THE HOLISTIC PSYCHOLOGIST

 I love writing little summaries of the books I read in this blog. It allows me to review the book and reflect on the messages I learned from it. I used to enjoy various classic fiction and murder mystery books but these days I prefer non-fiction. Psychology and human behaviour are something I have been curious about for a long time. wondering why we behave the way we do. Psychology or teaching are some of the favourite alternatives I would have done if I didn’t step into clinical medicine. Being an OBGYN today, I see many women who require a holistic psychology approach. The way I open the consultation towards mental health is to ask about their sleep. Women with anxiety or depression often complain about poor quality of sleep or waking up in the middle of the night.

I found the book “How to Do the Work” by Dr Nicole Lepera pretty useful in terms of understanding the underlying causes of human behaviour for example childhood trauma etc, and the ways to heal and make progress. She often emphasizes in her chapters how troubled humans keep repeating the same troublesome behavioural patterns and drifting towards destructive behaviours such as binge alcohol drinking, and sex addiction to feel better.

It is important to know that the mind and body are one unit and she would often point out how her own stressors lead to episodes of collapse or mental breakdown. One of the key aspects to help the troubled mind is emphasis on good sleep. Improving sleep quality by shutting down electronics, taking a bath, and reading a book. She pointed out in her book that she would even put an alarm clock to remind her at 6 pm to start winding down.

The author mentions moving the body and a healthy diet as part of the holistic approach to a healthy body and mind. Just taking a walk in nature can do magic for our body and reset a lot of brain fog. She also pointed out how changing her living environment to California and a more relaxed time helped her to recover faster.

Childhood trauma and the different toxic parenting styles were quite enlightening for me. Bringing out the various treatments we received from our parents up can be pretty uncomfortable. We know our parents were no perfect child psychologists. They were just hustling adults trying to make it through their days with their jobs and other day-to-day problems.

The most important chapter of the book talks about boundaries. It is one pf the most difficult to achieve especially with friends and family. It is very important to maintain healthy physical and mental health. I really enjoyed the book. The journaling tips at the end of each chapter was helpful in sustain most of the reflections and behavioural changes.

 

 

PLANT BASED DIET

When it comes to dietary patterns, the South Africans have one of the worst diets

                      I have ever seen. I was shocked when I learned the favourite food items such as fat cakes, bunny chow, chips, Russians, McDonald's, and KFC. All of them have high starch and fat content and low fibre. Later on, I got married in 2020 and moved in with my grandmother-in-law for three months, while I was waiting for our home transfer documents to go through. She was a lovely and friendly lady, and A very good cook. We mostly had some sort of curry with roti and rice. I soon realized that there is hardly any fruit or vegetable in that house. I started getting my own fruits and vegetables to be able to survive. In my home country, fruits and vegetables were an important part of our diet. We always had one or two fruits in the season and veges such as herbs and lettuce.

In recent years, there have been extensive studies on the relation of dietary patterns and various cancers and cardiovascular risk. The Mediterranean diet is known to be mainly plant-based with lots of nuts and olive oil, which is associated with less cardiovascular events.

A plant based diet is a broad term that covers many different diet patterns. From vegetarian to vegan etc. A diet that has at least more than two thirds of vegetables, fruits, whole grains, and beans, and no more than a third of animal protein. It does not have to be entirely vegan or vegetarian. It simply means that we are consuming more plants than anything else. This diet definitely has a profound effect on the person’s general health.

Digestive system cancers, including cancers of the esophagus, stomach, colon, rectum, liver and possibly pancreas, appear to be cancer types that are reduced with a plant-based diet. Studies show there was a 9% reduction rate of breast cancer, 13% prostate cancer, and 18% of digestive tract. This is something to think about next time we go grocery shopping to try and make small changes in our diet and become healthier.

 

THE CHALLENGES OF MODERN WOMEN

 Women in the twentieth century enjoyed significantly more freedom and independence compared to their predecessors. In earlier times, a baby girl was often viewed as a burden to the family until marriage. They were not seen as a part of the workforce that could contribute financially to the household. Even today, in India, many families choose to abort female fetuses out of concern for the future costs associated with dowries, weddings, and wedding jewelry. are outshining men in colleges, universities, and the job market. Women are prospering in their careers and achieving a lot. A lot of them have chosen to dedicate their full time and energy to their jobs and give up on dating, the ones who are looking for partners can hardly find any suitable matches. So they wait until the biological ticks to settle or they settle for someone with lower standards.

Men are not formulated to juggle a million things during the day. Even though they have a part-time job with more free time at hand, we often find the female partner juggling a lot of things during the day, which can lead to the rapid burnout of the female partner.

