Spring 2020 Spring 2021
Better Breathing An asthma sufferers life story pg.8
Breathe Better September launches! Understanding Obstructive Sleep Apnoea
Find out more about this often un-diagnosed condition
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Pg 5. Understan ding Obsructive Sleep Apnoea (OSA)
Our Team Chief Executive Letitia Harding Research and Education Manager Joanna Turner Office Administrator Dunia Cullingford
be eptem tter S e B e Breath nches Pg 6-7 lau
2 . Community news
Read about our Sailor the Pufferfish show, the new healthy homes regulations, and the huge uptake of our vaping education website.
3. Health professional news
PR and Comms - Head of Marketing Kate Davidson Marketing & Communications Advisor Sam Treseder
4. Respiratory research bulletin
Corporate Sponsorship and Engagement Advisor David Barclay
Read about a new asthma treatment study, how Vitamin D protects babies from respiratory illness, and trailblazing studies into vaping and COPD.
Medical Director Dr James Fingleton, BM, PhD, FRACP
5. Understanding Obstructive
Chief Cultural Advisor – Māori Sir John Clarke, KNZM, CNZM
Ground Floor, 85 The Terrace, Wellington Central, Wellington 6011 04 499 4592 ARFNZ.org.nz asthmaandrespiratoryfoundation asthmafndation asthmaandrespiratoryfoundation
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In this issue...
The Foundation’s COPD Guidelines featured in a recent edition of the Respiratory Research Review. Find out more about the guidelines and associated resources we have on offer.
Grants and Fundraising Manager Harriet Duncan
Pg 9. The Coug h Conund
Sleep Apnoea (OSA)
OSA is estimated to affect 3−5% of children, and is one of the most common respiratory disorders of childhood. At least 4% of adult males and 2% of adult females experience OSA too. Find out more about this often-undiagnosed condition.
6-7. Breathe Better September
The Foundation’s annual awareness and fundraising month is looking bigger and better than ever. Read about what we’re up to and some of the heroes who’ve stepped up to the challenge.
ISSN 2703-4127 Thanks to the Foundation’s sponsors for supporting our ongoing initiatives
help RCR reathe is b Kiw asier e
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pg.1
8. An asthma life story
One of our wonderful donors recently passed away. Her husband kindly shared her testimony about her life with asthma.
9.
The Cough Conundrum
Respiratory-musculo physiotherapist Tania Clifton-Smith shares some top tips for managing your cough.
10. Top tips for spring
We share a few tips to help manage your respiratory condition during hayfever season.
11. RCR helps Kiwis breathe easier
To show support for Kiwi youth living with asthma and other respiratory conditions, RCR will donate two heat pump systems to two education centres
12. ARFNZ partners with Dyson
Dyson offer intelligent air purifiers which automatically sense, capture and report pollutants in real time, including allergens.
Top Picks.. Page 4. Read about trailblazing Kiwi studies into vaping harms in our latest research bulletin Page 6-7. It’s Breathe Better September, and Kiwis are stepping up to the challenge Page 12. Partnering with our new Friends of the Foundation Dyson, whose innovative products make healthier spaces.
Did you know you can also read this magazine online? Head to the link below to view every issue of Better Breathing Magazine! issuu.com/betterbreathing
ARFNZ CE, Letitia Harding
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Letitia’s Message
ith the Delta outbreak and New Zealand once again plunged into lockdown, it has been a stressful few weeks for our respiratory community. I do hope you are all keeping safe and well out there. At the Foundation’s office, and more recently from home, our Foundation whānau have been busy preparing for Breathe Better September, a highlight in our calendar year. It’s a time to bring attention to the 700,000 people in New Zealand who suffer with a respiratory illness, and also a chance for people to get involved with their own individual challenges, while raising funds for the Foundation. We’ve been delighted to see a surge in sign-ups during the lockdown, with our heroes keen to take on a fun and lockdown-friendly fitness challenge and help a worthwhile cause. Money raised through Breathe Better September goes towards helping the 1 in 7 New Zealanders affected by a respiratory illness. The Foundation relies on grant funding as well as the support of the public to allow us to continue providing our asthma and COPD resources to health professionals and the public free of charge, and to continue advocating for those in need. You can go to page 6 to find out how you can get involved. The update of our online Asthma & COPD eLearning course has been a mammoth task, and we know that there have been some teething problems as we fix the old course and bring it into a much more user-friendly format. Bear with us, as we invest in updating the learning management system (LMS) so we can deliver a state-of-the-art online learning experience. The good news is that by overseeing this course in-house, we can engage with people who enrol one-on-one and address any questions you may have.
