Managing Breathlessness Respiratory physiotherapist Zoe Manderson shares tips for dealing with breathlessness while exercising. Spring 2022 Better Breathing MANAGING STRESS & ANXIETY tipstopforspring We offer answers and advice to managing this common condition. Breathe FairweatherforcesSeptemberBetterjoinswithBrett YOURQUESTIONSASTHMAANSWERED PRESCHOOLUNDERSTANDINGWHEEZE
14. Respiratory Achievers Awards
Foundation for supporting our ongoing initiatives.
8. Respiratory Research Bulletin
Letitia
You can also read this magazine online Just head to /betterbreathingissuu.com ISSN 2703-4127
We share advice from experts on how to manage the ongoing stress and anxiety caused by chronic respiratory illnesses.
Answered Foundation Medical Director Dr James Fingleton answers your asthma questions.
The latest respiratory research looks at women and COPD, the overuse of asthma inhalers, the growing risk of thunderstorm asthma and how poor sleep links to COPD.
4. Managing Breathlessness
Respiratory physiotherapist Zoe Manderson shares tips for dealing with breathlessness while exercising.
Learn about recent developments in asthma management technology and find out more about the Foundation’s upcoming COPD talks for health professionals.
Julia Wikeepa shares her journey from childhood asthma to running a business inspired by breathing.
In this issue...
We find out about a network of COPD exercise and support groups in Canterbury and farewell long-term Asthma Waikato general manager Sheryl Long.
Thank you to the Pub Charity Ltd for their continued support of the Foundation, allowing us to provide Better Breathing magazine free of charge to the respiratory and healthcare communities.
9. Understanding preschool wheeze
Chief Executive
3. Your Asthma Questions
5. Health Professional News
how to manage breathlessness whileexercising.
Thank you to our Friends of the
Please recycle this material after use. This material has been printed with vegetable oil-based/mineral-free inks. The paper used comes from sustainable forests.
Pg 12. Check out our top tips foryour well-being this spring.
Harding Research and Education Manager Joanna Turner Office and Donor Appeal Administrator Dunia Cullingford Grants and Fundraising Manager Harriet Duncan PR and Communications Advisor Charlotte Lee-Smith Marketing & Communications Advisor Sam Treseder Marketing Assistant Polly Chamberlain Māori Community Liason Sharon Pihema Corporate Sponsorship and Engagement Advisor Amy-Rose Todd Medical Director Dr James Fingleton, BM, PhD, FRACP Chief Cultural Advisor – Māori Sir John Clarke, KNZM, CNZM Ground Floor, 85 The Terrace, Wellington 6011 PO Box 1459, Wellington 6140 04 499 asthmaandrespiratoryfoundationasthmafndationasthmaandrespiratoryfoundationasthmafoundation.org.nz4592
6. Breathe Better September
The Foundation’s annual celebration of inspiring individuals in the respiratory community is back. Find out how to nominate the achievers in your life.
forceswithaerobicscompanyJumpJam.
13. Top tips for spring
What is preschool wheeze and how is it different from preschool asthma? We offer answers and advice to managing this common condition.
Forecasters are predicting warm, wet conditions ahead which means pollen will be plentiful this spring. Learn some tips to help you get through the season.
It’s time to step up again! The Foundation’s annual fundraising campaign is back and this year we have the backing of a Kiwi aerobics legend.
Our Team
11. Managing the stress of respiratory conditions
12. My Breathing Story
2. Respiratory Community News
risk. Both are exciting developments and show how technology provides new methods of self-management for our Finally,community.someexciting news.
I am very pleased to share with you that the Foundation’s Respiratory Achievers Awards is returning for 2023. We last ran these awards in 2018, which feels like a lifetime ago! The awards are our opportunity to honour the efforts of outstanding individuals living with respiratory conditions. We have added a new category this year, the Respiratory Educator Award to acknowledge the invaluable contribution that nurse educators make to so many in our community. Find out more about the awards on page 14 and get your nominations in!
I hope you enjoy sitting down with this magazine and browsing through the articles, there’s lots to enjoy this issue. We love hearing your feedback, so please don’t hesitate to get in touch. You can email us at ChiefLetitiaNohoasthmaandrespiratory.org.nzinfo@oramaiHardingExecutive
If you find exercise a struggle, then you will want to read the article on page 4 by respiratory physiotherapist Zoe Manderson which covers dealing with breathlessness while exercising. Zoe is a member of the Foundation’s Scientific Advisory Board, and this is the first of several practical articles she will be sharing with us.
Kia ora Welcomekoutou,tothe
1 Better Breathing
spring edition of Better Breathing. I always look forward to this time of year when the days start lengthening, and we begin to see the sun more regularly. It’s a relief when winter finally comes to an
Advances in health technology continue at pace. On page 5, we cover two recent New Zealand developments; the release of a subscription-based asthma management app and new funding for Dr Amy Chan to begin work on a tool that may help predict asthma
It’send.been
Living with a long-term respiratory condition comes with a certain amount of stress and navigating a pandemic for the last three years has certainly compounded that for many of us. However, there are practical things we can do to manage anxiety so that we can continue to live full and active lives. On page 11, we share advice from two professionals, a clinical psychologist and a respiratory physiotherapist, on how to manage stress and improve wellbeing. Their advice is aimed at people living with respiratory illnesses, but it is valuable for all of us!
