Inflammation, Covid-19 and your health

 

Inflammation and your health

Professor Graeme Meintjes, who works at Khayelitsha and Groote Schuur hospitals has warned South Africans of a third Covid wave ‘in the near future’.       

This means that it’s not the time to get complacent about Covid-19. The health-care system may be gearing up for an increase in the number of patients, but we do our best to get or stay healthy.

Covid-19 is a respiratory disease – and causes pneumonia. In a nutshell, this virus causes inflammation of the respiratory tract that includes the nose, throat, bronchi and lungs. From there the virus attacks the rest of the body.

Let’s understand a bit more about inflammation.

Inflammation helps the body to fight infections and speeds-up healing. Extra blood is pumped to areas affected by toxins, infections or injury. Extra blood to the area of inflammation means a boost of extra oxygen and white blood cells – known as leucocytes or the body’s infection control. A bit like ambulances and other rescue vehicles that rush to the scene of an accident.  Superficial inflammation caused by say a thorn or splinter is easily identified because this area becomes red, feels hot and throbs. Internal (also called systemic inflammation) is not so easy to recognise.

In response to inflammation, the body makes antibodies. These help to prevent re-infection. Sometimes it happens that the immune system gets confused between "self" and "non-self" antibodies, and this can lead to autoimmune disorders like Rheumatoid arthritis, Lupus, IBS (Irritable Bowel Disease), Multiple sclerosis (MS) Type 1 diabetes, Psoriasis and others. Some people who have recovered from Covid-19 has been left with autoimmune symptoms.  

Typical signs of systemic inflammation are body aches, muscle weakness, fatigue, and memory loss. There are also more serious symptoms like dizziness and insulin resistance, IBS (Irritable Bowel Syndrome), lower backache, and an increased risk of a heart attack or a stroke. 

What can you do to minimise Covid-19 risks?

-    Keep-up with precautions – wearing a mask, social distancing, and hand washing. The effectiveness and pros and cons of wearing a mask is a blog on its own. But let’s just say it reminds you to keep your hands away from your face.

-    Make sure you get a good night’s sleep – preferably without the help of sleeping tablets

-    Fresh air and exercise: try walking for at least 40 minutes every day – 20 of these bare-foot on the soft grass. Walking barefoot on the grass, sand, sea-shore or smooth pebbles are nature’s ‘reflexology’ that reconnects you to the earth

-    Daily yoga and meditation

-    Revisit your spice-rack. Turmeric, rosemary, cinnamon, cumin and ginger have wonderful healing benefits

-    Grow herbs in your garden

-    Eat more fruits, vegetables, chopped nuts, beans and fish

-    Green leafy veggies contain antioxidants that help to minimise inflammation

-    Lose that extra weight you’ve been carrying around with you for way too long now. Obesity increases your risk of other health problems

-    There’s a good reason why you should stop smoking, and minimise your alcohol intake.

 

Baby's survival immediately after birth

 

Babies are smart!

The first ‘magic hour’ after birth

 

I only need to look at my grandchildren to marvel how true this is. I studied paediatrics to learn about developmental milestones, yet, they (like babies all over the world) know, exactly what to do, when and how - without opening a book!   

 

Newborns are programmed to survive. They’re little ‘toughies’ and yes, there may be times when they need a bit of help, but generally speaking, just about all babies manage to get through the first critical hour after birth on their own.

 

More and more, doctors and midwives are learning the value of not interfering, and giving newborn’s the chance to recover from birth and adapt to living in the air on their own. Just like baby turtles paddling their way down the beach towards the sea, a newborn’s first mission is to ‘crawl’ over the contours of mom’s body to find their way to her nipple where they’re rewarded with their first suckle at the breast.

 

Why is this so important and how can it be achieved?

 

It’s not that babies have to eat as soon as they are born. On the contrary. They simply suckle at the breast to connect with mom, absorb microbiomes (good bacteria) from her skin and find comfort hearing her heartbeat.

 

In the first hour after birth, the baby is adapting from living like a little fish in the water to living on land and breathing oxygen. It took land-creatures millions of years to learn how to do this – newborn’s do it in the first few minutes after birth!

 

Breathing is their first step to independence. After this comes suckling – not only for nourishment, but also to self-soothe. Remember that when we were primitive babies, we were at risk from predators, and incessant crying could attract unwanted attention. * Babies need to find comfort from their mothers to overcome the shock of birth, to be reassured by her beating heart, and nourished by precious colostrum – baby’s first food.

 

During the first hour after birth, mom and baby are at their peak of ‘alertness’. The baby, once patted dry, is covered with a cloth, and left naked, skin-to-skin on mom’s flattened tummy where s/he is free to ‘crawl’ toward the target – her nipple – that's been darkened by pregnancy.