Remember, if you have any questions regarding the online Fundamentals eLearning course, you can contact us at info@arfnz.org.nz. On August 11th, we saw legislative changes come into effect around the sale of vape flavours. General retailers - dairies, supermarkets and service stations - across the country are now only allowed to sell three vape flavours: mint, menthol, or tobacco. It is part of a roll-out of Smokefree legislation, and the Foundation welcomed the move, which will support the Smokefree Environments and Regulated Products (Vaping) Amendment Act to ensure vaping products are not marketed to young people. Concerns were also highlighted in the World Health Organisation’s July 2021 report on the global tobacco epidemic. The report emphasises that Electronic Nicotine Delivery Systems (ENDS) are addictive and not without harm, and that they should be strictly regulated. The report also states that children and adolescents need to be protected from these products. It highlights the negative impact nicotine can have on brain development, leading to long-term consequences. The Foundation couldn’t do everything we do without support from our wonderful partners, who really understand what the community needs. Which is why we are so happy to once again partner with Te Taura Whiri i te Reo Māori to bring 15 Heremana Te Kōpūtōtara (Sailor the Pufferfish) shows to schools and kura across New Zealand in 2021 and 2022. While lockdown has impacted our schedule, we’re looking forward to our performer Hinerongonui
Kingi hitting the road with the engaging musical show, which educates tamariki about asthma, in the coming months. New Zealand’s asthma statistics are among the worst in the world, with Pacific people and Māori tamariki, mokopuna and whānau disproportionately affected. The ARFNZ biennial Impact Report on respiratory health was published earlier this month, and shows there are still huge disparities in respiratory health. Go to the ‘Key Statistics’ tab on our website to check the latest figures out. Other interesting topics in this edition of Better Breathing include an asthma sufferer’s life story on page 8. It’s a message from one of our donors, who recently passed away. Before she did, she wrote about her experiences as a lifelong asthmatic, and her husband kindly shared this with us. We also have a very practical piece of advice on cough management by respiratorymusculo physiotherapist Tania Clifton-Smith. Tania’s new book How to Take a Breath is out now, and we have a signed copy to give away. Head over to page 9 for more details. There is also a useful article on top tips to prepare for Spring allergies on page 10. Finally, as always, we hope that you continue to support and value what the Foundation does. Please provide us with feedback, the positive and the negative, as we welcome engagement from you - our readers. The Foundation can only do all that we do through the generous support of our Friends of the Foundation sponsors, our donor whānau, and the generous community grants that we are always so thankful to receive.
Letitia Harding Chief Executive
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Respiratory
news Celebrating Lyn’s service Lyn Tissingh, Manager/Nurse Manager and Respiratory Specialty Nurse from Asthma and Respiratory Management Bay of Plenty, is retiring after 17 years of outstanding service. In this time, she has become a well-known respiratory nurse throughout New Zealand. Lyn (pictured, centre) trained as an RN at Waikato hospital in 1977 then worked in a variety of areas. In 2003, she was offered the post of Respiratory Nurse/Manager at the then Asthma Centre in Tauranga, which was run mostly by mums with an interest in asthma and one full time paid nurse. “Lyn has been instrumental in turning the centre from an education centre for asthmatics into a centre of excellence for respiratory clients, which now includes COPD, bronchiectasis, pulmonary fibrosis, chronic cough and shortness of breath, as well as asthma,” says Elaine Page, Senior Respiratory Specialty Nurse. In 2014, the Asthma Centre was rebranded as the Asthma and Respiratory Management BoP Inc, or ARM BOP. Lyn developed networks amongst Respiratory and Cardiac consultants, Respiratory Physiology departments, GPs, Māori and Pacific healthcare providers, practice nurses, community nurses and other health providers. She also attends New Grade training programmes and community nurses’ training days for education around asthma and COPD, and education in proper use of inhalers/devices/spacers among other things.
More people seeking vaping info There has been a massive increase in visits to the Foundation’s vaping education website ‘Don’t Get Sucked In’ over recent months. Almost 5,000 new users visited the site between February and June, and it attracted 3,500 visits and almost 10,000 page views from mid-May to mid-June. The Foundation has also been receiving an increasing number of enquiries and requests from schools and teachers too, who are hugely concerned about the worsening teen vaping problem. For more information, visit dontgetsuckedin.co.nz
Sailor the Pufferfish sailing round schools and kindies The Foundation’s entertaining and educational asthma show, Sailor the Pufferfish, performed by children’s entertainer Chris Lam Sam, has been visiting schools and kindergartens in Porirua and Tawa thanks to the Trust House Foundation grant. Feedback we received from the schools and kindergartens has been massively positive. One school teacher said, “I have asthma and think everyone should see this show. It’s a shame our whānau all weren’t here to see this.” Another added, “What you’re doing is amazing - don’t change a thing!” A kindergarten teacher told us, “I learned something new today - I didn’t realise you needed to shake up the inhaler for each puff.” We’re now very excited to have our Te Reo show, Heremana Te Kōpūtōtara, hitting the road again soon, thanks to the kind support of Te Taura Whiri I te Reo Māori.
Healthier Homes for Kiwis On 1 July, the Foundation welcomed the implementation of the new Healthy Homes Standards, which will make it easier for tenants to keep their homes warm, dry and healthy. All private rentals must now comply with the Government’s Healthy Homes Standards within 90 days of a new or renewed tenancy. The Healthy Homes Standards ensure all rental properties must meet a minimum standard for heating, ventilation, insulation, draft proofing, moisture ingress, and drainage. “This is great news for all tenants, and especially for those living with a respiratory condition,” says Foundation Chief Executive Letitia Harding. “Living in a warm and dry environment is good for everyone, but for people with a respiratory condition it is vital for them to stay well.”
