logo
Trump's chronic venous insufficiency mirrors trend in SA, says doctor

Trump's chronic venous insufficiency mirrors trend in SA, says doctor

TimesLIVE5 days ago
US President Donald Trump's diagnosis of chronic venous insufficiency is not unusual and mirrors a growing trend among ageing South Africans, according to a Durban vascular surgeon at Lenmed eThekwini Hospital and Heart Centre.
Dr Vinesh Padayachy said the condition, where blood struggles to flow back from the legs to the heart is frequently seen in South African men and women over the age of 70.
'This isn't unique to Trump. We see hundreds of patients a year with the same issue here at home. It's a progressive condition linked to ageing, sedentary lifestyle, weight gain and even genetics. In South Africa, with rising rates of obesity and diabetes, we're seeing more cases, and sometimes at younger ages.'
The White House on Thursday announced Trump underwent medical testing after he had been seen with deep bruises on his hand and swollen legs.
White House press secretary Karoline Leavitt said Trump was diagnosed with chronic venous insufficiency.
'The president underwent a comprehensive examination including diagnostic vascular studies, bilateral lower extremity intravenous doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70,' said Leavitt. Doctors ruled out any major concerns such as blood clots or cardiac issues, confirming only venous insufficiency.
Padayachy said that was an important distinction.
'The real concern would've been if it was deep vein thrombosis or signs of heart failure. But in this case, the diagnosis is straightforward and treatable.'
Symptoms often include swelling, heaviness, fatigue in the legs and, in some cases, visible varicose veins or skin darkening.
'In South Africa, especially in the public sector, many patients ignore the early signs because it seems minor until ulcers or infections develop. By then, treatment becomes more complex,' he said.
Padayachy said while photos of swelling may alarm the public, the condition does not indicate failing health.
'At Trump's age, this is expected. It doesn't suggest he's unfit or unwell. If anything, it's a wake-up call for many South Africans to take leg health seriously especially if they sit or stand for long hours without movement.'
He noted that truck drivers, teachers, factory workers and office staff are often at risk.
Treatment involves compression stockings, elevating the legs, light daily movement and avoiding long periods of sitting or standing.
'Treatment also includes minimally invasive procedures to seal off the vein that is not working. These procedures can be done in a vascular surgeons' rooms as a walk-in, walk-out procedure,' added Padayachy.
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Why ignoring bullying is like bandaging a deep wound: the scars run deeper
Why ignoring bullying is like bandaging a deep wound: the scars run deeper

IOL News

time4 hours ago

  • IOL News

Why ignoring bullying is like bandaging a deep wound: the scars run deeper

If you or your child needs help, reach out to your school counsellor, talk to a trusted teacher, or contact Childline South Africa. Even more alarming: one in three South African teenagers is a victim of cyberbullying, where group chats, doctored photos and social media shaming extend humiliation far beyond the school gates, leaving no safe space. Once brushed off as a 'rite of passage,' bullying now affects an estimated 40% of school-going children, according to research from the Department of Basic Education. In playgrounds, WhatsApp groups and school corridors across South Africa, bullying isn't just a playground drama; it's a silent crisis reshaping children's mental health, social life and future relationships. 'We're not just dealing with bruises anymore,' warns Dr Alicia Porter, psychiatrist and board member of the South African Society of Psychiatrists (SASOP). Porter adds, 'Children become anxious, depressed, and sometimes even suicidal. The psychological wounds often last far longer than the physical ones.' Children who are bullied often hide what's happening, only speaking out after repeated trauma. What's left behind is deep: loss of self-esteem, academic decline, social withdrawal and sometimes self-harm. Porter says the real tragedy is that these aren't just childhood memories. 'We see adults still haunted by bullying decades later, struggling with trust issues, PTSD, anxiety and relationship challenges. These are psychological injuries, not just stories from the past.' A 2022 study in the Journal of Child Psychology and Psychiatry found that children who are frequently bullied have double the risk of developing clinical depression by adulthood. That's a generational wound, and it's one South Africa can't afford to ignore. The different faces of bullying While bullying cuts across gender, age and race, Porter explains that the forms it takes can differ: Boys often experience physical bullying, such as shoving, fighting or threats. Girls are more likely to face relational bullying, exclusion, name-calling and malicious rumours. But lines blur fast. Emotional bullying leaves scars just as deep as physical bruises, and many kids experience both. Right here at home, bullying can also mirror broader social issues: children from different races, ethnicities or socioeconomic backgrounds often find themselves targeted, particularly in multi-ethnic or under-resourced schools.