Let's hope we are all kinder to that work colleague who needs to go for a school pick up or has a sick child in the future, and let's hope the male partners actually start helping more around the house and with the kids

CHANGE OF HABITS

 It is very common for people to have new year resolutions and try and do things differently. For example, exercising more often, eating healthy, or focusing on achieving more career or academic goals. I can recall certain habits that I have changed gradually over the years that have helped me have more peace of mind.

News addiction: I come from a Middle Eastern country, and there is always something happening either in the Middle East, like a new war, terrorist attack, or something happening in the west that might affect us indirectly. I lived with my grandparents up until my late twenties, and I often found them sitting in front of the TV watching various news channels and drinking tea. After immigration, this habit remained with me to try and be on top of the SA local news and the international news using various channels. After finishing my registrar training, being extremely burnt out and tired and pregnant, I stopped listening to any news on my car radio and stopped streaming different international channels. It is the worst thing to do while rushing to work in traffic and listening to mostly negative news and endless adverts on the radio. I spend that time wisely listening to various educational podcasts or a calming playlist.

Social media: I developed a very toxic relationship with social media, especially after immigration and having no filtering on Facebook and other channels. I remember back in 2013 while I was sitting at home waiting for my HPCSA registration, I would wake up early in the morning, feed the cat and go to the loft area where the family desktop was. Switch on the computer and scroll on Facebook. It was around when most of my friends were getting married and doing exciting things in life. I would start my day scrolling and feeling miserable about life. Later on I had my own smartphone and also joined Instagram and the scrolling continued. First thing before showering and making my morning tea  would be scrolling, trying not to miss anything. Around the same burnt out state of mind I had in 2021, I took a 3 week break from Facebook and Instagram. I limited my scrolling to 10 minutes per day and avoided them on weekends completely, and rather spent my time reading books or any other productive activity.

Retail therapy: this was a terrible trait of me and my mother. Going out and buying whatever was on sale and whatever looked nice and cute. The consequence of that is a dysfunctional wardrobe where you actually have nothing proper to wear and a very cluttered house. I have stopped that. I assess my clothes now and know exactly what I need for that season. I do not just buy something because it is on sale. I go for quality, more practical style, and solid colours and match easily.

I am hoping to work towards my terrible trait of being a people pleaser, have more boundaries with work, friends, and family, and stop venting to people and over sharing my life.

 

 

MOVIE REVIEW

 Triple six eight

                It was a very touching movie that made me cry. A love story from the world war two. Showing the lover's fun life briefly at the beginning of the show. An African American girl dating a wealthy Caucasian boy. In my mind I wanted the young boy to survive and come back safely after the war. Unfortunately, he is killed during the war and leaves the young girl with a broken heart. She decides to join the army. You start understanding the racial issues in                             America in the forties when the African girls and the white passengers are asked to be separated on the train. She works hard during her training, another strong female character also comes to play is their commander, played by Kerry Washington. Another touching scene is when the female soldiers are sorting out the mail backlog in Europe and she comes across her boyfriend’s letter. During their mission, two soldiers are lost.

                  The female soldiers serve their country under such difficult circumstances with grace and patience. They work extra hard to prove to their male counterparts that they are also efficient in their duties. The essay was based on a true, and it shows showed how determination and courage can lead to success no matter what the circumstances are.

Mother’s instinct

                  I watched this movie because I am a great fan of Ann Hathaway movies. It was filmed around the 60s in America. I absolutely loved the movie, I would probably watch it again. It was very well crafted with special attention paid to their wardrobe, settings, cinematography, and dialogues.

                       At the story's beginning, we witness the monotonous life of two stay-at-home moms. One of them has the desire to try and build a career, her partner has no understanding and support for her. The line of the story changes after on of the mothers loses her son in an accident and there is a build-up of tension between the two families who are neighbours. The ending surprised me, but overall I enjoyed the movie a lot. 

IN MEMORY OF DR MAPELA

 The other day one of my colleagues sent me an interesting photo from 2017. It is me in Chris Hani Baragwanath with my senior unit registrars. The image is captured as we are walking in one of the wards, and we accidentally happen to be wearing matching blue scrubs. I was thrilled to be working in Bara. Being exposed to a lot of different cases and growing well in my clinical and surgical skills.

A specific registrar who is standing in the front was Dr Mapela. We rotated together for a major part of our registrar training. I learned a lot from him. He was much older than the other registrars I had worked with. He had a lot of knowledge and skill. He would often challenge the other seniors and consultants in the ward round, pull out the latest piece of evidence, and win the arguments.