ARFNZ CE, Letitia Harding
a difficult winter for many in our respiratory community with lots of viruses doing the rounds, as well as COVID-19 variants, creating a severely overburdened health sector. On top of that there has been some truly dire weather creating a lot of disruption, especially for those at the top of the South Island, and even for us here in the Capital. It is unsurprising then, that as winter ends, I’m hearing from more and more of you about increasing levels of anxiety and stress.
Letitia’s Message
A key takeaway from this article is the importance of exercise for both good lung health and wellbeing. This is something that the Foundation is promoting in our biggest annual appeal that launched this month; Breathe Better September. We are encouraging New Zealanders to sign up for an active, achievable challenge for the month that will help improve lung health, while raising money for the Foundation’s work. This challenge could be walking, climbing stairs, singing or joining our friend Brett Fairweather, creator of kids’ aerobics programme Jump Jam, in some classic Kiwi workouts. You can read more about our plans for the month on page 6.
JuliehaveAsthmaservices.WaikatoappointedRangitaawa as the new 2022.roleSheManager.Generalwillbeginheron12September
The Waikato respiratory community is farewelling long-term asthma advocate and educator, Sheryl Long, who is moving on from her role as Asthma Waikato General Manager.
Sheryl says her approach to asthma education has been to focus on “the why” of asthma care. “I think if people understand the why, they will be more willing to comply. So, for example instead of simply saying, you need to shake your inhaler before you use it, it’s important to explain that it’s because you need to mix the medicine and aerosol together first, otherwise you’ll just get one or the other, which doesn’t work. People get that and are therefore more likely to do it.”
Over her six years heading the society, Sheryl has helped hundreds of families and transformed the society into a well-oiled machine. She says the biggest rewards have been receiving feedback from families who have benefitted from the service and being there for “penny drop moments” with
“Whenclients.
Volunteer-run exercise and social groups are providing vital services to people with respiratory conditions in Christchurch.
Christchurch COPD exercise and coffee groups build community
2 Better Breathing
The success of this model is clear; Pauline has gone on to set up three more exercise and coffee groups and further, two are run by different volunteers in other areas of Christchurch.
The first group was based at the CanBreathe (Canterbury Asthma Society) rooms and offered a mix of exercise, socialising and information to participants. “We exercised to music for half an hour using Thera bands, hand weights, balls, bean bags and scarves. Before COVID struck, we used the next hour for guest speakers and anything people wanted to hear about, as well as enjoying bikkies, coffee and sometimes home baking,” says Pauline.
you see that someone understands what asthma is and what the medicine does, that is really satisfying,” she explains.
Respiratory Community News
This understanding came from her own journey with a daughter who had severe asthma as a preschooler. “I was that Mum who didn’t get it. I didn’t understand that asthma could be well-managed and not interfere with day-to-day life,” she recalls. Over time, she learnt more about asthma management, including the importance of preventer inhalers. As she began to see her daughter’s asthma improve dramatically, Sheryl was inspired to share that knowledge and to let others know that asthma is not a life sentence, and in fact, uncontrolled asthma can have serious consequences.
Over the years, the group has had speakers on a wide variety of topics including health, gardening, home heating and legal issues, and they have completed two first aid courses.
COVID has meant that the groups haven’t been able to host guest speakers recently, but Pauline says that instead they have drawn on the expertise of participants. “There is a wealth of knowledge that we have on all types of subjects, so we share. Our coffee and chats are fantastic.”
Farewell to Sheryl Long
“For me that’s the biggest thing. Asthma is simply a glitch in the body. All it means is that you’ve got airways that are overly sensitive. For the vast majority of sufferers, asthma is manageable and preventable. You don’t just have to bear it. You can live a full life.”
After many years in asthma care, Sheryl identifies the biggest challenge as the inconsistency of information provided to people with asthma. “They are told one thing by the hospital, another by the GP, then there are different instructions sometimes with the medications. It is really difficult for people to know what to do and it’s beyond frustrating for us when we are trying to help them.” She also points to regional inequity around funding as a major barrier to offering asthma
Pauline Mohi, who lives with COPD, set up the first group six years ago after completing the eight-week Better Breathing course for COPD run through the Canterbury Clinical Network. “I became a volunteer on the course, and I realised that I needed to keep up the rewards of all I had learnt, so I set up an exercise and coffee group for people with breathing problems,” she explains.
“The groups serve both our physical and mental wellbeing. Most of us believe that coming to the groups has kept us out of hospital and many say they couldn’t imagine their lives if they didn’t come to the group. We have great fun,” says Pauline.
If you have a question you would like answered about asthma, or another respiratory condition in the Better Breathing magazine, send it to comms@asthmaandrespiratory.org.nz
I can’t remember if I’ve used my preventer inhaler, is it OK to take an extra puff or should I wait until the next day?
There’s no direct link that means someone with diabetes or rheumatic disease is much more likely to get asthma. There are some complex interac tions which means that people with multiple conditions are more likely to be diagnosed with other conditions.
Generally speaking, if you don’t remember taking it, one extra puff or two extra puffs isn’t going to cause any harm at all. If you’re regularly not sure, then try and think about when you take your inhaler and if there is something you can do to help you remember. Can you take it at the same time as you clean your teeth every day or can you set a reminder on your phone?