Small win for activists, but SA's HIV projects won't get reopened
Small win for activists, but SA's HIV projects won't get reopened

TimesLIVE

time8 hours ago

  • TimesLIVE

Small win for activists, but SA's HIV projects won't get reopened

The $400m that US Congress hasn't cut with the rest of its funding programme doesn't undo the blow to global HIV and TB programmes By The $400m that the US Congress took off a list of programmes from which the Trump administration will now take back previously approved but unspent funds, doesn't mean the cuts to global HIV and TB programmes in February, including those in South Africa, are now reversed. HIV projects that have closed in South Africa, which were formerly funded by the US government, won't restart as a result of this decision. In fact, quite the opposite. The 'limited Pepfar waiver' that President Donald Trump announced in February remains in place. That means no HIV prevention activities, unless they intend to stop pregnant and breastfeeding women from infecting their babies, can be paid for with US government money, and projects that make it easier for teen girls and young women in Africa, trans people, sex workers, injecting drug users and gay and bisexual men — groups of people that have a higher chance to get HIV than the general population — cannot be funded. Without a proper explanation for it, the $400m seems to be a random amount that Trump's administration picked to take back from Pepfar, a US government programme that funds Aids projects in poorer countries with high HIV infection rates, such as South Africa. The amount is about 8.5% of Pepfar's $4.725bn budget for this financial year and was part of a larger $9.4bn 'rescissions package' — that has now been reduced to $9bn and passed as the H.R.4 Rescissions Act of 2025. Rescissions happen when the presidential administration wants to cancel funding that was approved by Congress and then use it for something else. What the decision to remove the $400m from the package does, however, mean is that activism could finally be starting to pay off. Activists have had hundreds of meetings with US senators and Congress committee chairs. There have been 'Save Pepfar' social media campaigns, and plenty of media coverage about the devastating consequences of the funding cuts. Tens of modelling studies have also projected what could happen if the lost funds are not replaced. Opposition from within Trump's Republican Party against nonevidence-based cuts to a programme that has, for two decades, been supported by both the Democrats and Republicans and has saved over 25-million lives, is now at last emerging. 'It's a small win within the bigger context, but nonetheless, a huge win for advocacy, and a reminder that activism is powerful and alive, and making an impact,' Jirair Ratevosian, a former head of staff at Pepfar and fellow at Duke University's Global Health Institute, told Bhekisisa at last week's Conference on HIV Science in Kigali. Around $8bn of the money was for foreign aid and development programmes, including global health, and just over $1bn for public broadcast stations that the Trump administration has accused of being biased because they're too liberal. But the Rescissions Act is, in itself, bad news. 'It opens the floodgates for the Trump administration to say 'we don't want this or that in the budget that Congress approved',' says Mitchell Warren, the head of international advocacy organisation Avac. 'It's trying to take the congressional power of the purse and put it in the executive branch to usurp the role of Congress in deciding how much money — and on what to spend it.' So how did this all happen, and does it hold any good in the long term for South Africa? We break it down. 1. How did we get here? In the US, Congress — it consists of the Senate and the House of Representatives — decides how much government money goes to who, just like parliament does in South Africa. Both the Senate and the House have to pass budgets. But, as analysts at the Centre for Budget and Policy Priorities in Washington, DC point out, President Trump wants more control over how his administration's money is spent. In March, he signed the 2025 budget that Congress approved into law. Three months later, in June, he decided he wanted to change some of that and submitted a $9.4bn rescission request, which the House of Representatives (it has five more Republican than Democrat members) passed on June 12. When it was the Senate's turn to vote on this, some Republican senators weren't happy with the $400m Pepfar cut, signalling they wouldn't sign off on the deal unless the Pepfar part was removed. Because there was a danger of them swinging the vote, the Republicans removed the $400m from the Rescissions Bill and got the House