HERITAGE DAY

 Heritage Day is a public holiday that is celebrated on the 24^th of September every year. It is a day that celebrates the diverse cultural heritage of South Africa, including its languages, traditions, customs, and history. My favourite part of Heritage Month is people with various cultures wearing their traditional attire and sharing their traditional food. Other activities during this month are different music and dance festivals, food markets, more art and museum visits, and most importantly family and friends getting together and braaiing!

At work, we planned to celebrate Heritage Day and organize a farewell party for one of our colleagues on Friday the 27^th. It was a beautiful day with everyone wearing their traditional clothes to work and bringing a signature dish to share with everyone else. I am from the Middle East and was wondering what food item to bring. The traditional rice dishes are difficult to share. I thought about making chicken kebabs and flatbread, or small portions of the rice pudding with saffron and sprinkled with cinnamon.

We ended up going to the Turkish restaurant for lunch on the 24^th and I bought some Turkish delights as a backup plan in case everything fails. In the end, I brought Turkish delight on the celebration day. We have a lot of different signature traditional dishes, such as vegetable stews, we have crispy rice, lots of soups, and dessert recipes. My husband is not quite a fan of our traditional food and I hardly cook for him. My mom cooks the different vegetable stew dishes and because the portions are big we end up eating them for a couple of days.

A lot of things are different when I compare my conservative Middle Eastern culture to the more modern and open South African culture. I enjoy the diversity of cultures and languages in South Africa. Everyone is very warm and friendly. I have enjoyed my stay in this country for the past 11 years. I am grateful for all the various opportunities this country has offered me in my late twenties.

Heritage Day is an important part of South Africa’s reconciliation process as it promotes understanding, tolerance, and acceptance of the country’s diverse culture and history.

 

 

 

THE LIGHT WE CARRY

 I am a fan of women who have contributed to making a change in society. Michelle Obama was the first woman of colour to become the first lady of the United States of America. She carried out her duties gracefully. I enjoyed her first book “Becoming”. It was a small glimpse into her childhood, adult life, college, meeting Barak, having kids and the election campaign, and finally settling in the White House. I came across her other book "The Light We Carry" in the library and grabbed it excitedly. I read it in less than a month with my full-time job and a toddler at home. It was indeed a very good read.

She touched on the Covid-19 Pandmic. The times of fear and uncertainty and of course lockdown. I was fascinated when Michelle pointed out her knitting journey to battle with stress. “ I am not sure if I would have gotten there without the period of enforced stillness and the steadiness I found inside of knitting. I’d have to go small to think big again. Shaken by the enormity of everything that was happening, I needed my hands to reintroduce me to what was good, simple, and accomplishable. And that turned out to be a lot."

She spoke about her daughters growing up and being independent and the proud feeling every parent has when visiting their children’s house. Seeing their different behaviour compared to the times they stayed with their parents. Also looking at the new generation dating. Addressing the fear she experienced when Barak wanted to run for president, she didn’t want to stop him, knowing she might regret that decision. “How will you meet your soul mate if you don’t go on that date? How will you get ahead if you don’t take that new job, or move to a new city? How will you learn to grow if fear stops you from leaving home to go to college?

She spoke about her mother’s vital role, supporting her young daughters while Michelle and Barak were busy with their day-to-day duties in the white house. Her mother stayed with them for the whole 8 years. She spoke about herself being very self-aware of her physical difference from the other girls her age. Reading this part made me feel better about myself.

I'm tall and that’s a good thing

I'm a woman and that’s a good thing.

I'm black and that’s a good thing.

I am myself and that is a very good thing.

 

She spoke about her political motto of going high. “ When people ask me about going high, I explain that for me, it's about doing what it takes to make your work count and your voice heard, despite the despites. It helps if you're able to stay agile and adapt to change as it comes. And all of that becomes more possible, I've found when you are ready and practiced with a full range of tools. Getting high is not about what happens on a single day or month or outside one election cycle either. It happens over the course of a lifetime, the course of a generation.”

 

TURNING 39

 It was my birthday on the first of September! It is also the first day of spring in South Africa. I have never been a fan of big birthday parties since childhood. In fact, I don’t think I had any major birthday celebration since the age of five. Sweet sixteen, eighteen, twenty, and thirty went by without much of a fuss. This time we had balloons and some friends over and we all celebrated. It was a beautiful day full of laughter, and positive energy!