I remember he was on call for gynae and I was cutting caesarean sections. I had offered to do any gynae emergency cases so I would get more experience in that field. The one ectopic case I started doing happened to be in the isthmus part of the fallopian tube I called him for help and he showed me how to do a wedge resection and achieve haemostasis.

We later rotated in Rahima Moosa Hospital together and had a good time in late Dr Bera’s obstetric unit. I ended up in a different gynaecology rotation from Dr Mapela but still kept in touch, I knew that his gynae theatre list was on Mondays. After a Sunday shift if the night had not been busy I would usually join him for the second gynaecology case. We would do a hysterectomy together. He would do his side with the ligature and I would do my side the old-fashioned way trying to master the art of tying knots.

There came 2020, the covid pandemic, and everything went upside down. I was in my second year of registrar training and Dr Mapela was doing his last year. he stayed in Potchefstroom, and had requested to finish his time with the Klerksdorp rotation in December 2020. when he was busy with a difficult Caesar in a Covid-positive patient he got infected, was admitted to ICU, and passed away in January 2021. We were all devastated. He will always have a special place in my heart. I am where I am today because of him. 

 

 

 

 

 

 

 

 

SEX AFTER PREGNANCY

 Seeing the post-partum women with their happy and healthy bundles of joy in the consulting rooms is the most rewarding thing. They are glad to be out of the house, most of them bring the little one and some leave them with the grandparents or a caregiver. The dads usually accompany the moms, if it is their first baby they often look exhausted and overwhelmed. Some dads ask the eager question of whether it is safe to have sex again!

Pregnancy and childbirth are transformative experiences that affect every aspect of a person’s life, including sexual well-being. Despite this fact, most clinicians ignore sexual well-being. All we address in the six-week visit is emphasizing the importance of breastfeeding, pap smears, and contraception. Sexual health does not only affect individual well-being; it is an important part of relationship satisfaction. It is common that in the post-partum period the frequency of sexual engagement and desire declines. A lot of women report changes in arousal, orgasm, and sexual pleasure and sex is associated with pain most of the time.

Many factors can contribute to post-partum sexual issues, including hormonal changes, body image concerns, and mental health conditions. Women who are breastfeeding experience amenorrhea which benefits them with post-partum blood loss, but it also causes vaginal dryness and reduced sexual arousal due to hormonal shifts.

The health care providers need to understand the importance of this topic and try to create a safe environment for the patients to start the conversation about sex. Using simple and non-judgemental statements such as saying “Many people notice changes in their sexual desire or pleasure after childbirth. Has anything like this happened to you or your partner?” can encourage women to share their concerns.

Assessing the importance of sexual problems can help direct the need for any intervention. Following up on these concerns and offering support, through counseling, pelvic floor physical therapy, or referral to a sexual medicine specialist or a sex therapist can be some of our interventions. Our women need to know that it is not Ok to feel pain during intercourse in the post-partum period. We are the first caregiver whom they encounter and we need to look for potential problems.

 

 

 

 

 

 

 

FIRST DAY OF PLAY SCHOOL

 As parents, we experience various milestones with our babies from birth. The most delightful milestone of my baby was when she was about two months and she smiled at me for the first time! It was very rewarding after weeks of feeding, changing nappies, and sleepless nights she smiled at me and all the post-partum fatigue went away. Around four months she started crawling and I put her on the couch and she fell within 5 minutes, luckily she did not sustain any injuries, but I knew that she could crawl and move around and I needed to watch her.

She has grown up so much, she can run around and climb and play. The other day I caught her standing on the table in the balcony and bending over the railing. Luckily I saved her and put the table away. Her favourite activity is watching Coco Melon, running outside, dancing to music, and playing with water. We had a short trip to Suncity and she slipped and fell in one of the shallow kiddie pools. She was very scared that day and had a fright. She is afraid to go inside the pool, but I often take her to the poolside to play with her toys. I either swim myself or relax and listen to music. Toddlers get bored very easily, so to have them busy with some activity is a blessing.

I made the decision to put my little one in school, at the end of last year. We stay in a good area and most of the schools look fancy. The other criterion was to have the closest school to our house, so we could cope with the drop-offs and the pick-ups in the peak traffic hours. I had a lot of stress in December before she started school. She is very attached to me and had a bit of separation anxiety when I used to drop her off by the grandparents on weekends. Even if I have to go to the bathroom she follows me and I sleep with her during the night. I have read things about sleep training in toddlers. I feel like everyone is different and I will give her time to understand and be able to sleep alone.