3 Better Breathing
I’m a mum with severe asthma, is it likely my baby will get asthma?
Your baby is at slightly higher risk of having asthma, but not necessarily of having severe asthma. There is a genetic component to asthma, but also asthma is affected by your environment. Someone that lives in the same household as you will be exposed to the same allergens and may share your triggers. It’s something to be aware of. If you notice your baby has symptoms, then it’s worth discussing this with your doctor.
Is asthma related to rheumatism and diabetes?
Any suggestions on how to get back in control of my asthma after having COVID?
ASTHMAYOURDRFOUNDATIONANSWEREDQUESTIONSASTHMAYOURMEDICALDIRECTORJAMESFINGLETONANSWERSQUESTIONSABOUT
There are a number of ways that having had COVID can affect your breathing, I’d recommend if your breathing is worse than usual that you arrange a review at your GP practice. If you don’t have a per sonalised asthma action plan from your doctor, with instructions about how to change your reliever and preventer medication when your asthma worsens, then this should be important as part of a review. (Editor’s note: free downloadable asthma action plans are available at asthmafoundation.org.nz/resources)
I have mild asthma and only use my preventer when my asthma gets worse. Is that OK, or should I be using it regularly?
This is something we see a lot because people whose asthma is relatively mild will feel they don’t want to take a medication every day because they feel well. The problem with that is, if you don’t take medication regularly you can get more inflammation in the lungs, which means you are much more likely to get a flare up of your asthma. I would recommend that you use a regular Standardpreventer.bluereliever inhalers, like salbutamol will help with your symptoms at the time, but they don’t do anything to prevent the asthma. In fact, if you overuse them, they can make your asthma worse.
BREATHLESSNESSMANAGING
All this means that daily activities that might usually make you breathless (eg. getting dressed, hanging out the wash ing) will become easier, so you have more energy to get on with the fun stuff in life!
If you become excessively breathless, feel dizzy or experience chest pain while exercising, stop what you are doing and seek medical attention.
Pursed lip breathing: try breathing out through pursed lips (lips held close together so just a little bit of air can escape). This provides back pressure to splint your airways open to allow all the breath out and make room for your next breath in.
If you have a respiratory condition and want support to exercise, ask your GP to refer you to your local pulmo nary rehabilitation programme or a respiratory physiotherapist.
Here are some tips you can try to help manage your breath lessness while exercising:
About the author
Exercise can be a challenging thing to contemplate when you have a respiratory condition. If you suffer from breathlessness, you might worry that exercising will make you more breathless.
Pace yourself: try and exercise at a steady rate and slow down or take rests if you need to. Don’t forget, use gentle exercise to warm up and cool down.
Rescue (reliever) inhaler: if you usually use a rescue inhaler/puffer to help manage breathlessness with exercise, try taking it before you exercise. Remember to always use a spacer if one can be used with your inhaler.
Know your triggers: if certain things (eg. cold air, fumes, pollen) make your breathing worse, try and avoid these when you exercise. This might mean you exercise inside at a gym or even by walking around your local mall. If you want to exercise outside, con sider wearing a scarf or something similar that you can pull over your mouth and nose to warm the air you breath in.
Getting breathless is a normal reaction to exercise; it is just the point at which you start to huff and puff that varies. Breathlessness with exercise is not harmful. In fact, doing exercise will help improve your breathlessness, because it will make you fitter by making your muscles stronger and improving the efficiency of your heart and lungs.
4 Better Breathing
Recovery positions: if you need to take a rest during exercise, try and use a forward lean recovery position (eg. leaning forward with your hands on your knees or rest your elbows on a surface like the back of a chair). This will give support to your breathing muscles to help you recover (see below)
Zoe Manderson is a respiratory physiotherapist in Taranaki for Te Whatu Ora and a member of the Asthma and Respiratory Foundation’s Scientific Advisory Board .
Tips from Respiratory Physiotherapist Zoe Manderson
Senior clinical research fellow at the School of Pharmacy, Uni versity of Auckland, Dr Amy Chan has received $250,000 from the Health Research Council to use over the next three years to develop a tool to help patients and whānau predict the risk of asthma attacks. In the first stage, Dr Chan will collect data including step counts, sleep patterns, breathing rates, medica tion use, peak flow rates and weather patterns from both the environment and smart devices.
Asthma technology in New Zealand has had two important advances in recent months with the release of a new asthma management app and funding secured for the development of real-time risk prediction tool.
Dunedin Speaker: Professor Bob Hancox (Research Profes sor and Head of Preventive and Social Medicine at the University of Otago)
Date: 16 November 2022
HEALTH PROFESSIONAL NEWS
Wellington Speaker: Dr James Fingleton (respiratory physician, Presi dent of the NZ branch of The Thoracic Society of Australia and New Zealand, and Medi cal Director for ARFNZ)
She will then use artificial intelligence (AI) techniques to analyse this data and determine which factors are most predictive of the asthma attacks. The final stage will involve building a risk predication model that can be integrated in a smartphone app, allowing users to monitor their risk of asthma attacks in real time and take preventative action.
eventually see the value in purchasing this technology for all New Zealanders.