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Health Professional News COPD Guidelines featured in Respiratory Research Review
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he Foundation’s COPD Guidelines featured in Issue 186 of the Respiratory Research Review, which focused on COPD. Professor Lutz Beckert, who provides commentary for the Review, said “The ‘New Zealand COPD guidelines: quick reference guide’ addresses the needs of COPD patients.” He also noted how the quick reference guide helps health professionals to improve patients’ understanding of COPD by identifying and managing social and cultural issues, optimising knowledge of COPD and adherence to treatment, and developing an action and selfmanagement plan. Professor Beckert praised the concise nature of the quick reference guide too. The COPD Guidelines were developed by the Foundation’s working group of respiratory health experts, led by Professor Bob Hancox from the University of Otago and Dr Stuart Jones from Middlemore Hospital. The Foundation also has some great supporting resources available for COPD, including COPD Action Plans in English, Māori, Samoan and Simplified Chinese, Breathlessness Strategies for COPD, and a one-pager Breathlessness Quick Reference guide. Access the guidelines and the quick reference guide at nzrespiratoryguidelines.co.nz/copdguidelines.
Asthma and COPD Fundamentals eLearning course For $180, the Foundation provides the most current Asthma and COPD Fundamentals course available in New Zealand. It’s designed for all registered health professionals including nurses, pharmacists, physiotherapists, occupational therapists and GPs. The course has been endorsed by the College of Nurses Aotearoa (NZ) Inc. for 12 CPD hours. Updated in February 2021 to align with the new NZ Asthma and COPD best practice guidelines, the course incorporates the latest research with specific information for the New Zealand context, such as pharmacological and non pharmacological treatment, treating Māori and Pacific peoples and best practice health literacy. Visit learn.asthmafoundation.org.nz to find out more and enrol.
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Respiratory Research Bulletin R
help regulators assess the long-term safety of the flavours added to e-cigarette liquids.
New ways of treating asthma
While the added flavourings are regulated under the Food Standards Code, this only covers the safety of ingesting flavourings in food - not inhaling them.
esearch into respiratory health plays a vital role in improving understanding and treatment of respiratory disease. In this issue, we focus on a few exciting studies taking place here in New Zealand.
The Medical Research Institute of New Zealand (MRINZ) is launching a new year-long study on how patients should vary use of their 2 in 1 inhaler, in response to changes in the severity of their asthma.
MRINZ’s asthma research has included three landmark studies which have shown that a 2 in1 inhaler, containing both the preventer and reliever medications budesonide and formoterol, is far more effective than the traditional single reliever inhaler. Based on this knowledge, the Foundation recommends the use of AIR therapy as the preferred reliever treatment across the range of asthma severities. The new ‘AIR Algorithm Study’ of 100 New Zealand volunteers looks deeper into the implementation of AIR therapy, across the spectrum of mild to severe asthma. Dr Pepa Bruce, MRINZ Clinical Research Fellow says, “This study is the first to explore how people can move between different steps of AIR therapy... It should provide an extremely important piece of the evidence needed to empower people with asthma to take greater control of their own treatment.”
Vitamin D to protect babies A new study by the University of Auckland suggests pregnant women should take Vitamin D supplements to boost their baby’s immunity before it’s born, and thereby decrease the risk from respiratory disease. Currently, over half of babies are born Vitamin D-deficient. Researchers looked at Vitamin D levels from just over 1,000 babies at birth, and examined their respiratory admissions in their first year of life. Those with a Vitamin D deficiency were twice as likely to end up in hospital with an acute respiratory infection. “The safest approach would be for all pregnant women to receive the supplement as they do in other countries,” said University professor Dr Cameron Grant.
Vaping research under way
Meanwhile, the University of Auckland’s Dr Kelly Burrowes has launched the most advanced study of its kind in the world, using human trials and state-of-the-art 3D computer models to get a precise look at what vaping does to our lungs. The study examines what goes into vaping aerosols, where the chemicals travel in the body, and what effect they have on everything from cells to whole organs.
University of Auckland’s pioneering COPD research Researchers at the University of Auckland are pioneering a new approach to the understanding of COPD, combining worldleading research into genetic modelling of the disease with mathematical modelling of lung structure-function. The research is being led by Professors Merryn Tawhai and Justin O’Sullivan, who are respectively the deputy directors of the Auckland Bioengineering Institute and the Liggins Institute. They aim to develop an approach that will help identify how both disease and treatment affect people at a personalised level. “Everyone has their own genetic profile, and the way they respond to a disease such as COPD is different,” says Dr O’Sullivan. The disease will be investigated at myriad scales and levels, including DNA sequence, the cells involved, the way the cells interact in the tissue, the distribution of tissue damage within the lung, and more. “This will help us predict the trajectory of the disease at a very personalised and individualised level,” says Dr Tawhai.
Want to know more? We have collated leading peer-reviewed respiratory research from across the globe in our research portal. Check it out at asthmafoundation.org.nz/research
Otago University researchers have been funded to develop tests that will
Better Breathing 4
Understanding
Sleep Apnoea What is Obstructive Sleep Apnoea?