The first week of school went well. The teachers and my work colleagues were very supportive. She was able to settle, eat, play, nap, etc. There is an application where all the daily activities are updated from the nappy changes and the things the children have eaten during their meal and snack time. I am happy to see her sitting with other kids and having food. We are lucky it is currently summer in the southern hemisphere, so hopefully there will be fewer viral illnesses making kids sick in school. The mornings are also nice and bright, which makes the days less sad.

 

WORKING IN THE FESTIVE SEASON

 I have been working in South Africa’s healthcare system for 9 years now, during all the festive seasons except for December 2022, when I was on maternity leave. I willingly made this choice, mostly because my family does not celebrate Christmas. I feel happy to know that my colleagues who celebrate during this time can spend time with their families. We know that we are part of a team and can support each other and fulfill our duties.

We have to take extra care and consideration for the patients who are also in the hospital during the festive season. Some patients might show up to casualty with vague complaints just because they didn’t want to be alone. We have even had women coming to maternity complaining of decreased fetal movement, and not initially disclosing to us that she has been a victim of gender-based violence. There are those patients who delay presenting to the hospital with their illness and they present very ill, in need of resuscitation, blood transfusion, or ICU admission.  

We have to bear in mind that being a doctor during the holidays means that we are working while other people are busy celebrating because illnesses and injuries and in my case childbirth does not take a break! When we are in medical school we tend to have a great break after the exams, but things start to get busy from internship when the interns learn that working on holidays is part of the medical work. They are still young and do not have committed relationships or children as yet which makes them adapt easily.

For those doctors who feel the tug of family, a virtual call can help them stay connected especially with little children who miss their parents. We must also remember to take care of ourselves and make sure we are eating right, taking breaks, and are able to manage stress. 

This is me and my Rahima Moosa registrars and interns on Christmas Day 2024

END OF YEAR 2024

 It is that time of the year when things tend to slow down, and we have time to reflect on what has happened through the past eleven months. Looking back, I have a good feeling about this year. We have been happy and healthy and trying our best to survive. I want to elaborate on the different aspects of my life.

My health journey: I have not had any major health issues this year besides those intense dentist visits and getting crowns for my teeth which cost a fortune. My pap smears and blood tests are up-to-date. The thought of having to do mammograms in my 40s from next year is scary. Mentally there are those days when I feel overwhelmed, overstimulated, and exhausted, but I am trying to give myself precious time to journal, read a book, and relax. Physically, I have not been successful in my weight loss journey this year, but I hope to do better next year. We cannot eat what we used to eat in our 20s and have the same figure.

Work has been going well. The first half of the year was spent on job hunting filling out application forms and praying for interviews. My prayers were eventually answered and I managed to get a job in a hospital that is much closer to my house and has a better academic environment. I started working there in July and so far have been enjoying it and growing well, professionally. For me, a job is not merely something that pays the bills, and I don’t ever dream of having enough money to sit at home and go shopping sprees and drink smoothies every day. My job gives me purpose and meaning and I love it.

Family is everything. That is what fills the rest of my heart besides my job. Hubby and I have survived another year without killing each other! There have been good days, bad days, loving days, and disagreements here and there. The good has been more than the bad, hence we are surviving and doing our best to raise our little daughter. I am thankful to the grannies and uncles who have helped us in every aspect this year, especially my mom for looking after the baby most of the days.

We are thankful for another blessed year, and wish everyone a prosperous new year. looking forward to next year with more exciting content on women’s health in this blog. 

 

 

WORLD AIDS DAY

 The 1st of December is marked as World ADIS Day. The purpose of this is to raise awareness about HIV/AIDS and honour those who are affected by the disease. This year’s theme is “Collective Action: Sustain and Accelerate HIV Progress “. The day was first observed in 1988, and since then significant progress has been made in addressing HIV/AIDS through advancements in medical research, increased access to treatment and prevention, and a broader understanding of the virus.

The objectives of dedicating a day to HIV/AIDS is to:

Raise awareness about the disease's impact

Support the affected groups

Promote HIV testing and prevention

Advocate for policies and programs that support research, treatment, and prevention

 

We can all get involved by:

Wearing a red ribbon, which is the symbol of the world AIDS day

Sharing information about HIV/AIDS on social media

Participating in local events and fundraisers

Supporting organizations that work on HIV/AIDS research, treatment, and prevention

 

Here is a passage from Laura Bush’s biography explaining her visit to African countries in 2006 like South Africa and describing its effects. “Many African nations like South Africa have lost a vast portion of their population to AIDS. They were economically devastated and coping with massive human suffering. The tragedy was compounded by the fact that for well over a decade people across the African continent were not tested for AIDS. A positive test was a death sentence because there was no medication available. “

 

Let’s work together to create a world where everyone has access to HIV prevention, treatment, and care.