 

Babies are instinctively drawn to mom’s left breast where her heartbeat is strongest. This very first ‘tummy-time’, reconnects mom and baby like a magnet. Mom’s sense of relief and elation now that her ordeal is over, pumps up hormones like endorphins (happiness) dopamine (motivation), and oxytocin (the love hormone) that, in turn, help her to adjust over the next few critical days to her new role as mom. A glut of these hormones also helps to minimise ‘baby blues.’

 

We would be blown away if we could zoom onto the surface of mom’s skin to see what’s happening. Thanks to research, the microbiome (good bacteria) and its benefits are in the spotlight. These ‘healthy’ micro bacteria are passed from mom to baby during the birth, skin-to-skin contact, and breastfeeding. When the baby swallows these microbiomes, they’re colonised in the baby’s gut, helping the baby to digest milk and initiating immunity. It's nothing short of a miracle.

 

We’ve learned that babies don’t need to be taught how to breastfeed. All they need is time and patience and ‘hands-off’ from doctors and midwives. Left alone, the baby’s senses (sight, sound, smell, touch and taste) along with the sucking and rooting reflexes help to jumpstart breastfeeding.

* More about this in my next blog.

A treat for the weekend.

 

Quick apple pudding/cake

If you want something tasty and different, here’s a quick and easy apple recipe that can be served with cream, ice cream, custard, or on its own.

You need about 6 apples (or a tin of apples), 1½ tsp cinnamon, and about 2 tablespoons brown sugar. While the apples are cooking, grease a dish (15 X 20 cms) then add the cooked apples and sprinkle them with cinnamon and brown sugar.

   

Next, mix ½ cup sugar with 1 egg till its light in colour and creamy. Add 1 cup flour, 1 tsp baking powder, ½ cup milk, 2tsp cooking oil and 1 tsp essence (I used almond – gave the mixture a lovely nutty flavour). Mix it all up, pop into the oven (180°C) for about 30 mins. Decorate with a few raisins. Serve and enjoy the compliments.

     

Baby Jaundice, what is it and can it be prevented?

 

Why is my baby yellow?

Mother and author, Martha Beck writes in her book, ‘Expecting Adam’ * “There has been the second phase of my education, the one that followed all those years of school. In it, I have had to unlearn virtually everything Harvard taught me.”

In many ways, I feel the same way about my midwifery training. I’ve had to ‘unlearn’ so much I was taught. Baby jaundice – also known as new-born or physiological jaundice – is one example.

I left nursing college practically expecting every new-born to become jaundiced (yellow) after the first 24 hours of birth. This is because when red blood cells are broken down (new-borns have too many of these), the iron is stored to make new red blood cells (in about 100 days’ time). The yellow-coloured waste is called bilirubin and sent to the skin. This gives a baby that tanned, yellowish look. The skin is the biggest organ in the body, and sunlight helps to break-down the bilirubin so that they can be eliminated by the bowel and bladder.

How does nature deal with this problem?

Colostrum or baby’s first milk (read more about this in my previous blog) is a natural laxative that helps to empty the bowel of baby’s first poo called meconium. Meconium is a thick, gooey, sticky mucous so dark green it’s practically black. A tip here for new moms is to smear Vaseline from the nape of your baby’s neck, down his back and all over his little bottom in preparation for this. The Vaseline helps to stop the meconium from sticking. If this happens, it takes quite some scrubbing to clean it off.

It makes sense then that the more often a baby feeds, the more colostrum there is available in the bowel to act as a laxative. I’m talking about two-hourly feeds for the first 24-hours. These are quick ‘top-up’ feeds that shouldn’t take more than five minutes at each breast. Freebies for doing this includes bundles of bonding and stimulating important breastfeeding hormones like oxytocin and prolactin. The new-born also learns to latch onto the nipple while the breast is soft and Mom gets used to the sensation of being suctioned.

How do you know that bilirubin levels are going down?

Firstly, the baby’s skin colour improves. Then there’s baby’s changing poo – from black meconium, to green slimy poop that changes to dark mustard yellow to Colemans Yellow Mustard that’s slightly frothy. After about five to 10 days your baby will produce normal, yellowish-brownish sweet-smelling breastmilk poop. Voila!

What did we go wrong ‘back in the day’?

1.       It wasn’t standard to put baby skin-to-skin with Mom during the first ‘magic hour’ after birth**

2.       Babies were whipped out of the delivery room.  A lucky few moms were given the chance to have a brief squiz of their new-borns, but dads were allowed in the labour room. I squirm to recall that the babies were put into an incubator to 'warm-up' where they cried their little hearts out, believing they've been abandoned. Its no wonder that psychiatrists today are raking in the bucks – but that’s another topic and another blog.

3.       Then, (I kid you not) babies were given their first drink of sterile water (about 20 mls) from a bottle! Yip!

4.       While mothers were in hospital (five days for normal deliveries and 10 days for c/sections) babies were trained (I blush just writing about it) to feed four-hourly. This was to make life convenient for the nursing staff, and ‘easier’ on the new mother when she went home

5.       During the night it was deemed essential that new mothers were left to sleep, and ALL babies were swept into the nursery and bottle-fed by nurse assistants or student nurses.

