiply, the more people will get sick. During the Listeriosis outbreak, people were advised not to eat processed meat products and ready-to-eat meats. Retailers were instructed to thoroughly clean shelves, fridges and all surfaces where polony and ready-to-eat meat was stored. It is essential that meat slicing equipment is dissembled, washed and disinfected daily.

Doctor:

Bacteria, viruses, fungi and parasites are everywhere – all the time. It’s important to pay attention to hygiene at all times – but especially when people are immune-compromised, pregnant and when there is an infectious outbreak.

Symptoms of food poisoning:

• Flu-like symptoms, such as fever, headache, and body ache
• Vomiting, diarrhoea, and abdominal pain

Pregnant women are particularly vulnerable because, even though she may have only have mild, flu-like symptoms (or may not feel sick at all), listeriosis (at any stage of her pregnancy) can lead to miscarriage, stillborn, low-birth weight and health problems for her new-born.

Dietitian:

Pregnant women should always be cautious about eating ready-to-eat refrigerated foods, unpasteurized milk, and foods made with unpasteurized milk. They should also avaoid soft cheeses (such as feta, brie, camembert, blue-veined cheeses, "queso blanco," "queso fresco" or Panela), unless they are made with pasteurized milk, sushi and raw meat.

Top tips:

• Wrap or cover foods with a sheet of plastic wrap or foil, put foods in plastic bags or clean covered containers before putting them in the fridge. Check that foods do not leak juices onto other foods.
• Use precooked and ready-to-eat foods as soon as possible. The longer they are stored, the more Listeria has a chance to grow.
• Keep meat, poultry, seafood, and eggs separate from other foodstuffs while shopping and in the fridge.
• Only eat freshly cooked food. Reheat hot dogs and lunch meats until steaming hot.

Laboratory:

Testing for Listeriosis:

It’s unnecessary to screen healthy people for Listeriosis. Gastritis is short-lived and for people who have not eaten contaminated food – but have food poisoning from another source – laboratory testing and antibiotics are unnecessary. However, testing should be done when people are immunocompromised (HIV, cancer and cancer treatments, lupus, liver and kidney disease) pregnant women, babies younger than six weeks and people older than 65 who have eaten contaminated food. Stool cultures may be negative because the test is not sufficiently sensitive to detect the bacterium, and blood tests are not sensitive enough either so they should not be done. For women who have given birth, the placenta can be sent for culture.

 (Information supplied by Ampath Laboratories)