to pass that too. All that's left is for Trump to now sign the Act. 2. What was the $400m that was removed from the Rescissions Act for? In short, no one really knows, because the Trump administration hasn't said what it was for — or what it plans to do with it. But what we do know is that the US law that governs rescissions, the Impoundment Control Act, says that the president can only request that Congress takes back funding that it previously approved, if the money has not yet been obligated — that means funds hadn't yet been given to a particular recipient, for instance, an HIV project in South Africa. We also know that the $400m was part of the financial budget for 2025, says Warren, but because the law gives Pepfar permission to spend money over five years, that money doesn't have to be legally spent until 2029. 3. What will the $400m now be used for? Again, no one knows. We don't even know if it will be used, because over the past few months, the Trump administration's main strategy has 'simply been to illegally impound funds — by announcing a 'funding freeze' or 'programmatic review' with no public notice at all — and force those harmed by the impoundments to pursue relief in court', the Centre on Budget and Policy Priorities explains in an analysis. But we do know what the money can't be used for. Unless the rules of Trump's 'limited waiver' are changed, Pepfar funds can mostly not be spent on any of the evidence-based strategies it paid for before Trump was elected in January. Pepfar used to focus on groups of people and areas where people have the highest chance of getting infected with HIV — that way, the programme got the biggest bang for its buck. In South Africa, for instance, Pepfar worked in the 27 districts with the highest infection rates and groups known as 'key populations' — sex workers, gay and bisexual men, trans people, injecting drug users and African women between the ages of 15 and 24 — that are much more likely to get newly infected with HIV than other South Africans. Now those projects, which studies show stopped many new infections, have been closed down and the Trump administration says it's not prepared to buy HIV prevention medicine for any group other than pregnant and breastfeeding women. 'It used to be all about evidence,' Warren says. 'Now it's all about ideology.' 4. What do scientists and activists want the $400m to be used for? Ratevosian says this moment should be used to gain Republican support to change the waiver rules, so that Pepfar money can cover more of the populations and services needed for HIV prevention. Lenacapavir, a pricey twice-a-year anti-HIV jab, which scientists believe could help to stop HIV in its tracks if it's rolled out properly, could be used to convince Republican Congress members, says Ratevosian. 'Pepfar has long wanted to get countries to transition to taking more ownership [read: pay more] for their HIV responses. So now activists are arguing: 'Preventing more new infections with the jab, will make it easier for countries to take ownership because the pandemic will be easier to manage.'' In December, Pepfar said it would join another organisation, the Global Fund for HIV, TB and Malaria to buy enough lenacapavir for two-million people over three years. But in July, the Global Fund had to go ahead with the deal by itself, because Pepfar seemed to no longer be on board. Warren says: 'If I were in charge, I would take the $400m and double the two million people the Global Fund is planning to cover, because that's how you build a market, prevent new infections more quickly and drive the price down.' 5. What will Pepfar look like in future? Trump's funding cuts didn't kill Pepfar — at least not in theory, but it's a shell of its former self. What it will look like, will depend on the size of its next budget (the Trump administration wants to cut it by 40% but, so far, the House hasn't agreed to that, (the Senate still needs to sit on it) and how much support Republicans who believe in Pepfar can gain to have waiver rules changed. But, Warren points out, 'we're not going to get pre-January projects back; we have to build something different. 'This has been the most seismic shift in democracy. We didn't think we lived in an earthquake zone, but January 20 [when Trump retook office] taught us: you need to be prepared for that earthquake and you therefore need a different infrastructure. 'In an earthquake you don't build back the same thing. You build better, something that is more resilient.' This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the

Caring for your pelvic floor is a guy thing, too.
Caring for your pelvic floor is a guy thing, too.

The Citizen

time17 hours ago

  • The Citizen

Caring for your pelvic floor is a guy thing, too.