What treatment is available?
n Obstructive Sleep Apnoea (OSA), the muscles at the back of the throat relax during sleep so that part of the airway is closed off. This causes you to stop breathing, then partially wake before starting to breathe again. This cycle can occur hundreds of times during sleep, reducing the quality and benefits of a good night’s sleep.
In children, OSA can be treated effectively with an operation to remove the adenoids and tonsils, and in adults mild OSA can often be managed with lifestyle changes, such as diet and exercise.
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People with OSA experience snoring, daytime sleepiness, altered mood and morning headaches, which can result in poor work performance, and work and motor vehicle accidents. There is also an increased risk of cardiovascular conditions such as hypertension (high blood pressure), vascular diseases and arrhythmia (irregular heartbeat).
For children, untreated OSA can affect cardiovascular health, and impair their development, behaviour and learning. OSA is considered a contributor to overall health loss and a risk factor for other life-limiting conditions like coronary heart disease, ischaemic stroke and type 2 diabetes. Who gets OSA? OSA can occur at any age, and is more common if a person is overweight, sleeps on their back, uses alcohol or sleeping tablets prior to going to sleep, or has nasal obstruction or a narrow upper airway (e.g. enlarged tonsils or differences in face or jaw shape). In New Zealand, OSA is estimated to affect 3−5% of children and is one of the most common respiratory disorders of childhood. A minimum of 4% of adult males and 2% of adult females experience OSA, though most cases are undiagnosed. OSA rates are higher among Māori and Pacific people: OSA is twice as common in Māori males compared to non-Māori males. Māori and Pacific people tend to have more severe OSA and more comorbidities.
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People with moderate to severe disease will usually need treatment with a continuous positive airway pressure (CPAP) device. CPAP provides air pressure through a mask, which is worn during sleep. This works well in 70% of cases, so it is important that other treatment options are available for those who can’t use CPAP. Maintaining a healthy weight is especially important for OSA, as obesity can have serious effects on the lungs and breathing. New Zealand is now the fourth most obese country in the OECD, so for the good of our respiratory health we need to improve our eating and exercise habits.
What if I need more support? A physiotherapist can teach techniques to control breathing patterns and avoid breathlessness. They can also help improve your fitness and endurance, and boost your immunity levels. Visit physiotherapy.org.nz to find a local physiotherapist. A dietitian can provide education about the best foods to eat for people with a respiratory illness, based upon their medical condition and individual needs. Visit the New Zealand Dietetic Association (NZDA)’s website dietitians.org.nz to locate a dietitian in your area.
Want to know more? For more information and resources about Obstructive Sleep Apnoea, visit asthmafoundation.org.nz/your-health/ obstructive-sleep-apnoea
Step up this September to help Kiwis breathe easier
N
ew Zealand has one of the highest rates of asthma in the world, with 1 in 7 children and 1 in 8 adults living with the condition. That’s why each year, the Foundation runs Breathe Better September, our appeal month which offers a fun way to help raise the national profile of respiratory health in New Zealand and encourage better breathing.
The Foundation team have set their own Better Breathing team challenge: walking 700,000 steps over the course of September. for the 700,000 Kiwis with respiratory disease.
Sign up today! It’s fun, it’s simple, and the money raised makes a real difference for Kiwis with asthma and other respiratory conditions. What’s more, there are some great prizes to be won, kindly donated by our Friends of the Foundation.
Last year was a huge success, with almost 70 people taking part and raising over $20,000 for the Foundation. This year, we’ve broken last year’s record and have over 200 heroes signed up to make a difference.
You can sign up to complete a Better Breathing Challenge as an individual, family, or a team, with schools and workplaces encouraged to take part too.
“This year is looking bigger and better than ever,” says Foundation Chief Executive Letitia Harding. “There has been a surge in registrations since New Zealand went into lockdown, and while the lockdown might present a challenge for some activities, runs and walks in your local area are a great way to stay fit and raise funds at the same time.
If the Challenge isn’t for you, you can always just make a donation. Any donation of $5 or more puts you in the draw to win a prize.
“It’s always great to see communities and local businesses get involved and support the Foundation,” adds Letitia. “So many people have been touched by asthma and other respiratory diseases, and it’s wonderful that they want to give back and to make a difference for fellow Kiwis who are struggling.” The money raised contributes to the work the Foundation does to support the 700,000 Kiwis living with asthma and other respiratory diseases. The Foundation supports health professionals to help people living with these conditions, and educates and advocates for better respiratory health outcomes for all New Zealanders.
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Just want to donate?
Kids Art Competition As part of Breathe Better September, we are also running a kids art competition. The theme is “What a healthy home looks like to you” and is proudly sponosred by Micro Scooters. There are three age brackets for entry; 5 years and under, 6-8 years and 9-13 years. Each category winner will receive a Micro Scooter and have their artwork featured in the next issue of our magazine. You can see the details at breathebetterseptember.co.nz/ artcompetition
Be in to win Our friends have kindly donated some awesome prizes for us to give away! These include a Rinnai Heat Pump and installation, a Daikin Air Purifier, a month’s free power from Pulse Energy and a SmartVent home ventilation system!