Sadly, some older-generation midwives still swear by these methods and impose them whenever they can.

What can you do to avoid baby-jaundice?

1.       Learn as much as you can about breastfeeding while you’re pregnant. The breastfeeding “Bible” I recommend (published by the breastfeeding support group called La Leche League International) is called “The Womanly Art of Breastfeeding”. The title sounds horribly old fashioned, but believe me, it’s regularly updated and is very interesting reading – besides being a useful reference

2.       Find out about a lactation consultant in your area, phone her and introduce yourself

3.       Learn about breastfeeding support groups in your area. You could even go to one of their meetings if you have the privilege of maternity leave before you give birth

4.       Speak to your doctor / midwife / about breastfeeding – especially when you go on your ‘hospital tour’

5.       Some women insist on “No Bottle / No Water” instructions attached to their baby’s bassinette and 24-hour ‘rooming in’

6.       Put your baby to the breast as soon after birth as possible, insisting on skin-to-skin – providing there are no medical complications

7.       Breast-feed as often as possible – especially during the first 24 hours while colostrum is still available. This will also guard against hypoglycaemia

8.       Luckily, most mothers go home (all being well) on their second or third day (after a c-section). During Covid this may be as soon as a few hours after birth. If this is the case, make sure that you have dependable home-care e.g. an experienced mom (mom-in-law), friend or if necessary, a midwife in private-practice who is prepared to come to your home.   

 *  Judy Paitkus publishers 2000. Highly recommended especially if you are expecting a ‘different’ child.    

** More about this in my next blog

 

Covid in 2021

Coping with Covid in 2021

We survived the first wave of Covid-19 in 2020. For the last two weeks, I’ve sat perched like a cat on the windowsill, simply watching the world go by, recollecting my thoughts, reading and crocheting yet another blanket and trying to build up the courage to jump back into the living room and re-connect with the ‘real’ world.

I told my grown-up kids: “Brace yourselves. 2020 was a practice run. 2021 is the real deal.”

Here’s why.

Since the day we heard rumours about this nasty virus that jumped species in Wuhan in November, 2019, we have been inundated with conflicting information that’s kept us glued to our TV sets and rooted to our couches where we consumed mountains of potato chips and grew enormously fat and lazy. Well … maybe not everybody did this.

While it all seems so unfair, we have no choice but to come to terms with the situation. How we do this differs from person to person, but there are more or less the same stages to acceptance that we all go through. These are (in no specific order) denial, grief, anger, bargaining and depression. Sometimes we simply go backwards and forwards between stages, never really making any progress. Optimists may hit a double-six more often than pessimists, while extraverts may struggle more than introverts.

Be that as it may, leaders, decision-makers, trend-setters and you and I need to seriously think about planning for the long-term effects of Covid.

1.       Covid will be with us for a l-o-n-g time. It will ravage society for many years to come before it ‘burns itself out’.

2.       Developing a vaccine is not the only answer.

a.       Viruses mutate (change their appearance like chameleons do) getting stronger before growing weaker when they mutate too often and too quickly

b.       The current vaccine will not cover all these mutations

c.       People will need at least 2 vaccinations for these to be effective, increasing costs

d.       Can governments (especially third world) afford these? Will donations be ‘left-overs’? Will private health-care costs soar?

e.       Do we honestly know the side-effects?

3.       Coping with the aftermath. Training people like doctors, pilots, engineers – even post-office workers and traffic officers takes money and time. These people need to be dedicated and passionate about their work, enjoy good health and have years of experience under their belts before they can get to grips with the task at hand. Already we have lost too many qualified people to Covid. Who will replace these vital people we rely so much on? Inevitable this will lead to:

a.       Food shortages

b.       Baby shortages. Infertility has been a pressing problem for years. The new strain of Covid is affecting younger people – those in the childbearing age bracket.

c.       Unhealthy life-styles has led to widespread health problems and obesity – even in children.

Before you slit your wrists or curl up into the foetal position on the window-sill, there’s hope. Yes, there is. And it’s quite simple really.

·         Stick to the original non-pharmaceutical precautions: Social distancing, wearing a mask (washing it at least every day) and washing your hands every time you’re out, sanitising them as often as you can while you’re out

·         Eat healthy. If necessary, grow your own vegetables, or at least herbs in flower-pots on your balcony.

·         Teach what you know to others. Share what you have learned in your lifetime with others so that they too can learn skills.

·         Teach yourself something new, a new language or a new career with an online course. Some of these are free.

·         Support child-rearing families. Give them hope. Encourage them to be prepared. Don’t waste. Learn to minimalize. Use what you’ve got.

·         Cherish people. Take nothing for granted. Celebrate life.