An expert said focused physiotherapy can play a big part in recovery. Pelvic floor dysfunction is not just a women's health issue. It's a guy thing, too, and for many men, it is the cause of pain, embarrassment, and an unwanted segue from normal life. It can mean challenges in the bedroom, a surprise and unwanted bit of leakage with a sneeze and a cough or a slow, exhausting recovery after prostate surgery. Pelvic floor physiotherapy has traditionally been an environment for or at least a treatment for women. Dr Lisa Kaestner, a urologist at Netcare Christiaan Barnard Memorial Hospital, said that it is helpful for post-prostatectomy incontinence, sexual dysfunction, and pelvic pain in men. But it's not really at the top of any man's health-awareness chart. 'There's a lack of awareness and not enough pelvic floor physiotherapists comfortable treating men,' she said. 'And rehab like this is not well funded in most South African healthcare settings, which makes it a personal expense many cannot afford.' This is probably why many guys say nothing, do nothing, and just suffer in silence. Men stay silent John De Klerk, a physiotherapist with a special interest in pelvic rehabilitation, said the entire concept has roots in women's medicine. 'Pelvic floor exercises, commonly known as Kegels, were initially developed for women by Dr Arnold Kegel,' he said. 'The research focused on women's reproductive health, especially for incontinence during and after pregnancy.' The same principles have been found effective for men with certain pelvic dysfunctions. But that does not mean the conversation is easy. 'To speak about a problem in a sensitive and private area, it must be brought out from the darkness of ambiguity,' De Klerk said. There is no single symptom that exclusively points to the challenge. Kaestner said it can range from incontinence to sexual issues and chronic pelvic pain. 'The back, the prostate, the pelvis, the pelvic floor are not separate entities,' she said. 'They are interrelated; even bowel function is part of the equation.' De Klerk unpacked it more. 'Overactive pelvic floor symptoms include difficulty initiating urination or defecation and pain during sexual function,' he said. 'Underactive symptoms relate to incontinence and excess flatulence. Then there's uncoordinated pelvic floors, which involve timing and control issues.' ALSO READ: Why Gen Z fears phones Men recovering from prostate surgery are particularly vulnerable, Kaestner said 'Pelvic floor physiotherapy can speed up recovery to continence after radical prostatectomy,' she said. Physiotherapy helps fix male pelvic floor issues De Klerk said focused physiotherapy can play a big part in recovery. 'Physiotherapy aims to improve modifiable factors of recovery,' he said. 'That includes urinary control, pain management, and longer-term erectile function recovery.' It is not just about exercise, though, he noted. 'We clear up misconceptions, explain the process, modify lifestyle factors like alcohol and caffeine use, and tailor a plan unique to each person,' he said. 'Training involves strengthening neural pathways to form new habits. In plain English, to prepare men in bracing the pelvis in times of need with better timing than Cheslin Kolbe in a World Cup kick-charge-down.' It remains a sensitive topic, though, and a reluctance to seek help is endemic. 'Pelvic floor physiotherapy is awkward and uncomfortable because it is incredibly intrusive,' said Kaestner. 'The key is to explain why it's needed and how it helps. Many men just need someone to open the door slightly. If they want to talk, they'll take that gap.' De Klerk agreed. 'Fewer men are embarrassed as much as they are afraid of the unknown,' he said. 'We meet them where they are, reassure them, and give them control of the process. The patient is in the driver's seat. We just navigate.' It's not just about doing Kegels. 'It starts with consent and a conversation,' said De Klerk. But don't do this at home, yourself, he warned the guys. Hypertonicity, or over-tightening, can occur. 'More men are trying to self-diagnose with apps and online videos,' he said. 'That can lead to more harm than help. Knowledge is not wisdom. A breadknife and a scalpel both cut, but one is made for the job.' Impacts sexual health Sexual health is, of course, a big driver for men to finally take some action. It's also a big taboo courtesy of society. Kaestner said that she found men do want to talk about stuff, but they do not always receive a safe space wherein to do so. As for the first step, De Klerk suggested a visit to a physio, GP or urologist. 'It is a great place to start. In the right clinical setting, pelvic rehab is a practical and evidence-based service. And don't be afraid, because there is hope, and there is no shame.' NOW READ: Feeling fine? Think again – Why annual check-ups are a must.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store