Locally designed and developed asthma management app, RespiTrak, was launched in late July by Active Health Tech. The subscription-based app allows users to record data on their symptoms and general health, and record their peak flow using a Bluetooth peak flow device which feeds data directly to the Theapp.app
Date: 26 October 2022
The app will save users’ data securely and allow users to share this data with health professionals in personalised reports. The developers have plans to incorporate more data into the app in the future. The first feature in develop ment will provide information on quantities and sources of pollen in the environment.
All attendees will receive: a copy of the NZ COPD Guide lines, a COPD Quick Refer ence Guide, COPD action plans in various languages, and a free registration for the Foundation’s Asthma and COPD Fundamentals eLearn ing course, valued at $135.
5 Better Breathing
Once installed, the sensors will feed the data to the cloud where AI technology will analyse the findings and send them to the RespiTrak app. The company hopes to have the first three sensors in place in Auckland by early September 2022.
Presentations will be followed by a Q&A session and a coffee and catch up.
5 Better Breathing
can be used by individuals or families, with one sub scription covering a parent and up to five children. The app costs $20 per month, but RespiTrak product manager Brent Sorensen says the company will offer a limited number of free lifetime subscriptions through asthma societies to those most at need. They are also hopeful that the Ministry of Health will
To supply this information, Active Health Tech is looking to install 12 pollen sensors at key locations across New Zea land to collect data on pollen.
Advances in asthma technology
Please contact joanna@arfnz. org.nz to express your inter est in attending these events.
Zealanders living with a respiratory illness, everyone has a friend, family member or colleague who at times struggles to breathe. “We have one of the highest rates of asthma in the world. Respiratory diseases are the third most common cause of death in New Zealand and cost an estimated $7 billion every year. The Foundation is working hard to change those outcomes, but without Government funding, we are reliant on the generous support of New Zealanders who understand the seriousness of respiratory conditions and who want to make a difference,” says Letitia.
How it works
Scan the QR code to visit the Breathe BetterwebsiteSeptember
www.breathebetterseptember.co.nz
Visit our website: breathebetterseptem ber.co.nz and sign up to do a challenge for the month of September. You can choose the challenge that suits you: run ning, walking, singing, dancing aerobics or some breathing relaxation exercises.
The next step is to invite your commu nity to support your challenge.
6 Better Breathing Pictured: ARFNZ Chief Executive Letitia Harding and Jump Jam founder Brett Fairweather
Breathe andSeptemberBetterisbackbetterthanever!
Last year, 250 people signed up to do a better breathing challenge in September, raising a total of $15,598. Foundation chief executive Letitia Harding says this was a significant achievement, given the 2021 cam paign was disrupted by a COVID-19 lockdown. “There was such an impressive effort from so many of our supporters last year despite not everything going as planned. We are hopeful that New Zealanders will step up again, given how many of us know someone directly affected by respira tory Withillnesses.”1in6New
The Foundation’s an nual Breathe Better September appeal kicks off this month, and we are asking Kiwis to step up for their own lung health and to raise money for our work on behalf of New Zealanders with respiratory conditions.
do an individual challenge, or get together with friends, workmates or family for a team challenge.
The Foundation is hoping to raise $20,000 this September with the help of our supporters.
Commit to doing this challenge for at least 16 minutes a day (for the 1 in 6 people with respiratory disease in New SignZealand).upto
Find out more about Team Jump Jam here:teamjumpjamwww.breathebetterseptember.co.nz/www.breathebetterseptember.co.nzwww.breathebetterseptember.co.nz
If doing a challenge isn’t for you, you can always make a donation. You can donate via the QR code or choose a challenger to support through our website:
Why do it?
Breathe Better September is receiving a turbo-charged boost from iconic kids’ aerobics company Jump Jam this year.
People can donate directly to your profile page on the Breathe Better September website. All the money raised during the campaign will directly fund the Foundation’s education, research and advocacy work.
Just want to donate?
Stepping it up with Team Jump Jam
Brett is hoping current and past fans will jump at the chance to join Team Jump Jam this September. “The Foundation does such important work. Everyone in New Zealand knows someone with asthma or a respiratory condition. They deserve to have full and active lives, and the Foun dation is working to make that happen.”
As well as raising funds for a fan tastic cause, you will improve your own lung health (and maybe the lung health of your teammates!). As an added incentive, we have some amazing prizes that have been supplied by our generous Friends of the Foundation and oth er business supporters. Everyone who raises more than $20 during Breathe Better September will go in the prize draw.
Jump Jam creator, and New Zealand aerobics legend, Brett Fairweather will be sharing eight of his all-time favourite workouts across the month and encouraging Kiwis to join him for a quick, fun-filled aerobics routine. “Jump Jam has been keeping kids active for over 20 years, so I am really happy to be able to use our resources to help this fantastic cause,” he says.
8 Better Breathing
Respiratory Research Bulletin
change, and for regular airborne pollen monitoring in all major New Zealand cities.
Climate Change increases risk of thunderstorm asthma
The research from Queen Mary University of London found that of the 700,000 people surveyed aged between five and 80 years old, more than a quarter were receiving six or more SABA (short-acting betaagonist) inhalers a year, with some receiving more than 12. Overuse of this type of inhaler can increase the airways’ sensitivities to triggers and hide the severity of underlying asthma control. It also found that a quarter of the study participants were underusing preventative corti costeroid inhalers.