To find out more, sign up or donate, visit breathebetterseptember.co.nz
Featured Fundraisers Nick Ashill We’re delighted that Victoria University Marketing Professor and ultra-marathon runner Nick is taking part in Breathe Better September! Putting his running prowess to good use, Nick will be completing a 24-hour running challenge. “My challenge is to run for 24 hours non-stop around Wellington city,” says Nick. “The run will start at 9am on Friday 24th September and finish at 9am on Saturday 25th September. People can join me on the day or throughout the night, and follow me on Strava.” Keep an eye on the Foundation’s social media for more details on Nick’s epic Breathe Better challenge.
Victoria Wilson Victoria has set herself the goal of walking 10,000 steps a day throughout the month of September. “While it might not sound a lot, when I’m sitting with my daughter in hospital and looking after her while she’s sick, it’s hard to find the opportunity to go out walking,” says Victoria. Victoria’s daughter Maddi, 7, has chronic suppurative lung disease and asthma, and is regularly in hospital. She recently contracted RSV while in hospital for another issue, and it developed into pneumonia and pleurisy. When Maddi is feeling well, she enjoys gymnastics, netball, and running around with her friends like any seven-year-old, but it does take a lot out of her. “She struggles with things many of us take for granted, like climbing flights of steps,” says Victoria. “Some days 100 steps are too much for her, let alone 10,000, so I want to put in the effort to raise money for others living with this condition. People often underestimate asthma and its seriousness. I see Maddi’s asthma attacks, and I wish everyone understood more how serious it is.”
Aimee’s Better Breathing Challenge: Aimee is planning to walk an average of 10,000 steps each day over the course of the month and encourage other people to join her. She has had asthma all her life, but says that as well as being her biggest struggle, it is also what makes her strong. “I’m a gym owner and live, BREATHE, walk and talk fitness to my clients,” says Aimee. “The importance of being fit and healthy is an investment we should all put at the top of our list - if you’re working around a life-threatening issue even more so. It truly makes you appreciate the simplest things in life when you’ve struggled to breathe before.
Mike’s Better Breathing Challenge: After raising a cool $1,000 for last year’s Breathe Better September, Mike Anderson is setting himself another challenge this year with the aim of raising even more. He’ll be rowing 50km over the month and blogging about his progress. Mike has lived with asthma his whole Iife, and is now a father to two lovely young boys. He says “asthma affects so many of our young kids and adults, and the Asthma and Respiratory Foundation do amazing mahi in working towards improving outcomes for everyone affected. There’s still plenty of work to do, especially around finding out why so many Kiwi kids have the condition.”
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An asthm asthma An life story sufferer’s life story
One of our wonderful donors recently passed away as a result of endocarditis. Her husband kindly shared her testimony about her life with asthma. “I have been asthmatic all my life. When I was 4, my parents starting building a beach house. During the project we stayed in what my sister and I called the “Ratty Bach”, an old converted barn. Every time we stayed I got asthma. Once the bach was finished we were there every school holidays, every long weekend and often weekends in between, and every time I got asthma, usually only on the first one or two nights. The attacks always happened at night. During the day I was fine and did all the things kids do at the beach. As I grew older I participated in sport without any problems. However, I was unable to stay overnight with friends as every time I would suffer an asthma attack. It was very frustrating. In those days the only relief came from a bottle of disgusting liquid called simply “The Medicine”. It did relieve the symptoms a little, but it was awful stuff. When I was 7, my doctor did skin tests. The results suggested I was allergic to the usual triggers of dust mites, cat and dog fur, feathers and cow’s milk. My parents were told to
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replace my kapok pillow with a rubber one and the mattress with an inner spring. I was taken off cow’s milk and ALL milk products. No more ice cream, cheese, butter, milk puddings or custard. I had to take a supplement of calcium powder. A good decision but revolting to eat. I still suffered from asthma attacks, but they were less often and less severe. At 14 I was prescribed ephedrine. It was very effective but gave me severe palpitations so it was discontinued. Medication improved over time, but the asthma stayed the same. When I was first married we lived in a very old house in Auckland. It had scrim and paper on the walls, which probably caused the first really serious prolonged unresponsive attack I had. At three in the morning my husband took me to the Emergency Department and I was given intravenous aminophylline. Instant result and such a relief. A few months later we moved to Australia and I was asthma free for five years. We returned to New Zealand, and at Christmas went camping on the Coromandel Peninsula. While there I suffered another prolonged and unresponsive attack. My husband took me to Coromandel Hospital.
I was given a subcutaneous bronchodilator, which gave relief but only for 4 hours. After three or four attempts, the staff put me in an ambulance and sent me to Thames Hospital. Once there, the symptoms finally subsided. Over the next few decades medication improved and eventually I was using Serevent and Beclomethesone morning and night as preventers, and Ventolin as a reliever. Then I was prescribed Atrovent as a reliever, which worked very well. In 2005 I moved with my second husband to Rotorua. My asthma improved, possibly due to the clean air, lower humidity, and maybe even the sulphur in the air. I suggested to my doctor that my medication could be revised and asked about Seretide. He agreed. Since then I stopped the Serevent and Beclomethasone. I didn’t use my reliever at all, and some days forgot to use the Seretide. After more than 60 years, my symptoms all but disappeared. All my early life I was told my asthma could resolve itself by the time I was 7, or 14, perhaps by 21. By 35, I guessed it would never be resolved. I want to thank everyone involved in the research and development of the drugs that made my life so much easier.”