This is my new year, and it is the time for me to sit back and reflect on my life. I have lived quite a life and this part of the journey will determine what the rest of my life will look like in the future. In this reflection, I am going to look at various departments such as health, family, career, and finances.

Being a healthcare professional I appreciate the gift of health every day. Being able to get yourself out of your bed, take a shower, eat, and get into your car to work is an amazing thing. Dealing with patients who rely on help just to make it to the bathroom from the hospital bed gives me a different perspective on life. Knowing all this, getting a couple of grey hairs or wrinkles on my face is the least of my worries. I look good for my age, and there is no shortcut for this. I eat well, sleep well, and stay away from alcohol, cigarettes, and too much sun. we need consistency for good results. I am a bit heavier than what I used to weigh ten years ago, but I have started to eat cleaner and have increased my physical activity. I even now have a fitness watch. I have been watching my cholesterol, blood pressure and doing my pap smears and HIV tests annually. I have a strong family history of diabetes and I hope I can keep it away for as long as I can.

Family is everything. I feel blessed to have my husband and my daughter in my life. It is not always easy to keep a house running and give everyone the attention they need, but I am doing my best. I want to have a healthy family with good relationships and a happy child who will grow up to be a happy girl! Having Middle Eastern parents who will freak out at every little thing that goes wrong with a lot of tension makes me want to do better.

I love my job! I love the fact that you are not quite sure what your day will look like in labour and delivery when you leave your house. It is diverse, we teach the younger medical students and we learn from our mentors. There is room for academic growth, but I am keeping it slow and mellow. I was in a rush to specialize, but the fellowship can wait for now while I enjoy being a general ob-gyn.

Finances have had its ups and downs. We have had phases of great expenditure and growing debt but now we are in the damage control phase. Finances have never been my strong point. I grew up in a middle-class family. We were savvy with money but as soon as I moved to SA and started making more money I started spending more. I did not understand how credit card interest works and how bank interest rates work. After the pandemic, we have had a rise in interest rates and inflation. We are doing our best to pay the debt and try and save effectively for retirement. 

WEIGHT LOSS

 Conversations regarding weight loss are prevalent in the OBGYN consulting rooms. We encounter many females with obesity who have irregular menstruation and fertility struggles, and they are desperately looking for a quick fix to regulate their hormones. They do not want to hear the advice regarding healthy eating and regular exercise. I recently consulted a girl who managed to regulate her menses by losing 20 kg and came for her viability ultrasound and she was 8 weeks pregnant. She was still obese and we consider this a high-risk pregnancy, but without weight loss, we do not see the desired results. I have also met several patients who were turned away from fertility clinics to do weight loss surgery and then start fertility treatment.

Another category of patients is women in the postpartum period who are trying to lose pregnancy weight. This period has it is own unique challenges. A busy and sleep-deprived mother can hardly find the time and energy to exercise. A lot of women spend the first 6 weeks to four months postpartum period at home and they might turn to high-calorie foods and unhealthy lifestyles. I personally believe that after the COVID-19 pandemic, a lot of women stopped their gym subscriptions and outdoor activities and now prefer to stay at home and order takeaway food. Having support in the postpartum period is important for women to be able to look after themselves and shed pregnancy weight.

The menopausal period is another era where women start feeling uncomfortable with their weight. I had a patient who was in her late forties. She was a flight attendant and they needed to stay in shape for their job. And she started noticing increased central obesity and she was struggling to fit into her work clothes. We had to prescribe some anti-obesity medication for her because she needed results within a short period.

We know that there are several useful anti-obesity medications in the market, however healthy nutrition, physical activity, and behavioral modification remain key pillars of weight management. Women in whom anti-obesity medications may be indicated are those with a BMI of 30 or greater, those with a BMI of at least 27 along with at least one obesity-related comorbidity, such as hypertension, high cholesterol, diabetes, or sleep apnea. The goal of treating obesity with medications is at least a 5%-10% reduction in body weight.

There are three basic categories of anti-obesity medications. The short-term options include phentermine and diethylpropion. Long-term options are Orlistat, phentermine/topiramate ER, naltrexone/bupropion ER and lastly, we have the three GLP-1 receptor agonist drugs, liraglutide, semaglutide, and tirzepatide. The GLP-1 agonists have shown very promising results in clinical trials with most patients losing up to 20% of their body weight. I will dedicate a blog to elaborate on the dosage, regimens, and route of administration of the GLP-1 agonist agents.