Overuse of rescue inhalers in the UK
The research into respiratory health that takes place in New Zealand and overseas plays a vital role in helping us to understand, diagnose and treat respiratory conditions. Read on for cutting-edge research from Aotearoa and beyond.
The researchers are calling for health authorities to be prepared for this
asthma is caused by the effects of storms on airborne al lergens like pollen and fungal spores. The storm breaks the allergens into fine particles that can be inhaled and then trigger asthma symptoms. Inland areas with extensive plantings of pollen-producing grasses, like the Waikato, are thought to be particularly vulnerable to thunderstorm asthma. Thunderstorm asthma can affect peo ple with no prior history of asthma, and those with pre-existing asthma.
New research has found that the risk of asthma triggered by thunder storms in New Zealand will increase as the climate warms. The research ers shared these findings in the New Zealand Medical Journal, and warned that while this asthma is currently rare, the increase in summer storms caused by climate change, combined with our high levels of pollen could lead to much of the country being at risk of future
Thunderstormevents.
Tech helps people to take asthma as prescribed Technology could be a gamechanger for asthma management according to a review published in June by researchers from New Zealand and the UK. The authors found that digi tal technologies, like text message reminders or adherence monitors attached to inhalers, improved regu lar medication taking by 15%. They also discovered that those using digital technology had better control of their asthma, and half the risk of asthma attacks.
Women may be at greater risk of COPD
New research has shown that women have narrower airways than men, which increases the risk of chronic obstructive pulmonary disease (COPD). In the study, researchers analysed the lungs of 10,000 people aged between 45 and 80. They found that in both smokers and non-smokers women’s lungs were narrower, while men had thicker airway walls. The researchers said this difference may make women more susceptible to developing COPD and other airway disease. They also explained that smoking causes air ways to narrow further, which means women who smoke can experience more severe symptoms of COPD.
Poor sleep and COPD flare ups
Poor sleep is linked to a significantly increased risk of COPD flare-ups according to a new study by the US National Institutes of Health. The risk of sudden bouts of worsening breathing was between 25% to 95% higher in people who had poor quality sleep. The lead author said that sleep was a better indicator of the risk of exacerbation than the patient’s history of smoking. Those people with the worst sleep had a 95% increased risk of having a COPD flare up within a year, while those at the lower end of the scale had a 25% risk of a flare up.
A study of British asthma patients has found that 26% were overusing their rescue inhalers, putting them at greater risk of severe asthma attack and hospitalisation.
What exactly is preschool wheeze? Isn’t that just asthma? Many parents find the diagnosis of preschool wheeze confusing. In this article we try to explain the difference between preschool wheeze and preschool asthma, and why it can be difficult to diagnose asthma in a young child.
What’s the difference between preschool wheeze and preschool asthma?
Often people use the terms wheezing and asthma to mean the same thing, but for health professionals it has different
infrequent preschool wheeze is used to describe a mild wheeze that only affects your child when they have a virus, but otherwise they are wheeze-free. It may be treated with a reliever inhaler.
The treatment will depend on how often your child is experiencing wheezing and how severe the symptoms are. Healthcare practitioners might give your child a reliever inhaler and then try other preventer medications if needed. Always talk to your healthcare practitioner if you feel the treatment is not controlling your child’s symptoms or if they are getting worse.
It can be important to know if your child’s preschool asthma diagnosis has changed as it can have consequences for their future. It could limit job opportunities (Police) or recreational activities (diving) and it can affect travel and life insurance, although many children with asthma face no limitations on what they can do later in life.
What can I do to help my wheezy preschooler?
Understanding preschool wheeze
How is it diagnosed?
Wheezing is a high-pitched, whistling sound caused by narrowed airways. Wheezing can be a sign of asthma. However, wheezing in children between one and five years old is often caused by viral illnesses. Many preschoolers who experience wheezing, do not go on to have asthma when they are older.
Anmeanings.
Preschool asthma is when your child frequently experiences wheezes (more than every six to eight weeks) or severe flare ups with viruses, or has other symptoms between viruses or flare ups, like regular night waking with either a cough or wheeze. If your child responds well to treatment with an inhaled corticosteroid inhaler (like Flixotide), that is another indication they may have preschool asthma.
It is unlikely they will test their lung function using spirometry or peak flow, as these tests aren’t usually suitable for preschool lungs.
To make this diagnosis, health professionals need to understand your child’s and family’s health history, the frequency of their symptoms and how they respond to treatment before they can be sure that your child’s wheeze is preschool asthma. It is a diagnosis that can take time and may change as your child gets older. For that reason, it can be frustrating for parents trying to understand what is going on with their child. If you think that your child’s wheeze is changing, or becoming more frequent or serious, always contact your healthcare practitioner.
What will your health professional need to know?
9 Better Breathing
Will preschool asthma or preschool wheeze go away as my child gets older?
What treatment is given to preschoolers with a wheeze?
What is a wheeze?
It might, which is why it’s important to get your child reviewed when they are school-aged. At this age, healthcare practitioners may be able to do lung function tests like peak flow measurements that will help with a diagnosis. It also could be the time to reassess medication. If your school-aged child is diagnosed at this point, their diagnosis will change from preschool asthma or preschool wheeze to asthma.