The Cough Conundrum By Tania Clifton-Smith, respiratory physiotherapist
S
ince COVID-19 has swept the world, we have all become hypervigilant about coughing, both our own and other people’s. Coughing is a common reflex action whose function is to clear the throat or airways of mucus or foreign irritants. However, is it not as simple as that and there so many different reasons, forms and causes behind what triggers a cough. One could write a book on this subject. As a health professional, the first step is to identify the possible cause, and there are plenty: from the common cold, excess mucus, and gastric reflux through to purely habitual coughing. It helps to try and understand why the cough is present. The cough may be dry or moist. Secondly, and very importantly, the duration. A cough lasting less than three weeks is termed acute, and one lasting longer than eight weeks is defined as chronic. If longer than eight weeks, please see your health professional. Note that a cough can alert us to a problem. Thirdly, treatment strategies. Here are some top tips to try at home, but again we advocate to see a health professional if the cough is interfering with daily living and is persistent or chronic.
Top tips: Nose breathe; mouth breathing causes dry harsh air to move through the airway and can serve as an irritant. Breathe low and slow in your belly, at low volumes. Relaxed breathing patterns allow for energyefficient relaxed airways, whereas upper chest breathing at rest causes energy-hungry and tense breathing patterns, irritating the airways. •
•
•
Sip plenty of water. Hydration helps mucus move more easily, and helps a dry irritating cough. Pause between sentences when talking and swallowing to soothe the airways. Suck over-the-counter cough lozenges before telephoning/ speaking for long periods. Suppress the desire to cough: at the first sense of a tickle, swallow hard, then drop your shoulders and concentrate on breathing out, and focus on breathing slowly for a few seconds. Repeat if necessary.
If you still have problems, see your chest physiotherapist to learn how
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to do an effective assisted coughing for a chronic dry cough, or chest clearance for a chronic persistent wet cough. You can also visit asthmafoundation.org.nz for more information.
How to Take a Breath: reduce stress and improve performance by breathing Tania Clifton-Smith’s new book, How to Take a Breath, explores how breathing well empowers you to be well. Breathing might seem simple, but it turns out that most of us are doing it wrong, and when corrected it can be life changing. Making even slight adjustments to the way we inhale and exhale can jump-start athletic performance, rejuvenate internal organs, improve snoring, allergies, asthma and autoimmune disease, and even straighten scoliotic spines. Tania has been helping people correct their breathing patterns for over 30 years and has seen first-hand what a difference it makes. Learn easy-to-follow techniques that can help you optimise your breathing for a great reduction in stress and anxiety, better sleep, clearer thinking and improved performance in sports and at work. How to Take a Breath is published by Penguin and is available at all the main retailers including Paper Plus, Whitcoulls and The Warehouse.
Win a signed copy of How to Take a Breath! We have a signed copy of Tania’s new book to give away. To be in to win, email your name and address to comms@ arfnz.org.nz and title your email ‘Book Competition’. Entries close at 5pm on Thursday 30 September.
S
pring has officially sprung, and while it’s lovely to come out on the other side of the cold winter months, it does mean a whole new range of triggers emerging for people with asthma and allergies. Here are some tips to help keep your allergies under control this season.
1. Prepare for pollen Pollen is a fine powder produced by plants to fertilise other plants of the same species. From September to February pollen is abundant, and of course this is when we enjoy spending time outdoors in the warm weather. If pollen is one of your triggers, it’s a good idea to avoid going outside as far as possible on days when the pollen count is very high. The MetService website gives daily local updates on pollen levels and types. Pollen levels are generally highest in the morning, peaking around midday and then gradually falling. You can reduce your exposure to pollen when you’re outside by wearing sunglasses and a hat (if you have long hair, tucking it inside the hat is a good idea).
2. Keep windows closed – at home and in the car It’s lovely to have a spring breeze coming through the window, but unfortunately it brings pollen with it. Try to at least keep your windows closed in the morning when pollen levels are at their highest. When driving, try shutting the vents in your car and recirculating the interior air, or use an air conditioner.
3. Dry your clothes indoors Drying clothes on the line outside can be risky, as pollen settles in the fibres and can cause an allergic reaction when you put on the clothes later. If you have a dryer, use it. Otherwise, hang your clothes indoors.
4. Invest in an air purifier with a HEPA filter While we can do our best to keep our homes pollen-free, some of those tiny particles are bound to get in. A high-quality air conditioning unit with a HEPA filter can reduce the allergens circulating in your home. It’s good for mould, dust and pet hair as well as pollen, so whatever your triggers are it should help.
5. Keep your medication to hand Using your inhalers or other medications is one of the most important things you can do. While you can limit your exposure to triggers, you should always have your medication available in case of an emergency.
