ASK THE DOC
Specialist surgeon and lecturer Dr Sarah Rayne answers your questions about cholesterol, the PCV13 vaccine and contraception.
Q: I have heard talk of good cholesterol. What is it?
A: Cholesterol is neither good nor bad: it is a requirement and building block for every cell in the body. But if too much of it builds up in the wrong place, it can increase your risk of heart disease and stroke.
To travel around the body, cholesterol piggybacks on lipoprotein, which is either high density (HDL) or low density (LDL). LDL is often referred to as ‘bad cholesterol’ because it encourages cholesterol to build up in the arteries in layers, and combines with triglyceride fat to increase the risk of heart disease. In comparison, HDL is ‘good’ because it scavenges LDL and its cholesterol, cleans up the arteries and transports everything back to the liver for reprocessing. Increasing the HDL in your blood helps combat heart disease and decreases your risk of heart attacks and stroke.
A blood test can measure the levels and different types of cholesterol in your blood. Everyone over the age of 20 should have it checked, and that caution extends to children if very high cholesterol runs in the family.
Q: Does the pneumococcal conjugate vaccine have side effects?
A: Pneumococcal diseases are infections that are caused by a group of bacteria called pneumococcus (pronounced new-mo-cock-us). Most commonly, the bug infects the lungs to cause pneumonia, the ears as an ear infection and the lining of the brain as meningitis. It can also spread through the blood as pneumococcal septicaemia. Both septicaemia and meningitis can be really difficult to treat, with some patients requiring intensive care. The bug is commonly found in most people’s noses and throats, and doctors don’t really understand why it suddenly invades the body.
Vaccination with the PCV13 vaccine protects against 13 types of this bug. The vaccine does not contain any living bacteria, only parts of the bacteria’s skeleton from which our clever immune system learns to identify the full bacteria if the body is invaded.
The vaccine has been freely available for all children in South Africa for the past 10 years. We don’t have statistics for this country, but in the USA the rate of severe infections has fallen by 88% since the vaccine was introduced.
There are minimal side effects: 50% of patients will experience drowsiness, and one in three will have a local reaction or mild fever, headache and chills. Severe allergies are very uncommon and almost always immediate: if you or your child has severe allergies or other illnesses, discuss these with a doctor before you have any immunisations.
If you’re undecided about vaccinating your child, google images of pneumococcal septicaemia before making a decision against vaccination.
Q: Is the copper T still considered a safe contraceptive option? I’m concerned that it may be outdated or dangerous, especially if you haven’t had kids.
A: The copper T is an intrauterine device (IUD) that is a long-acting and completely reversible form of contraception. It was first used more than 100 years ago but became really popular in the ’60s and has remained so.
It’s a small T-shaped piece of plastic covered in copper, which creates a hostile environment in the uterus, preventing the sperm from meeting and fertilising the egg. It’s usually inserted for five to 10 years but can last longer. There are some side effects, so it doesn’t suit everyone. It can be uncomfortable to insert, particularly if you haven’t had children, and it can make your periods heavier. However, if you’ve been using it without issue, stick with it! It’s still one of the most reliable methods of contraception, with a failure rate of less than 1%.
But remember, while the copper T will prevent an unplanned pregnancy, it does not protect you from sexually transmitted infections and diseases such as HIV. If you aren’t in a monogamous relationship, you should also use condoms.