Ask lots of questions when you visit your health professional. Ask them to explain what can cause a wheeze and what they think is happening for your child. Ask what treatments are available in this situation and what other information they can provide you. Ask about how to best use a spacer and inhaler, if this is Keepingprescribed.your home smokefree, and as warm and dry as possible will also help your child. Encouraging regular handwashing, keeping up with immunisations and reducing exposure to triggers like dust, mould and pet fur will also make a big difference to your child’s health.
To make a diagnosis, your health practitioners will ask you about how often the wheeze occurs and how long it lasts. They will also want to understand what triggers the wheeze; it might be exercise, laughing, crying, cold air, allergies or a virus. They may listen to your child’s chest and check their temperature and oxygen levels.
Your brain is always thinking and
Understanding your condition, its symptoms, your triggers and the treatments available is essential to managing stress. This knowledge will help take away the fear of the unknown and allow you to help yourself. It is also vital to accept your diagnosis. No one wants a respiratory condition but accepting that this is your reality can allow you to move on with your life. “The only place you can recover from is where you are at right now,” explains Fran.
Good things still lie ahead
Understand and accept your condition
Many people believe when they are diagnosed with a respiratory illness, they can no longer do the things they love.
Learn breathing control techniques
ANXIETYANDSTRESSMANAGING
While a positive attitude to life will help your mood, it’s also OK to have bad days. “Self-compassion is really important,” explains Fran. “Research shows that we do better with health conditions when we are kind to ourselves rather than beating ourselves up when things don’t go as planned.” Instead of getting angry with yourself, Fran recommends reminding yourself that you are doing your best and living with a respiratory condition is challenging.
Living with a long-term or serious respiratory illness can be stressful. There can be frustration at your current circumstances, grief at the loss of the life you once had, fear at what the future holds, and ongoing anxiety triggered by breathlessness. The good news is that there are ways to manage those stresses and to continue to find joy in your life.
We asked two health professionals, Te Whatu Ora Taranaki clinical psychologist Fran James, and Hutt Valley-based physiotherapist Colleen Stevens, for their advice on how to manage the stresses of a respiratory condition.
Be physically active
your mind. When you are breathless, your body sends danger signals to the brain, making you feel anxious. That anxiety can make you even more breathless. Breathing control techniques will allow you to get your breath back more quickly and stop that negative anxiety/breathlessness cycle. Fran points out that sometimes when you are breathless, your brain can automatically ‘switch on’ feelings of anxiety, even when you are not stressed. “In this situation, you need to ask yourself: ‘What’s going on in my body?’. Perhaps I just need to concentrate on my breathing to feel calmer.”
what you think affects how you feel and what you do. Often the first step to reducing stress and anxiety is mindfulness; to become aware of your thoughts, and then ask; are these thoughts helpful or harmful? Some thoughts can make you feel more stressed. “We need to learn how to say I’m not going to pay attention to that unhelpful thought, or I’ll just let that one go past,” explains Fran. Colleen encourages people to take the ‘glass half full approach’ to their lives. “Instead of focusing on the things you have lost, think about what you can do.”
Be kind to yourself
Breathing control techniques can help control breathlessness and calm
10 Better Breathing
Are my thoughts helpful or harmful?
Both Colleen and Fran agree that exercise is key to managing both your mental wellbeing and your respiratory condition. “Regular exercise is the thing that’s going to make you feel less breathless and get you stronger. It will enable you to do more, and if you can do more, then you’re going to feel better about yourself,” explains Colleen. “It also builds confidence, so people realise that they are capable of doing things they might have thought impossible; like doing the shopping or attending a child’s sports game.”
COVID and stress
11 Better Breathing 11 Better Breathing
Find people who get it Joining groups with other people who have respiratory conditions can be incredibly powerful (see page 2 for an example). “You’ve got people around you that have a shared knowledge and a shared understanding in a really deep way of what you’re going through. The groups that are the most success ful are the ones where you can have fun and laugh a lot. Nobody wants to sit around and talk about misery!” says Fran. A list of pulmonary rehabilitation classes can be found on the Foundation’s website.
Colleen cautions that when it comes to dealing with stress there is no one solution. “You need to take a holistic approach. It’s doing exercise, it’s setting goals and it’s being aware of your thoughts. It’s putting all those things together.”
Talk about what’s going on Your family and friends may not understand what it means to have a respiratory condition. They
Colleen Stevens is a physiotherapist based in the Hutt Valley who has taught pulmonary rehabilitation classes for the last 20 years.
Fran James (pictured above) is a consultant clinical psychologist based in Taranaki who presents at pulmonary rehabilitation classes on managing stress.
could either underestimate or overestimate how your condition is affecting you. For example, you may feel stressed by expectations to continue to look after grandchil dren or it could be that you may stop getting invited to events, as people think you won’t be able to cope. Openly explaining your con dition and how you are managing it, will help everyone to under stand what you can manage.
They warn against trying to push through when you’re struggling or doing extra when you are having a ‘good day’ as this can lead to exhaustion and worsening symp toms. They also warn about priori tising work or tasks and forgetting about social time and hobbies. “If you fail to make time for the things you love it can lead to feelings of frustration, low mood and irritabil ity,” Fran explains.