6. Do a spring clean using allergy friendly products Having a springtime declutter is a great idea, as clutter accumulates dust. When you’re shopping for cleaning products, choose allergy-friendly and fragrance-free ones – they’re safer for people with allergies, asthma or a chemical sensitivity. Keep up regular vacuuming and dusting too, to ensure you’re continuing to remove the pollen on your surfaces.
7. Take a shower at night Your body and hair can collect surprising quantities of pollen when you’re out and about. Taking a shower and washing your hair at bedtime is a good idea, and remember to wash your clothes and bedding as often as possible too.
10 Better Breathing
Allergy tips for Spring
RCR helps young Kiwis breathe easier R
CR Infrastructure is proud to partner with the Asthma & Respiratory Foundation to help support the 700,000 Kiwis with respiratory disease. As part of the partnership, RCR is teaming up with another Friend of the Foundation, Pink Batts, for the Foundation’s main campaign of the year: TM Breathe Better September. Throughout September, the Foundation raises funds and increases awareness of respiratory disease in New Zealand.
To show support for Kiwi youth living with asthma and other respiratory conditions, RCR will donate two heat pump systems to two education centres: Hutt Valley High School in Lower Hutt and The Satya Sai Preschool in Auckland. Our friends at Pink Batts will also be insulating both of these communal learning spaces, ensuring each space provides year-round comfort. With Hutt Valley High School unfortunately experiencing some issues with mould earlier this year, having the opportunity to work with RCR and Pink Batts was very welcome news following a tough start to the year, according to Principal Denise Johnson.
Asthma and allergies are among the most widespread and troublesome common medical conditions. New Zealand has one of the highest rates of asthma in the world, with 1 in 8 adults and 1 in 7 children living with the condition. If you or your child suffer from asthma, chances are you are acutely aware of the life-changing inconveniences that come with it. When a person living with a respiratory condition is exposed to common triggers like mould, dust mites, pollen, and atmospheric pollution, their airways can swell, restricting airflow to the lungs and making it difficult to breathe. Cold air is another significant trigger, which makes it important to invest in the best available heating solution. Heat pumps are a great choice for families who suffer from seasonal allergies, and new research shows that appropriate heating and insulation can reduce the incidence of asthma and allergies significantly. By simply choosing the right heat pump, you can reduce the allergy and asthma triggers inside your home and save on your energy bills and on potentially costly medical interventions for allergy and asthma symptoms.
“We’ve selected our Pavilion building for insulation and a heat pump,” says Denise. “It currently has an old gas heater and no insulation. It is a wellused space even though it is cold in the winter and hot in the summer. Adding a heat pump and insulation means it will be a more welcoming, healthy, and warm space for students and staff. “To have this space insulated, heated and cooled using a New Zealand company is very important to us,” adds Denise. “We are mindful of supporting New Zealand and work hard to establish links with local business and community groups.” In addition to the heat pump donations, RCR is thrilled to be taking part in a Step-Up challenge team for the month of September. You can follow the team’s progress here: https://www.breathebetterseptember.co.nz/t/ rcr-teams-team
Image: Hutt Valley High School Pavilion Building, 2021.
Better Breathing 11
ARFNZ partners with Dyson Since the global pandemic began, cleanliness in homes and commercial spaces has never been so high on the agenda. However, the impact of in-home and workplace purification and hygiene for those suffering from allergic rhinitis or allergy-triggered asthma symptoms can be underestimated. With Dyson’s deep understanding of airborne allergens, its 6,000 engineers and scientists recognise that cleaning surfaces and vacuuming carpets isn’t always enough to prevent the inhalation of allergens and that attention should be paid to the indoor air quality. Whether cleaning the air or floors and surfaces, machines with sealed filtration systems are crucial to managing allergen capture.
L
eading air pollution expert, Professor of Global Environmental Health, Sotiris Vardoulakis, from the Australian National University (ANU) Research School of Population Health says: “There are many different types of pollutants in the indoor environment that can exacerbate asthma symptoms or respiratory allergies when breathed in. Natural ventilation is important for reducing the levels of indoor pollution, but it is not always possible to keep the windows open due to noise, bad weather or outdoor pollution. Air purifiers (those with HEPA and active carbon filters) can be very effective in improving indoor air quality.“ With 25 years expertise in HEPA filtration and filter media, Dyson is one of the only manufacturers globally to have inhouse microbiology labs. The company’s in-house team of microbiologists puts emphasis on studying purifier filter contents to understand the air in real homes and workplaces. Pollen, plant fragments, pet dander, dust, dust mites and dust mite faeces regularly occur on purifier filters across the globe – and all happen to be particles that carry or produce allergens, the triggers for allergy and asthma symptoms. Importantly, they appear in both vacuum and purifier filters, showing the need to clean both air and surfaces. Dyson’s intelligent purifiers automatically sense, capture and report pollutants in real time down to 99.95% of particle pollution as small as 0.1microns1 , including allergens, bacteria, pollen and mould spores. The machines then project 290 litres per second of purified air throughout the whole room2. They are also engineered for real spaces: the industry standard for testing air purifiers measures performance using a laboratory test conducted in a compact chamber 12m² in size, with a ceiling fan to circulate the air and one sensor inside the room measuring air quality. For more representative testing, Dyson’s POLAR test is based on a larger room size of 27m² with no added fan and uses eight sensors in the corners of the room and one sensor in the centre to collect air quality data.
Dyson’s cord-free machines provide owners with powerful suction, as well as consistent high-performance cleaning including No Loss of Suction, fade-free battery through 1 discharge and fully-sealed filtration that traps microscopic particles such as pollen, dust and bacteria. Helping to create healthier homes, the Dyson V15 Detect is the most powerful, intelligent cordless vacuum3 , capable of detecting, removing, sizing and counting microscopic dust as small as 10 microns, for scientific proof of a deep clean⁴. For pricing, free delivery and dedicated business support for commercial spaces available with Dyson’s latest range of pioneering technologies, visit https://www.dyson.co.nz/for-business/overview, call 0800 397 667 or email nzcommercial@dyson.com.
1 Tested for filtration efficiency at 0.1 microns (EN1822) 2 Tested for filtration efficiency at 0.1 microns (EN1822), air projection (DTM801), purification coverage in a 81m3 room (TM-003711) and heating performance in a 35m3 room (DTM 961).
3 Suction tested to IEC 62885-4 CL5.8 and CL5.9, loaded to bin full, in Boost mode. ⁴ Quantity and size of dust displayed on screen varies depending on usage. Examples shown may occur within one or more displayed size range. Some particles have a range including sizes smaller than 10µm, which may not be detected.
12 Better Breathing
A natural way to help relieve congestion Helps relieve nasal congestion due to sinusitis, hayfever & colds Washes away allergens, dust & pollen
Helps clean & clear blocked noses* Non-medicated Helps maintain nasal health Available at your local pharmacy. Always read the label. Follow the directions for use. If symptoms persist, talk to your health professional. *Caused by excess mucus FESS® is a Registered trademark of Care Pharmaceuticals Pty Ltd ABN 30 009 200 604. Distributed in New Zealand by Healthcare Logistics, Auckland.
TAPS# PP7905
Find your local Society! Did you know that ARFNZ is affiliated with many asthma societies and groups across New Zealand who are here to provide you with support, rehabilitation and nursing assistance with your respiratory condition?
Horowhenua Breathe Easy Group iandlmckenzie@xtra.co.nz LEVIN 0279521439 06 3688069
MahiTahi Hauora 28-30 Rust Avenue WHANGAREI 09 438 1015
MahiTahi Hauora 182 Commerce Street KAITAIA 09 408 3142
Asthma NZ 581 Mt Eden Rd AUCKLAND 09 623 0236 0800 227 328 anz@asthma.org.nz
Manawatū Breathe Easy sjorgi64@gmail.com Palmerston North 0272420669
Eastern Bay of Plenty & COPD Support Group COPD@drct.co.nz Disabilities Resource Centre 141 King Street WHAKATANE 0800 227 363
Asthma Waikato info@asthmawaikato.org.nz www.asthmawaikato.org.nz 18 Claudelands Road HAMILTON 07-838 0851
Southland Asthma Society southlandasthma@xtra.co.nz Federated Farmers 70 Forth Street INVERCARGILL 03 214 2356
Asthma NZ Level 1, Salvation Army 125 Johnsonville Rd JOHNSONVILLE 04 237 4520 0800 227 328
CanBreathe office@canbreathe.org.nz www.canbreathe.org.nz 196 Hills Road, Edgeware CHRISTCHURCH 03-386-0278
North Otago Asthma sec.noasthma@gmail.com 0277535711 Asthma Otago otagoasthma@xtra.co.nz Dunedin Community House Cnr Moray Place & Gt King Street DUNEDIN 03-471-6167
Gisborne & East Coast Asthma Society lynlolohea@hotmail.com
14 Kennedy Street GISBORNE 06-868-9970
Asthma NZ C/- Korowai Aroha 1292 Hinemoa St ROTORUA 07 347 1012 0800 227 328
Nelson Asthma Society asthma.nelson@xtra.co.nz 9 Cambridge Street RICHMOND 03 544 1562 Asthma Marlborough Inc asthma.marlborough@xtra.co.nz Marlborough Community Health Hub 22 Queen Street BLENHEIM 03-579-1609
Asthma & Respiratory Management BOP reception@asthmabop.org.nz www.asthmabop.org.nz 254 Chadwick Road TAURANGA 0800 276 267
Breathe Hawke’s Bay admin@breathehb.co.nz www.breathehb.co.nz 199 Dickens Street NAPIER 06-835-0018
Tu Kotahi Māori Asthma Trust anne@kokiri-hauora.org.nz 7-9 Barnes Street Seaview LOWER HUTT 0800 939 462
About ARFNZ Asthma and Respiratory Foundation NZ (ARFNZ) is New Zealand’s principal authority for all respiratory conditions. The Foundation’s purpose is to lead respiratory health knowledge through research, education, and advocacy, with the goal to reduce respiratory related hospitalisations, and improve respiratory health outcomes for all.