For more information on improving your wellbeing check out this TedTalk from psychologist Lucy Hone on get ting through tough times and the Mental Health Foundation’s has great tips on wellbeing, including these tips.
Fran explains that this doesn’t need to be the case. “You need to think about what matters to you the most and find ways to adapt those things, so you can continue to enjoy them.” She gives the example of tramping. It could be that what a keen tramper enjoyed most about that activity was being in nature or the companionship of certain friends. While they might no longer be physically capable of going bush, they could still drive somewhere and sit in nature, or catch up with those friends over coffee.
COVID has heightened stress levels across the world, particularly for those people already dealing with respiratory conditions. Fran says the recent impact of the ‘twindemic’ (COVID and flu) on our hospitals has been another stress for the respiratory community this winter. Her advice is to keep protecting yourself from COVID, but to find ways to keep living and enjoying your life. Colleen encourages those who are staying home to avoid COVID, to keep moving. “If you stop exercising then you will become more symptomatic and that will cause more stress.”
Last thoughts
One of the hardest things to learn when managing a respiratory dis ease is how to use limited energy wisely. Fran and Colleen suggest looking at the whole day and prioritizing what you need to do and then planning for the day or week ahead. For example, if you have a doctor’s appointment in the afternoon that you know will be draining, then you might need to have a quiet morning.
Fran emphasises that stress is part of life and the way our body responds to what’s happening around us. The stress response can be useful when we need to step up to meet a challenge, but when we feel stress all the time it can become a problem. She explains: “The goal isn’t to never feel stressed. The goal is to be able to recognise when you are stressed and to take action to deal with it.”
Prioritizing and planning
Asthma & FundamentalsCOPDeLearningCourse enrol learn.asthmafoundation.org.nznowGain12CPDhourswiththe Course available to healthcare professionals only*
I started using breathing techniques in my own life. When I felt anxiety come on, I would do a long ex
In January, I launched my business which sells a breath ing necklace. It’s a tool that can help you connect with your breathing, which is something that many people don’t do. They’ve unlearnt that habit. For some people using the tool might feel uncomfortable to start with, but it’s about doing it gently and not pushing yourself.
Growing up, quite a few of us in our family had asthma and my father had it quite badly his whole life. Seeing his struggle made me see that breathing is a gift and it’s something that we take for granted.
Iclearly.wasteaching
a hauora course in schools to help kids learn how to deal with stress and big emotions and breathing was a big part of that. I think we need to give it more focus in our education system and normalise using it as a tool to help with wellness. It can help with every area of life.
I studied psychology and human resource management. That was the first time I came across the con cept that we had this thing called a nervous system and we could regulate it through breathing. We didn’t go into depth at uni, but I was intrigued and started investigating further. I realised that breathing was this amazing tool that we can use for our wellbeing.
I was on and off inhalers and nebu lisers depending on the season, but I eventually grew out of asthma when I was about 12. As a child, I never really put it together that breathing exercises or practices could help with my asthma. I had no idea about the correlation between the two. It wasn’t until university that I learnt about the connection between the breath and self-regulating the body.
Within Te Ao Māori, we have a lot of tikanga practices that use the breath. Like karanga for example, which triggers the vagus nerve and helps us to regulate our mental and emotional systems. We also do things like haka and chants which also trigger the vagus nerve.
hale just to help me get through moments. I also do breathing exercises with my son every morn ing and evening, which helps us remember to use the breath throughout the day. I also practise a technique called transforma tional breathwork, which I find really powerful and intuitive. Now if I find myself stuck with some thing, I have a breathwork session and that helps me to think more
(Ngāti Awa, Ngāti Maniapoto, Te AtihaunuiĀ-Pāpārangi) founder of Hā Habit
Please note: the “Ha tool” is not a medical device. If you have a respiratory condition, please consult a medical professional before trying new breathing practices or protocols.
Pictured: Ha Habit founder Julia Wikeepa
12 Better Breathing
You hear people say: “Just take a breath” or “Just breathe”. So, we do know that using the breath con sciously is good for us, but there can be resistance to that idea. It’s almost because it’s such a simple thing to do that people doubt it can really help.“
My JuliaStory:BreathingWikeepa
4. Using air conditioning
Pollen, dust and other allergens can accumulate on clothes and skin throughout the day. Having a hot shower at night will help remove these triggers before bed. A hot shower is also a good way to relieve a congested nose caused by allergies.
7. Reduce gardening activities
1. Stay indoors (when you can)
During spring and summer, unfiltered, outdoor air will bring in more pollen. Using an air conditioner can help re-circulate and filter this air, reducing the number of triggers in your home.
Mowing, weeding and hedge-trimming can stir up pollen, and other allergens like dust and spores. If you are sensitive to these triggers, then try and find someone else to do these jobs or wear a mask if you need to do them yourself.
Another asthma trigger to be aware of over spring and summer is smoke. Pollution particles from smoke are small enough to get into your lungs and quickly irritate your airways. Keep your distance from BBQs and outdoor fires over spring and summer.
5. Keep medication handy
6. Beware of problem plants
13 Better Breathing
3. Shower at night
Pollen will drift onto washing hung outside. To avoid bringing pollen particles into your home, dry clothes inside or in a drier. Be sure to wash your bedding and clothes in hot, soapy water to remove any pollen that has become attached.
8. BBQs and outdoor fires
Reduce your exposure to pollen by staying inside, with windows and doors shut when pollen is at its peak, particularly in the early morning and on windy days. Check out the Foundation’s online guide for when various types of pollens are in the air. If you are not sure which pollens trigger your allergies or asthma, it may be worth asking your healthcare practitioner for a skin prick test.
Forecasters are predicting a longer, and earlier pollen season thanks to a warm start to the year and recent heavy rains creating ideal growing conditions. For those of us with asthma and allergies, it’s more important than ever to take sensible precautions in the months ahead.
Make sure that whenever you are out and about, you have your medication with you to deal with any issues. Be sure to keep using your medication as directed and follow your Asthma Action Plan if you have an allergy related asthma flare up.
Some plants are more prolific pollen producers. Early in the season, pines are a major source of pollen (July to September), whereas over summer various grasses, privet hedges and plantains can cause serious issues. If any of these plants are triggers, consider removing them from your garden.
2. Dry your bedding and clothes indoors
G.J. Gardner Homes managing director Ellie Porteous says her team is thrilled to be supporting the Foundation and the Respiratory Achievers Awards. “Having personally seen the effect asthma has had on family members, Grant and myself, along with the GJ’s team are proud to support the Asthma and Respiratory Foundation and the important work that they do”.
The Foundation is thrilled to announce that our Respiratory Achievers Awards will be held again in February 2023 in Wellington.
Asthma 5 – 12 years old Asthma 12 – 18 years old Adult asthma
Chronic obstructive pulmonary disease Other respiratory conditions (including cystic fibrosis, bronchiolitis and bronchiectasis) Cody Forbes Award for courage Media awareness award – open to journalists writing on respiratory issues Respiratory educator award – open to nurses and other educators working with people with respiratory illnesses.
The awards ceremony will be held on Thursday 23 February 2023 in Wellington. Winners in each category will receive a return trip for two to Wellington to attend the awards ceremony, a trophy and one night’s accommodation.
The NZ Respiratory Achievers Awards are proudly supported by G.J. Gardner Homes.
Nominations can be made across eight categories:
Nomination forms can be accessed by scanning the QR code or on the Foundation’s website.
Nominations are now open and will close on Wednesday 28 October
14 Better Breathing
The awards were previously held every two years but have been on hiatus since the last event in 2018. The event has been reinstated thanks to the generosity of the Foundation’s newest sponsor G.J. Gardner Homes.
14 Better Breathing
“We are really excited to have them on board as our first ever Platinum sponsor in our Friends of the Foundation programme. Their support means that we can again run this fantastic event celebrating the achievements of truly inspirational New Zealanders living with respiratory conditions,” says Foundation Chief Executive Letitia.
The awards recognise people with respiratory conditions who have made achievements in one or more of the following fields; sporting, leadership, academic, cultural or community, while managing their condition and living a full and active life.
2022 Home HBuilders ome Builders 2022 Home HBuilders ome Builders 2022 Home HBuilders ome Builders 2022 Home HBuilders ome Builders 2022 Home HBuilders ome Builders 2022 Home HBuilders ome Builders
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? 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. About ARFNZ Find your local Society! Asthma & ManagementRespiratoryBOP reception@asthmabop.org.nzwww.asthmabop.org.nz254ChadwickRoadTAURANGA0800276267 Asthma NZ 581 Mt Eden anz@asthma.org.nz080009AUCKLANDRd6230236227328 Asthma NZ Level 2, 120 Featherston FAX:PH:WELLINGTONStreet042374520044772306 Asthma NZ 1290 Eruera Street, Rotorua FAX:PH:ROTORUACentral,073471012073471017 Asthma Waikato www.asthmawaikato.org.nz info@asthmawaikato.org.nz18ClaudelandsRoadHAMILTON07-8380851 Horowhenua Breathe Easy Support iandlmckenzie@xtra.co.nzLEVIN0279521439063688069 BreatheManawatūEasy sjorgi64@gmail.comPalmerstonNorth0272420669 Asthma Marlborough Inc asthma.marlborough@xtra.co.nz MarlboroughCommunityHealthHub22QueenStreetBLENHEIM03-579-16090272057244 Nelson Asthma Society asthma.nelson@xtra.co.nz9CambridgeStreetRICHMOND035441562 CanBreathe office@canbreathe.org.nzwww.canbreathe.org.nz196HillsRoad,EdgewareCHRISTCHURCH03-386-0278 Asthma Otago CnrDunedinotagoasthma@xtra.co.nz CommunityHouseMorayPlace&GtKingStreetDUNEDIN03-471-6167 Southland Asthma Society southlandasthma@xtra.co.nzFederatedFarmers70ForthStreetINVERCARGILL032142356 Eastern Bay of Plenty & COPD Support Group DisabilitiesCOPD@drct.co.nzResourceCentre141KingStreetWHAKATANE0800227363 Gisborne & East Coast Asthma Society lynlolohea@hotmail.com14KennedyStreetGISBORNE06-868-9970 Hawke’sBreatheBay admin@breathehb.co.nzwww.breathehb.co.nz199DickensStreetNAPIER06-835-0018 Tu Kotahi Māori Asthma Trust anne@kokiri-hauora.org.nz7-9BarnesStreetSeaviewLOWERHUTT0800939462
